If you’re living with HIV and hep C and still using drugs and alcohol, typically the best advice for you is to get clean. Alcohol can wreak havoc on an already taxed liver, and drug dependence brings its own baggage, including that some docs are reluctant to prescribe hep C treatment for active users. If you’re not ready to abstain, make sure you know some harm-reduction basics.

Shooting Safe
To avoid other infections and protect shooting pals, don’t share—that goes for syringes, cookers, cottons and water. Use new needles. If you can’t stick to your own rig, use bleach to soak your cooker and flush your syringes.

Know Your Limits
Drug and alcohol overdoses can be life-threatening. Know your tolerance and be extra careful if you start using again after being on the wagon—overdose is more likely if you haven’t used drugs or alcohol in a while. Also be cautious of mixing. Combining heroin or alcohol with other illicit drugs can spell trouble. If you’re injecting drugs and have access to a syringe exchange program, ask for an OD kit. It may contain a drug called Narcan (naloxone) that can slow the symptoms of an OD until medical help is found. 

Ask for Help
Ready to quit? Your doc or other care providers can help find a program that works for you—residential, hospital, in-patient or out-patient. Meds can ease withdrawal symptoms and prevent relapses. Also consider 12-step programs at Alcoholics Anonymous (aa.org) or Narcotics Anonymous (na.org).