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:

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.

 

Tobacco:

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.

Cannabis:

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.

 

Better living through chemistry?

Is it possible a better living through chemistry?

I took about 300 milligrams of oxycodone a day for about 5 years (by the way, it was the best 5 years of my life, work, family etc.), but then of course the big crack down began (pill mills etc) making it extremely difficult to obtain easily, so I had to stop as I did not feel like driving around to 300 pharmacies a day trying to fill my legally obtained prescription.

Anyway I stopped it  3 years ago. Anyway, since then I feel as if it is my first day off of them. I have absolutely no energy, tired constantly, no interest in anything, my gut is all screwed up, its total crap. Now not to long before SR got shut down. But I finally had access to the things that made me feel normal again (coke, adderall, oxy’s etc.).

I really believe that I am of the sorts that just do better with proper dosing of drugs, I spent my whole life with the mantra «better living through modern chemistry». But, in today’s age it is getting more and more difficult to self medicate properly and I am paying the price dearly for it (Job, family etc).

Do you think that my brain balance will ever return to normal without drugs? Would any sort of doctor see it my way . Is it impossible or ridiculous to say that I can function better with these drugs? I think my lifetime would show that it is and today’s governmental interference is wrecking my life.

Originally posted in SR 2.0 19/10/2013. Reviewed 20/2/22

Tolerance is one of the most important characteristics of many psychoactives. It is necessary to increase doses to feel the same effect. Thus, some people take doses that would be lethal for non-tolerant people.

It is possible that some work better with drugs, but the adverse effects and long-term effects (including the risk of dependence) must also be taken into account.

I’m not sure that needing high doses of stimulants or opioids to perform daily activities is a «better life,» although I’m not judging your life or your choices.

Drugs (and here I am referring to both drugs prescribed by a doctor and controlled psychoactives) can be used for pleasure . They can also help at some difficult times in life. But, in general, medications, pharmaceuticals or drugs are never the solution for people’s lives.

Most of the «chronic brain imbalance» messages associated with illegal drugs belong more to anti-drug mythology than to scientific evidence. Most controlled drugs and prescription drugs do not produce chronic brain changes that result in chronic brain damage (with the exception of some antipsychotics and methamphetamine).

Pharmacological tolerance decreases over time, but psychological and life factors are also important. You will never get back to who you were before simply because of the passage of time.

I’m sorry but your question and situation is one of these that is difficult to assess over the internet alone. It would be a personal and long term contact to be able to help you.

 

Methamphetamine and extreme headache

I wanted some advice. I’m a regular injecting opiate user but tonight I had 70 mg of of ice IV for only the second time ever, just to try something different. I’d had my usual evening smack shots, probably around a point before I had the meth. Within a couple of minutes I had the most intense pain in my head, like a vice was on my head. It was an absolutely excruciating, unbearable pain. Then it started to wear off after half an hour until I power vomited. Now I’m well enough to write but still feel nauseous and have a painful headache.Does anybody have any ideas about what went wrong?  In another thread a respondent said that it was probably a blood clot and that i just dodged a stroke. They said to count myself extremely lucky and that i should start taking aspirin every day. They also said they were not a medical expert. I thought it time I get another opinion.

Originally posted in SR 2.0 3/6/22 . Reviewed 3/2/22

In medicine, one of the warning signs of a headache is that the patient says «it’s the worst headache I’ve ever had in my life». In this situation, it is mandatory to rule out a heart attack or cerebral haemorrhage. In your case, the history of intravenous use of methamphetamine (which is a stimulant and can increase blood pressure sharply), is one more reason to think that there may be an urgent pathology.. But a extreme headache followed by nausea and vomiting after iv stimulants can be a symptom of subarachnoid hemorrhage. You should seek immediate medical help to rule out this possibility. And taking aspirin would only aggravate this problem, if it exists.