ON STAYING UNDEAD :: A VAMPIRE’S GUIDE TO RISK MANAGEMENT WHILE PARTYING

By Stephen Meeneghan; Gif curation by booopie

You party? Well despite what D.A.R.E. might have you believe, your wild ways don’t have to mean renouncing your health. Yes, even if you do drugs, and even if you’re on a weekend bender — there’s always something you can do to be nice to your body. As your friendly queer naturopathic doctor, I know it can be tough to get advice on harm reduction for party kids, especially if one’s only recourse is either a patronizing, white-coated doctor or the world wide web. That’s why I decided to write this guide for 4U Mag. Whether it’s a high holiday or just another evening of your eternal youth, keep this health advice (accompanied by Booopie’s essential Black vampire gifs) in mind as you step out into the night. Because “undead” is a cute look for the club, but not so much for the morning after.

First some party basics.

HYDRATION

The solution to pollution is dilution. Adequate hydration is one of the most important tips in avoiding hangover symptoms like headaches and body aches.  You don’t have to say it out loud, but how much do you weigh in lbs? Okay, take that number and divide it in half — that’s how many ounces of water (or blood) the average vamp needs to drink on an average day. It sounds like a lot, right? And if you’re in party mode, sweating, boozing, and grinding your teeth, guess what? You need even more. So bring a bottle in your purse and order a water with your next cocktail. Juice, coconut water, kombucha and most other hippie beverages count towards your goal, but caffeinated bevvies and alcohol count against you.

BLOOD SUGAR

Most of our favorite vices mess with your blood sugar in some way. Booze decreases your blood sugar with each sip, which is why you might get hungry at the end of a night of drinking. Amphetamines and cocaine will suppress your appetite, so you have no idea if you need to eat. Why does this matter? Because if you end up with low blood sugar there’s an energy and mood crash in your near future. Whether you want to keep partying, have some boss lady business to attend to the next day, or just don’t want to feel like shit come sunrise, do your due diligence and eat something before you go out. Skipping dinner to be a cheap drunk or feel confident in that crop top might seem like a good idea, but if you’re running the party marathon no food will turn out to be your Achilles heel. Eat well and eat often.

SLEEP

Even the undead need to sleep. It’s when our bodies detox and repair the damage we’ve done, restoring our immortal youth. It’s also when our brains consolidate our memories. So while the amount of intoxicants is a primary determinant of whether or not you black out, lack of sleep can also erase your memories from the night before. Perhaps most important to artists, good sleep has been shown to increase our creative capacity threefold. So do what you can to sleep in on these long weekends. And when that’s not enough, sneak in a disco nap–even twenty minutes can have a profoundly restorative effect. In the words of Arianna Huffington, the secret to success is to literally “sleep your way to the top.”

If you find yourself ready for bed but too amped from the likes of cocaine or amphetamines, having safe sleep aids on hand can be important. That being said, sleep aids should be avoided or used with extreme caution if you have been using downers like alcohol, ketamine, barbiturates and benzodiazepines. The wrong combination can be fatal. Melatonin and antihistamines are among the safer sleep aids, but make sure you use those links before you buy to check for any potentially harmful interactions they could have to something you’re already taking. Medicinal marijuana, particularly indica strains, is also a generally safe sleep aid. If you’ve gone 48 hours without sleeping, connect with a health care professional for recommendations on getting your ass to bed.

Now for a review of the most popular party vices and the harm reduction techniques that will keep you undead. Disclaimer: As a doctor I believe that optimal harm reduction happens when people are trusted and empowered to make their own informed decisions. None of the statements below should be misconstrued as medical advice specific to your situation. Please consult with a medical professional with any questions or concerns about the information provided. None of the harm reduction advice provided is sufficient to prevent the serious outcomes of substance abuse and addiction. If you need help with drug or alcohol addiction, please check out those links or contact your doctor.

Your drug of choice: BOOZE

The euphoric, relaxed, good times feelings you get from alcohol are mediated primarily by GABA receptors, causing a “depressive” effect throughout the nervous system. You’re effectively telling your brain “sssh.”

NEGATIVE EFFECTS: Drinking depletes a lot of nutrients, which is why a hangover from alcohol is usually considered worse than that of all the vices listed here. As you already know, booze is a diuretic, making you dehydrated with every sip and trip to the bathroom. In addition to losing water, you also lose B-vitamins (B1, B3, B6, B12) and minerals like magnesium, phosphate and calcium. Your liver, pancreas and brain all become inflamed (doctor-speak for “pissed off”.) The liver gets the most offended, which you can read about here and here. In a very un-feminist turn of statistics, women are more likely than men to experience swelling of their livers and shrinking of their brains.

