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Snow Blow & HIV

Campaign resources

The ASK campaign is a harm reduction and HIV prevention campaign developed by Ana Liffey Drug Project & HIV Ireland. The campaign aims to help address increasing HIV diagnoses among injecting snow blow users in Ireland.

Download A4 Poster

Download A4 Factsheet

View A6 Booklet - print version is available from HIV Ireland & Ana Liffey Drug Project.


HIV diagnoses are increasing among people who inject the drug snow blow. People might not always disclose that they are using snow blow. 

For those working with people who currently use snow blow. Remember to:


What is Snow Blow?

Snow blow is a type of drug called a cathinone. It is similar to cocaine in that it is a short-acting stimulant drug. A number of different cathinones have been sold in Ireland as snow blow. In powder form, cathinones are generally a fine white, off white, yellowish or brown powder. Cathinones can also come in crystal form. Cathinones can be snorted, injected, inhaled or taken orally.

Cathinone substances became well known in 2007 when they were available legally in head shops in Ireland and they continue to be used among certain drug-using groups in Ireland. The Criminal Justice (Psychoactive Substances) Act 2010 effectively closed down the head shops by making it an offence to sell or supply for human consumption, substances which have psychoactive effects that are outside the remit of the Misuse of Drugs Act 1977. However, many of these substances are now available through other channels and are still being used.

Between 2005 and 2014 more than 81 synthetic cathinone derivatives were reported to the European Union (EU) Early Warning System. A number of cathinone derivatives have been sold in Ireland as snow blow, including: a-PVP, MDPV, butylone, pentedron and MDPBP.


Snow Blow Effects

Because snow blow is the name given to a number of different cathinone derivatives in Ireland, people may experience different effects depending on what cathinone they have taken.

Short-term effects of cathinones may include:

Mental health

Snow blow use is associated with difficult come downs and has also been associated with a recent increase in individuals presenting to emergency departments with acute psychotic episodes. Of particular note is the suicide association with cathinones. A UK study found a proportionaly high-prevalence of cathinone drugs in hangings or other mechanical suicides (not suicide by drug overdose) compared to other new psychoactive substances.

Injecting Episodes

People who inject snow blow are likely to inject more often, therefore increasing the risk of sharing injecting euipment. Using snow blow may also enhance your sex drive, increasing the risk of unprotected sex.

Snow blow is a short-acting stimulant type drug similar to cocaine or amphetamines - meaning people tend to re-dose frequently - with some reporting injecting between 10-20 times a day. This can result in users running out of clean injecting equipment and reusing or sharing equipment. Snow blow users should be encouraged to ask for enough needles, cookers, filters, water, injecting information and condoms at their needle exchange.



It is possible to overdose on stimulant drugs. Signs of an overdose are overheating, blue lips or limbs, fast breathing or difficulty breathing, rapid heartbeat, seizures, shaking, paranoia, psychosis and loss of consciousness. If you encounter someone who has overdosed on snow blow, place them in the recovery position and call 112.

Snow Blow and HIV

In February 2015, an outbreak of recently acquired HIV infections among people who inject drugs (PWID) was identified in Dublin. A multidisciplinary incident team was set up by the Director of
Public Health in Dublin to investigate and respond to the increase. Clinicians were concerned that the increase was linked to injection of the synthetic cathinone a-PVP, street name snow blow, with more frequent injecting and unsafe sexual and needle sharing practices. The increases were mainly seen in chaotic polydrug users, many of whom were homeless.

An epidemiological investigation and case-control study was undertaken by the HSE which reported the following summary results:

The investigation is the first evidence of an association between injecting snow blow and recent HIV infection in Ireland, with daily snow blow injectors being at highest risk. Snow blow has been found to contain a-PVP, a second generation cathinone and is closely related to MDPV.

A report was published on the epidemiological investigation and case-control study and can be viewed/downloaded at:

In Dublin, there are more than 500 homeless PWID, a significant population at risk of HIV infection.  For those working with PWID who may be at risk, there are a number of measures that can be taken:


Safer Injecting

Snow blow users tend to inject more often, therefore they require more injecting equipment. It is helpful to ask how many times a day they expect to inject - and to then calculate how much equipment they will need.

Harm reduction advice for safer injecting:

Safer Snorting

Snorting snow blow is generally less harmful than injecting.

Harm reduction advice for safer snorting:

Safer Sex

Condoms, when used consistently and correctly, are the best way to prevent the sexual transmission of HIV and other sexually transmitted infections (STIs).

Using snow blow can increase a person’s sex drive, therefore increasing the risk of unprotected sex.  Encourage service users to be prepared and carry condoms with them.

Condoms are available for free in all needle exchanges. Encourage service users to ask for free condoms at their needle exchange.

Some HIV organisations also provide free condoms such as HIV Ireland in Dublin. A list of these organisations is available at:

Safer Sex Advice for people who use snow blow:

For more information on condoms and how to use condoms correctly visit:

HIV Testing

People can have HIV and not have any symptoms. The only way to know if a person has contracted HIV is to get tested.

By getting tested and knowing your HIV status you can:

HIV testing is confidential. Pre and post-test counselling may be available at some testing clinics.

HIV testing is available free in Ireland at public testing clinics. The HIV test is a blood test.

A locator map of testing clinics around Ireland is available at:

For more information on HIV transmission, prevention, testing and treatment visit:

PEP (post exposure prophylaxis)

PEP is a course of medication that aims to prevent HIV infection following a recent sexual or needle-stick exposure to HIV.  PEP works to prevent HIV from establishing itself in the bloodstream.

PEP must be taken within 72 hours (3 days) after the possible exposure to HIV, and sooner if possible.

PEP is effective but is not a cure for HIV.

PEP is only available by prescription from some hospital emergency departments and HIV/STI clinics.  Not everyone will be prescribed PEP – this is based on an assessment at the clinic or hospital.

Anyone who discloses a potential recent exposure to HIV, through unprotected sex or from a needle, should be referred to a hospital emergency department or HIV/STI clinic to get assessed for PEP.  Ensure that the potential exposure was within the 72 hour time period before referring as PEP will not be prescribed once this time has elapsed.

A list of locations where PEP is available can be viewed at

More Information and Services

HIV Ireland
Free HIV and STI testing on the second and fourth Wednesdays of every month. Free condoms – walk-in service. Free community support services for people living with HIV. List of other free HIV testing clinics and services. List of other organisations where free condoms are available. List of clinics and hospitals that provide PEP. A range of downloadable resources on HIV and sexual health. Services Directory
List of Needle Exchanges. List of Drug and Alcohol Services. A range of downloadable resources. Online Chat Service.

Ana Liffey Drug Project
Open Access Service. Needle and Syringe Outreach Programme. Medical Services. Case Management Service.

HSE Helpline
Freephone:1800 459 459
Drugs, Alcohol, HIV, Hepatitis and Sexual Health Helpline.

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