This information has been produced to help those people who use any substance to do so more safely (by ‘substance‘ we mean any drug, legal (like alcohol) or illegal (like E), prescribed or not). Any substance use carries risk; by establishing what risks you are engaging in (through self-assessment) and finding areas where risk can be reduced, you can minimise the likelihood of harm. The only way to ensure that you engage in no risk at all is of course not to use any substance. If you are not currently using any substance, these pages hold valuable information that you may be able to pass on to friends who do.
The idea that the main risk involved in substance use is a ‘long slippery slope.’ inevitably leading to addiction and death is mistaken and misleading. This fear can obscure many of the real risks involved when we use substances. Cannabis by itself does not kill people, but this does not mean that using it is a risk-free activity. Risks might be physical, psychological, short-term or long-term (or a combination of all of these). Risks may relate to the substance itself, or how, where and why it is being used. Risks are clearly increased when a variety of substances are being used together, or when a substance is used regularly over a prolonged period of time. Safer substance use starts with assessing the risks you are engaging in.
How much do you know about the substance (or substances) you are using? One of the most obvious risks is using a substance you know nothing about. Information about risks relating to specific substances is available from a variety of sources (more on this later). Even if you know the specific risks for the substance you are using, this information will not help you unless you act on it, or if the substance you have acquired is not what you think it is (a particular risk when taking illegally-sold pills, capsules and powders). How you get the substance into your body dramatically affects the risks you engage in. The method that carries the most risk of harm is injection. Injecting might be seen as a cost effective way of taking a substance, but this is a false economy. There are a whole range of issues that are presented to any person who uses a substance in this way. There are a range of viruses (including HIV and Hepatitis) that are carried in the body fluids of infected people (who may themselves appear perfectly healthy).
These viruses can be passed on if you share any injecting equipment (including water, filters, citric/lemon juice, spoons, needles and barrels). Infections can also come from dirty (i.e…. non-sterile) equipment, and unsafe injecting practices. Pills and powders that have been produced in illicit laboratories (like E, speed, heroin and cocaine) won’t be sterile, and will contain adulterants – other substances that add bulk to what you buy.
Sometimes the adulterants will be toxic, and this can lead to damage. Generally, the least risk will come from swallowing a substance – our bodies are able to recognise a range of toxins which can be filtered by the gut (or expelled). Sniffing (or snorting) powders can lead to immediate damage, especially if the powder is severely adulterated (for example with a cleaning agent like vim or harpic). Regularly smoking any substance is likely to lead to respiratory problems.
Once a powder has been cut (or adulterated) there is no indication of how concentrated it is. Recent confiscations of street ‘speed’ have contained as little as 4% of amphetamine sulphate in the powder. Occasionally a powder with an unusually high purity (maybe as high as 80%) will be sold, usually by an inexperienced dealer. This may sound like a bonus, but taking a substance that is so pure is likely to lead to an overdose – effectively you could be doubling or even tripling the quantity you would normally use. We take drugs to affect how we feel, our behavior and our perception of the world.
Some risks come from these changes – our behavior may become less inhibited; we may be more likely to engage in unsafe sex, react violently to situations or make decisions which we later regret. All substance use changes our perception to some extent. This can affect our ability to react quickly – for example when driving or cycling – or can make a ‘normal‘ activity more dangerous (like crossing roads, swimming, dancing and climbing stairs).
There is a big difference between taking a drug to change how you feel and taking a drug to enhance how you feel. If you use a substance to lift you out of a depression or relieve yourself from stress, the result will only ever be short term.
They can mask problems, or make them seem less important, but they don’t resolve them. The danger is that someone who uses a substance to deal with an unchanging situation has to continually use the substance. Most substances (especially hallucinogens) enhance and amplify our feelings – taking LSD when you’re in a bad mood is unlikely to result in a ‘good‘ experience. A good way to assess your own substance use is to ask yourself a few questions…
How much do you really know about the substance you are using? Do you use everyday? Do you mix with people who don’t use? Can you afford your substance use? Do you have good times without using drugs? Does your substance use adversely affect other aspects of your life (like employment, studies or relationships)? Any patterns or aspects of your use that concern you can be checked out with others (see ‘who can I talk to’ at the end of this page).