HARM REDUCTION: Eat, drink and be merry. Adequate water and blood sugar will reduce alcohol’s negative effects.

Pace yourself. Your liver can detox alcohol at an average rate of one drink per hour. This is helpful to keep in mind if you want to make calculations about when to have another round … or when to sit one out.

Replenish. Get back the most essential vitamins and minerals you lost by taking B-complex and magnesium. I recommend taking the active forms of B12 and B6, methycobalamine and pyridoxal-5’-phosphate. Electrolyte drinks, from Pedialite to coconut water, are helpful in rehydration — but old-fashioned water does a great job too.

Don’t barf. Actually, if you need to vomit, you should probably listen to your body and get it over with. But if you’re prone to nausea and vomiting, there are a number of drugs and herbs that can bring you relief. On the natural tip, Curing Pills is a great Chinese formula. Taking one dose of these at the end of your night of drinking and two doses when you wake in the morning is very helpful for those with sensitive stomachs. Simple ginger juice can also be a godsend. If you live in Mexico you can get Zofran (ondansetron) over the counter. It’s the most effective drug for nausea, though it can make you feel a little loopy. If you’re in the States, your drugstore options are limited to these.

Headache. If your head is pounding the morning after, this could be attributed to dehydration or the neurotoxic effects of the alcohol. Try drinking water first. If that doesn’t do the trick and you want to reach for a painkiller, avoid acetaminophen (Tylenol) as it is the most liver-toxic painkiller–and your liver has had enough punishment.

Love your Liver. If you’re concerned about liver damage, in addition to the above strategies, studies have shown that taurine, an amino acid found in animal proteins and your favorite energy drinks, can prevent and reverse fat accumulation in your liver [avoid using if you have manic-depressive disorder]. Milk thistle is widely known for its ability to prevent liver damage.

Antioxidants. These are essential to detoxification in the liver and throughout the body: Vitamin C, beta-karotene, alpha lipoic acid, bioflavonoids, coenzyme Q10, Vitamin E, turmeric, and so on. Fresh vegetable and fruit juice are great natural choices for getting your antioxidants too. Dosing before and after drinking is ideal.

Your drug of choice: MDMA

3,4-Methylenedioxymethamphetamine is a euphoric empathogen and stimulant. It gives you that elated and psychedelic feeling through its effects on the serotonin receptors in your brain. Serotonin is the same neurotransmitter than antidepressants like Prozac target. Other neurotransmitters like dopamine and adrenalin are also at play, producing MDMA’s stimulant effect. MDMA’s onset is usually between 15 and 60 minutes. The duration of the effects are typically 3 to 8 hours, depending on dose, body weight, liver function and so on.

NEGATIVE EFFECTS: Neurotoxicity. The major concern with MDMA is that it can damage your brain. MDMA produces free radicals in the brain, causing inflammation, making the brain swell. It also uses up your serotonin, dopamine and adrenanline stores, which can result in depression, anxiety, lowered cognition and even psychosis in some users. Some anti-depressants, like MAOI’s, may increase neurotoxicity and the risk for Serotonin Syndrome, while other antidepressents, like SSRI’s, may weaken MDMA’s effects.

The other major concern with this drug is that it’s notoriously impure, containing a wide variety of adulterant chemicals used to water-down or imitate MDMA. Some people think “Molly” means pure MDMA. They are sadly mistaken. This is why testing your supposed MDMA is never a bad idea. The serious and sometimes deadly side-effects of MDMA are often attributed to adulterants.

If you or someone else on MDMA experience fever, chills, headache, rapid heart rate, heavy sweating or other signs of MDMA overdose, call in the emergency medicine troops.

HARM REDUCTION: Antioxidants. You can limit the neurotoxic effects of MDMA by taking antioxidants: Vitamin C, beta-karotene, alpha lipoic acid, bioflavonoids, Coenzyme Q10, Vitamin E, turmeric, and so on. You’d be choking down a fistful of pills if you tried to take all of them, so finding a combination supplement with a wide variety of antioxidants is the best way to go. Fresh vegetable and fruit juice is a great natural choice for getting your antioxidants too. Dosing before and after MDMA use is ideal.

Amino Acids. Taking the amino acid precursors to serotonin and dopamine the day after MDMA use can be helpful in replacing what you’ve used up, avoiding the low mood that sometimes follows. Serotonin’s precursor is 5-hydroxytryptophan (5HTP). Typical dose is 100-300 mg 5HTP per day, for one to 14 days following MDMA use. Dopamine’s precursor is tyrosine. Typical dose is 1000-3000 mg tyrosine per day, for one to 14 days following MDMA use. These are often recommended to be taken in a ratio of one to 10, 5HTP to tyrosine. Some people need this amino acid support for up to two weeks following MDMA, while others find a single dose to be sufficient. Just listen to your body.

