Diabetes and drugs: harm reduction

I hace Type 1 Diabetes. I am interested in diabetes and drugs: harm reduction strategies, tips…Also, I want to kow which drugs are more and less harmful.

Originally posted in SR 2.0 . Reviewed 20/2/22


In this post we will focus on Type 1 Diabetes Mellitus (DM1), the most common type of diabetes mellitus in youth and young adults. 2021, It is estimated that there were about 8 million individuals worldwide with type 1 diabetes: of these 1,5 million (18%) are less than 20 years, 5,4 million (64%) are 20–59 years, and 1·6 million (19%) are 60 years or older.

DM1, also known as juvenile diabetes, is a chronic autoimmune disease. This occurs when the body’s immune system mistakenly attacks and destroys the insulin-producing cells of the pancreas. This causes a lack of insulin production and can lead to high blood glucose (sugar) levels.

  • Some common symptoms of DM1 s include:
  • Increased thirst and frequent urination
    Increased hunger
    Fatigue and weakness
    Blurred vision
    Unintentional weight loss
    Irritability or mood swings
    Slow healing sores or frequent infections

Treatment for DM1 usually involves insulin injections or an insulin pump. It is important for people with DM1 to  monitor blood glucose levels and adjust insulin dose.

In addition, people with DM1 should follow a healthy eating plan, engage in regular physical activity. Also, monitor blood pressure and cholesterol levels. So, they can reduce the risk of cardiovascular, neurological or kidney complications .

1-Diabetes Mellitus and drugs


DM1 affects mostly young people. This segment of the population has the highest frequencies of recreational drug use.

Young people with DM1 have the same motivations and concerns as those without the disease. It is clear that not using drugs is the best way to avoid problems. But it is also clear that a significant proportion of them will use them. Indeed, there are studies that indicate this:

There are specific risk reduction measures for people with diabetes who use drugs.

2.-General measures:


In the first months after diagnosis, disease management is often particularly complicated. Some training is necessary to learn to manage the timing of blood sugar measurements.  To recognise hypoglycaemia or hyperglycaemia can be difficult. Also to measure insulin doses or calculate the meal before or after exercise. All this becomes simpler over time. Before considering the use of any drug, it is important to know how to manage diabetes.

Monitor blood glucose levels frequently: It is important for individuals with DM1  to monitor blood glucose levels frequently. This should be don both during drug use and in the hours following use. This can help them identify and treat hypoglycemia or hyperglycemia  as quickly as possible

Carry fast-acting sources of glucose: Individuals with DM1 who use recreational drugs should carry fast-acting sources of glucose with them always. For example,  glucose tablets, candy, or juice. These can be used to quickly treat hypoglycemia.

Stay hydrated: Some recreational drugs can cause dehydration, which can exacerbate the symptoms of hyperglycemia. DM1 drug users should drink plenty of water and avoid alcohol, that causes dehydration.

Never take drugs alone. Make sure that someone with you knows your situation. A friend who knows how to measure your blood sugar. And also to inject the right amount of insulin or fast-acting sources of glucose.

3.- Specific substances:



Alcohol consumption can have an impact on blood glucose levels, which can be particularly concerning for individuals with Type 1 diabetes who rely on insulin therapy to manage their blood glucose levels. However, in moderation, alcohol can be safely consumed by many individuals with diabetes.

When it comes to choosing which alcoholic beverages to consume, it’s important to consider the carbohydrate and sugar content of the drink. Drinks that are high in carbohydrates and sugar can cause a rapid increase in blood glucose levels, which can be particularly problematic for individuals with diabetes.

Here are some examples of alcoholic beverages that are generally considered to be less harmful for individuals with Type 1 diabetes:

Light beer: Light beer contains fewer carbohydrates and calories than regular beer, which makes it a better choice for individuals with diabetes.

Red or white wine: Red or white wine can be a good option as they typically contain fewer carbohydrates than beer and some mixed drinks.

Spirits: Spirits such as vodka, gin, or whiskey are lower in carbohydrates than beer or wine, and can be mixed with sugar-free mixers such as diet soda or Coke Zero.

On the other hand, there are other drinks particularlly risky:

Regular beer: Regular beer typically contains a higher amount of carbohydrates than other alcoholic beverages, which can cause a rapid increase in blood glucose levels. may pack 35–44 grams of carbs per 7-ounce (225-mL) serving

Sweet wines: Sweet wines such as dessert wines, port wines, and some sparkling wines contain higher amounts of sugar and carbohydrates than other wines, which can cause a rapid increase in blood glucose levels.