So, you’ve explored your substance use, become aware of the risks you are engaging in – now what? Reducing risks is not difficult. When you are planning to use a substance, think ahead and make the experience as safe as you can. Seek information about the substance; if you are buying it illegally then be aware that the substance has not been through any ‘quality control‘ – if you’ve decided to buy, then buy from someone you trust rather than a complete stranger. If you are injecting, use sterile equipment (available from needle exchanges).
Think (honestly) about how you feel – are you taking the substance to have a ‘good‘ time or to escape a ‘bad‘ time? Plan ahead – make sure that you are as unlikely as possible to encounter a stressful or dangerous environment. Will you feel safe? Will you feel comfortable (or threatened)? Will someone you know be there to look after you if you do get into difficulty? It’s far better to think all of this through before you take a substance rather than panicking whilst you’re using.
Other names :Methadone Mixture, linctus, meth, Physeptone.
Methadone Hydrochloride is an opioid (a synthetic opiate) that was originally synthesized by the German pharmaceutical company Axis during the second world war. It was first marketed as ‘Dolophine’ (to honour Adolph Hitler) and was used as an analgesic (a painkiller) for the treatment of severe pain. It is still occasionally used for pain relief, although it is more widely used now as a substitute drug for people addicted to other opiates (primarily heroin).
Methadone is usually available as a liquid – linctus or methadone mixture – which should be swallowed. Tablets and injectable ampoules are sometimes prescribed, and like many other medicines some of these prescribed drugs are diverted and become available illegally.
When methadone is prescribed to people addicted to other opiates (primarily heroin), the guidelines for the dosage are that enough should be given to prevent physical withdrawal symptoms – when you are prescribed methadone it is not supposed to give you a buzz, or get you high. If you take methadone orally (mixture or linctus), it will take around thirty minutes before you feel the effects. If you are using injectable methadone (Physeptone) then the drug takes effect much more rapidly.
As an opiate, regular use of methadone causes physical dependency – if you’ve been using it regularly (prescribed or not) once you stop you will experience a withdrawal. The physical changes due to the drug are similar to other opiates (like heroin); suppressed cough reflex, contracted pupils, drowsiness and constipation. Some methadone users feel sick when they first use the drug. If you are a woman using methadone you may not have regular periods – but you are still able to conceive. Methadone is a long-acting opioid; it has an effect for up to 36 hours (if you are using methadone you will not withdraw for this period) and can remain in your body for several days.
Methadone is a very powerful drug, and individual doses vary for each person. If you are using methadone that you have bought illegally be aware that you could overdose on an amount that would seem ‘normal‘ to somebody else – especially if you are not using opiates regularly, and therefore have a low tolerance (it doesn’t take very much to affect you). If you are using methadone regularly – prescribed or not – taking a higher dose than normal or using other depressant drugs (like alcohol, heroin, tranquilizers or sleeping tablets) on top could cause you to overdose. If you do lose consciousness and vomit you may well choke. If you become drowsy you should not try to drive or operate machinery – you could easily have an accident.
Methadone is very dangerous for children. You should store methadone where children are not able to get to it – in a high cupboard, not by your bed or in the fridge. If a child does swallow methadone they should be taken to the Accident and Emergency Department at your local hospital immediately – let the doctors know what has been taken, and if possible at what time and what quantity.
Other Names:‘Shrooms’, ‘mushies’, ‘liberty caps’, ‘fly-agaric’.
Magic mushrooms can be eaten raw or cooked, heated with water to make a tea or soup, or added to an omelette or another dish just like non-hallucinogenic mushrooms. Some species (like the Amanita Muscaria, or fly agaric) have to be cooked first to avoid poisoning.
It can take up to an hour for the mushrooms to take effect. If you have a small amount of the hallucinogenic substances contained in the fungus, you may feel relaxed and a little ‘stoned‘, a feeling similar to that obtained using cannabis. Higher doses can induce trips similar to LSD. How you feel and who you’re with will influence your experience dramatically. A mushroom trip can last for 6-12 hours, with some disorientation the following day.
Compared to the psychological effects these are minor – increased heart rate and blood pressure, and dilated pupils. Sometimes you may experience a mild stomach upset.