Antidepressants. Some MDMA users report benefit of certain classes of antidepressants like SSRI’s following MDMA use. Dosing for amino acids and SSRI’s is recommended only after coming down from MDMA. Taken before or during, these may lessen the desirable effects of MDMA.

B-vitamins. There are several B-vitamin cofactors necessary for the conversion of these amino acids into their corresponding neurotransmitters. Supplementing with a high quality B-complex with active forms of B12 (methycobaline) and B6 (pyridoxal-5’-phosphate) is recommended for this reason. These B’s will also help you detox and restore energy.

Magnesium. Most of us are deficient in this mineral. In the context of MDMA use, magnesium reduces your risk of neurotoxicity and relaxes muscles to help with the jaw clenching that some people get. I recommend magnesium glycinate because it’s least likely to cause loose stools. Dose 600 mg before, during and after MDMA use.

Sleep. As a stimulant, MDMA is prone to keeping you awake well into the next morning. Melatonin is an ideal sleep aid because it is made from serotonin, which is depleted by MDMA. And, bonus, it’s also an antioxidant. You can use a single dose of 5 to 10 mg of melatonin after MDMA use. Note that you should not exceed 3 mg per night on a regular basis or you risk dependency. A single high dose poses no risk, however.

Your drug of choice: COCAINE

This euphoric stimulant acts on the sympathetic nervous system, responsible for our “fight or flight” response, by stimulating dopamine, adrenaline and serotonin in the brain. This makes the user feel mentally sharper, elevates mood, and increases energy. Many users also report an aphrodisiac effect, which may be due in part to cocaine’s relaxing effects on sphincters, including the anal sphincter. The onset via nasal route is usually 1 to 3 minutes. The duration of the high averages 20 to 40 minutes.

NEGATIVE EFFECTS: Negative effects can include increased body temperature, heart rate, agitation and anxiety, paranoia, dizziness, nausea, vomiting, violent behavior, kidney failure, seizure, stroke, immune suppression, insomnia and heart attack. Those with heart conditions, high blood pressure and thyroid conditions are more likely to experience these effects. Do not combine cocaine with 2C-T-X, aMT, Tramadol, Meperidine, MAOI’s, or opiates.

Adulteration. Cocaine is also a very impure drug subject to heavy adulteration with chemicals like levamisole, amphetamines (speed), numbing agents, and a host of other toxic contaminants. The more direct the route of administration to blood stream, the more dangerous this contamination is. Injecting can be deadly.

The Nose Knows. Short-term nasal use causes irritation and often micro-bleeding in the nasal mucosa, usually resulting in a congested or runny nose. Long-term insufflation use can lead to a hole in the nasal septum, the piece of cartilage that separates the two halves of the nose.

Hepatitis C. Because nasal use causes micro-bleeds, the straw used to snort lines is often contaminated with blood. This is one way that the hepatitis C virus can be passed between cocaine users. Take Stevie Nick’s advice and always use your own “tooter.”

Addiction. One of the most problematic properties of cocaine is how addictive it is. The high does not last long and the subsequent doses of cocaine usually fall short of the initial high, promoting increasingly frequent and larger doses.

Neurotoxicity. Pumping out more dopamine than normal can have a toxic effect on the brain. In addition to inflammation and swelling in the brain, this can also deplete dopamine stores, leading to lowered mood, lower motivation, irritability, insomnia and fatigue the next day.

Cardiotoxicity. Cocaine can do a number on the heart. It can make it enlarge, beat too fast or off-beat, harden arteries and the worst cases cause a heart attack. If you have any chest pain during or after cocaine use, get yourself to the doctor.

Immune Toxicity. While cocaine itself is no friend of the immune system, cocaine adulterant levamisole, found in almost 70% of cocaine in the US, has been shown to suppress the immune system by lowering your white blood cell count.

Erectile Dysfunction. You may be surprised, and surely disappointed, to find that after turning up you may not be able to get it up. Luckily this side effect is temporary, lasting minutes to hours. Inability to climax has also been reported.

HARM REDUCTION: Amino Acids. Cocaine primarily acts on dopamine, whose precursor is the amino acid tyrosine. Tyrosine also one of the precursors to adrenaline and thyroid hormone. Doses range from 500 to 3000 mg per day, but typically 1000 mg per day. Dose the day after, not before. 5HTP can also be used if low mood is a primary concern. See the MDMA section for dosage.

Antioxidants. Once again, you can limit neurotoxic effects by taking antioxidants: Vitamin C, Beta-karotene, alpha lipoic acid, bioflavonoids, Coenzyme Q10, Vitamin E, turmeric, and so on. Juicing is a great natural choice for getting your antioxidants too. Dosing before and after use is ideal.