Mixed drinks: Mixed drinks, such as margaritas, daiquiris, and other cocktails, may pack 35–44 grams of carbs per 7-ounce (225-mL) serving. The same goes for cream liqueurs such as Bailey’s and Kahlua. These provide around 13 grams of carbs, of which 12 grams are from sugar, for every 2 ounces (60 grams) of beverage.



Probably, tobacco is the most harmful drug for a diabetic.Smoking tobacco is a major risk factor for cardiovascular disease, and individuals with diabetes are already at an increased risk of developing this condition. Smoking can further increase the risk of cardiovascular disease in individuals with diabetes, potentially leading to heart attacks, stroke, and other complications.

Tobacco can enhance insulin resistance and reduce the effectiveness of diabetes medications.

Smoking can impair wound healing, which can be particularly problematic for individuals with diabetes who are already at an increased risk of developing foot ulcers and other wounds.

E-cigs probably pose less risk than smoked, conventional tobacco.


The consequences of cannabis use in diabetic patients are not very clear. Some studies suggest that the risks are similar to those of tobacco although they are probably biased by the fact that many of the participants also smoke tobacco.
On the other hand, it has been suggested that some cannabinoids may have a beneficial effect on blood glucose control, although there are also not enough good studies.

It is important to remember that cannabis increases appetite, which may have consequences in DM1.

The use of vaporisers instead of combustion (with or without tobacco) is also particularly advisable.


Stimulants (cocaine, amphetamine, methamphetamine):

There is no direct effect between stimulant use and blood sugar levels. But it is important to be aware of what you are doing while using them. Intense physical exercise (sex, dancing) can have an impact on carbohydrate expenditure and facilitate hypoglycaemia.It’s important to take regular breaks and rest to avoid exhaustion, which can affect blood glucose levels.

On the other hand, it is important to consider that stimulants can also reduce appetite. It’s important to have healthy snacks available, such as fruit, juices and low-carbohydrate foods, to maintain blood glucose levels.


Psychedelics and psychedelic-like (MDMA):

The previous considerations on stimulants (in terms of exercise and appetite) apply.

In addition, some psychedelics alter the perception of time. It may be important to set an alarm clock to remember to monitor glucose.

Psychedelics, MDMA and ketamine alter the perception of one’s own body. In the usual state of consciousness diabetics can recognise a rise or fall in blood sugar by their bodily sensations. These substances can alter these perceptions, making it difficult to recognise them.


Cannabis and schizophrenia link

Cannabis and schizophrenia link

According to some studies, there is a cannabis and schizophrenia link. When I served in the Army I saw two cases. Although I take LSD and DMT more than weed, what are the chances of cannabis use activating a predisposed schizophrenic psychosis? Is smoking weed altogether or is it safe enough?
Not sure if you’ll have time to reply or if this is your area of knowledge, but it would be useful to know

Originally posted in SR 2.0 30/10/2013. Reviewed 20/2/22

One important point in this subject is that the fact that two things are correlated or linked does not necessarily mean that one is the cause of the other.

I read a study some time ago which suggested that «people who read the composition of the food have less problems with obesity». Possibly, people who read food labels are more health-conscious and have better dietary habits. However, simply reading a label is not enough to keep one healthy or in good shape.

Here are more examples of events associated, but not necessarily caused one by the other. 

This idea is crucial when discussing about drugs and mental health. In the model used to explain schizophrenia, there is a susceptible or pre-morbid personality and various «stressing factors» that trigger the disease. Examples of such factors include divorce of parents, military service, or a sentimental break-up.

The use of psychedelics, understood as a stressor,  can also trigger schizophrenia. But only happens in susceptible, pre-morbid individuals. It is worth noting that the use of cannabis has increased worldwide in the past 20 years. Nevertheless, ºthe incidence of schizophrenia remains stable at around 1%.

In this sense, a family history of schizophrenia is an accepted risk factor for developing the disease. Your risk of developing schizophrenia may be higher than that of other individuals, but it does not necessarily mean that you will definitely develop the disease. So, many factors come into play, including age, personality, and previous responses to other drugs. For individuals with a family history of schizophrenia, the use of psychedelics is not recommended as a general rule. 

Cannabis and tachycardia

Is there a cause-effect relation between cannabis and tachycardia?

Marijuana is sort of famous for increasing heart rate. Some websites talk about it effecting an increase of 40 bpm, while others mention an increase of 50% over resting heart rate.

Personally, my heart rate goes from a resting rate of 70 bpm, to about 120 bpm (as if I’m jogging). But I have measured it to go as fast as 156 bpm, which is about 80% the maximum heart rate for my age group. This >120 bpm heart rate can persist for an hour, sometimes two.