B-Vitamins. Vitamin B6 is essential for the production of dopamine. Get a high quality B-complex containing the active form of B6 (pyridoxal-5’-phosphate), which will also help with detoxification and energy.

Eat, Drink and be Merry. Remember that dilution is the solution to pollution — drink plenty of water. You won’t be hungry after that first bump so be sure to eat beforehand. This will help reduce any hangover symptoms resulting from low blood sugar.

Saline Rinse. If nose candy gives you a stuffy or runny nose, try using a neti pot or a nasal saline spray after use and again the following morning. Vitamin E oil can also be used inside the nose to help soothe and repair damaged tissue.

Sleep. See the Sleep section above for safe sleep aids if cocaine is causing insomnia.

Immune Boost. There are a million ways to improve immune function. In addition to a healthy diet, exercise, sleep and vitamin D, you might consider herbs like astragalus and ginger and mushrooms like shitake and reishi.

Your drug of choice: KETAMINE

This popular painkiller is used to achieve varying states of consciousness depending on dosage and highly variable personal susceptibility. It’s affects are mediated primarily by blocking NMDA receptors in the brain. Light doses may give you a drunk-like state, while heavier doses may allow you to achieve the ego-less state of disassociation known as a “k-hole.” In addition to use as an anesthetic in human and veterinary medicine, it is also used to treat major depression. If you snort ketamine, its onset is usually 7 to 20 minutes. The high usually lasts for 1 to 2 hours. Some psychological effects, though subtle, may persist for up to a day after use.

NEGATIVE EFFECTS: High doses and/or chronic use of ketamine can cause amnesia, vomiting, double vision, psychosis, and even kidney failure. The safety margin of this drug is relatively wide, but achieving the desired effect can be difficult, leading to an increase in the risk of overdose.

Neurotoxicity. Heavy and frequent users run the risk of cognitive impairment, including memory deficits. Current evidence shows that infrequent users do not show signs of neurotoxicity.

The Nose Knows. Just like with cocaine, short-term nasal use of ketamine causes irritation and often micro-bleeding in the nasal mucosa, usually resulting in a congested or runny nose. Snorting ketamine over a long period of time can lead to a hole in the nasal septum, the piece of cartilage that separates the two halves of the nose.

Abscesses. If you plant to inject ketamine into your muscle, you must be absolutely sure that it is sterile. If it’s contaminated, you run the risk of getting an infection and forming an abscess. Worse case scenario, the infection gets into your blood stream, which can be fatal.

HARM REDUCTION: Antioxidants. Once again, you can limit neurotoxic effects by taking antioxidants: Vitamin C, beta-karotene, alpha lipoic acid, bioflavonoids, Coenzyme Q10, Vitamin E, turmeric, and so on. Juicing is a great natural choice for getting your antioxidants too. Dosing before and after use is ideal.

Counteracting Neurotoxicity and Overdose. Would you believe that alcohol and drugs like barbituates and benzodiazepines can prevent ketamine from damaging your brain and stop an overdose? Strange but true. Natural options also exist, including GABA, which is also found in green tea.

Nasal Rinse. If nose candy gives you a stuffy or runny nose, try using a neti pot or a nasal saline spray after use and again the following morning. Vitamin E oil can also be used inside the nose to help soothe and repair damaged tissue.

Safe Place. If you’re looking for the full dissociative anesthesia that is the k-hole, it’s essential that you also look for a safe, comfortable place to enjoy it.

Don’t Vom. Many dissociatives cause vomiting at high doses, which can be dangerous if you are unable to move your body. If you avoiding eating for 3 hours before you use ketamine, it can be helpful in preventing vomiting.

Be Kind to Your Kidneys. If you enjoy regular ketamine use, get your kidney function checked by your doctor. Herbal formulas like this one are helpful in protecting kidney function.

ABOUT THE AUTHOR Dr. Stephen Meeneghan is a naturopathic doctor and acupuncturist. In addition to serving San Francisco’s vampire community, Dr. Stephen uses integrative natural medicine to treat digestive complaints, male fertility, male HPV infection, healthy aging and longevity, and LGBT health. Join him for B12 Happy Hour every Saturday morning in the Castro or find him during SF Pride at House of Babes where he’ll be slinging all of the natural hangover cures you just read about.

 

 

ABOUT THE ILLUSTRATOR Jackie Clay aka boopie is a San Francisco based writer.  Originally from Alabama, Clay graduated from California College of the Arts with dual-interdisciplinary degrees. Her intellectual work centers on the body and concepts of blackness, but she also writes about white Italian contemporary artist Vanessa Beecroft and American artist Larry Rivers.

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