Of course, if I were running a marathon, this would be considered normal. But all of this is when I am at rest and not exerting myself at all. Is such an elevated heart rate for such a long time dangerous to the body? Would this become risky as I age and the heart and blood vessels deteriorate, and maximum heart rate lowers to 130? 

Originally posted in SR 2.0 16/10/2013. Reviewed 20/2/22

Cannabis increases heart rate by a different mechanism than stimulants. The main effect is relaxation of veins and arteries. This effect lowers blood pressure. To compensate this and mantaining blood flow heart beats more quickly. Im general, cardiovascular toxicity related with cannabinoids is limited, compared to stimulants.

There are some cases reports of cardiovascular damage induced by cannabis, but are anecdotal and uncommon. But the main risk is fainting using cannabis too strong or too quickly. So if you feel dizzy, lie down to avoid hurting if you fall as a result of loss of consciousness.

The increase in frecuency you report is important and long-lasting. Possibly it does not mean a health problem.Or maybe you are particularly sensible to that effect. It is possible that it is just related to cannabis potency (you should try another variety or use less quantity).

But, also, it is theoretically possible that cannabis use could trigger an asymptomatic arrhythmia or pathological tachycardia.So, it should be interesting to have an electrocardiography test to rule out this possibility. 


Cannabis, pain and fibromyalgia

I have a question about cannabis, pain and fibromyalgia. Is therapeutic cannabis an option?

I am 54 years old and have been diagnosed with fibromyalgia . I am in pain most of the day and almost no treatment has been effective. I have read that cannabis could help me get better and would like to know your opinion. Thank you very much.

Originally posted in SR 2.0 . Reviewed 20/2/22

Fibromyalgia is a musculoskeletal disease that causes persistent pain, extreme fatigue, muscle stiffness. Also, there are also other symptoms such as psychological distress, sleep difficulties, headaches, and forgetfulness.

This condition is  controversial. Some physicians do not believe that this is a «disease» due to the lack of physical, laboratory, or imaging test alterations,. But others disagree and state that there are still no laboratory markers available

There are different hypotheses about  the triggers of fibromyalgia. The widely accepted theory considers that physical and mental stress, psychological and social factors, are the main causes. Other authors think that certain viruses or vaccines may be the cause.

In any case, most experts agree that the mechanisms of fibromyalgia involve a decreased pain threshold in the brain. And also an increased sensitivity of the body’s pain receptors.

The fact has led some researchers to hypothesize that  a deficiency of endogenous cannabinoids could cause fibromyalgia. These molecules contribute to the control and regulation of pain in vertebrates.

This hypothesis is still under investigation. But some studies have found elevated levels of anandamide, one of the cannabinoids naturally occurring in the body, in fibromyalgia patients.

Several studies have examined the efficacy of cannabinoid-based treatments for fibromyalgia. In 2006, a study showed improvement in a subgroup of patients treated with oral delta-9-THC in doses between 2.5 and 15 mg.

Another synthetic cannabinoid called Nabilone proved some benefits in at least two small clinical trials . However, some patients did not tolerate the medication well, and others did not experience any relief.

Recently, some studies suggest that vaporized marijuana or THC-rich cannabis oil may be an effective treatment for fibromyalgia. In any case, more research is needed to confirm these findings.

In fibromyalgia, no treatment is completely effective in a majority of patients. Some individuals improve with different types of drugs. Medications available include anti-inflammatory medications, analgesics, corticosteroids, antidepressants, and antiepileptics. Psychological and non-pharmacological therapies are useful, too.

Therefore,  cannabinoids may provide benefits for certain individuals. But there is need of more research determine their overall efficacy and safety for the treatment of fibromyalgia.

Cannabis urine detection

How long does THC stay in your system? Tips for passing a urine test

Hello. I have been a heavy cannabis user for the last 6-7 years, i am now been clean for 8 days, i train alot and have a healthy body, but now i have gotten a job and i need to pass a urine sample in 8 days, Is there anything i can use to get rid of this thc easier or do i have to wait ?, Wondering if i should take (Zydot Expellit) i was wondering what you mean about masking this urine sample.

Originally posted in SR 2.0 15/5/14 . Reviewed 20/2/22

Cannabis elimination has a constant rate. Drinking too much water, urine cleaners or doing exercise are useless to mask urine sample. Diluting it with water does not work (density of urine is also tested in exams). The only way to mask the urine is change with other person’s (if he or she does not use cannabis)