If you are going to pick mushrooms, preferably take someone with you who knows what the mushrooms look like, and where they grow – for example liberty caps grow in open, well manured grassland; if you find something that looks similar but is growing in a forest it’s the wrong mushroom. If you can’t take an experienced mushroom harvester, take a good mushroom guide such as Collins’ guide to mushrooms and toadstools.
Mushroom poisoning can be caused by picking the right species in the wrong condition – it is not safe to eat mushrooms that have been infested by worms or maggots. Older mushrooms should be avoided, as should wet or dirty ones (these tend to go off quickly). If you are going to store the mushrooms at all, remember that they deteriorate and rot quickly if they are damp, closely packed or left in an airtight container.
Mushrooms vary widely in the amount of psilocybin they contain – use a small number at first, and increase the dose if necessary. The symptoms of mushroom poisoning can manifest in 20 minutes, or may take up to 40 hours for more slow-acting poisons. Many different poisons can occur in mushrooms; the most common symptoms are vomiting, diarrhoea, cramp, watering eyes, increased saliva flow, jaundice and breathing difficulties. If you are with someone who is ill and has been eating mushrooms, take them to a hospital or doctor immediately – call for an ambulance if you’re stoned, don’t try to drive. If possible, take some of the mushrooms with you so that any poisons can be quickly identified.
Mushroom tripping isn’t something you should do alone, the psychological effects of tripping can lead some people into states of fear and anxiety attacks (‘bad trips‘). Being with friends can help you to move through these experiences more quickly and safely. Like any other hallucinogen, mushrooms should not be eaten if you’re feeling depressed, anxious or under stress. They won’t make your worries go away- generally, hallucinogens tend to amplify how you’re feeling at the time. Choose the right environment – somewhere relaxed and safe. Busy roads, rivers, festivals or crowded streets may cause you problems. You should never try to drive if you’ve eaten magic mushrooms. Mushroom trips can last for 8 hours or more.
Other names :Acid, Trips, Blotters, Microdot, Tabs, Purple Om, California Sunrise, Blue Star.
LSD is a chemical derived from the parasitic fungus ergot which grows on rye. The full chemical name is d-lysergic acid diethylamide. LSD is usually sold as a square of blotting paper about a quarter of the size of a postage stamp. The LSD is produced as a crystal, dissolved in alcohol and then a small amount is dropped onto the acid ‘tabs’. Each ‘brand’ of acid has a different design on the paper. This one (a pyramid) has an eye of Horus design.
About an hour after someone swallows the trip the effects start. Initially the user will feel disorientated. They may become giggly, confused or anxious. As the trip progresses feelings are enhanced. Colors and sounds seem more vivid. Everything appears to flow. LSD causes perceptual distortions or hallucinations – while someone is tripping they can affect how they perceive their environment.
The environment will also dramatically affect how the tripper feels. Change the environment and the nature of the trip will change. Time becomes meaningless. It is impossible to tell whether a moment has lasted a moment or a million years. Senses can become confused – you might taste colors or see sounds. It’s common for people at the peak of a trip to experience a sense of depersonalization.
They don’t feel like an ‘I’ anymore. They experience themselves as just a part of everything else. If someone doesn’t like what they are experiencing and tries to get away from what is happening they are likely to move into a state of extreme fear. They might feel anxious, panicky or paranoid. Tripping on LSD is essentially a trip into your own mind. Trips last for 8 – 12 hours.
LSD is thought to disrupt the way that serotonin is used by the brain. Serotonin is the chemical in the brain which enables electrical messages to pass through the synapses. The physical changes due to LSD use include a slight rise in temperature and heart rate and dilated pupils. Someone who has taken LSD may appear to be completely normal, although occasionally confused or unexpectedly giggly. The long-term physical effects of LSD use are not known. Concerns about chromosomal damage have not been proven. Some people have suffered from long-term mental health problems after using LSD. It is not known whether LSD caused their mental illness or uncovered a problem that was already there.
Someone using LSD may become less aware of risks from the environment – busy roads can become impossible to navigate safely. Activities that involve coordination like swimming, driving or cycling will be much more dangerous than usual. Even finding your way home can seem an impossible task. When someone trips how they feel will be dramatically affected by the people around them. LSD enhances feelings so any anxiety or concern will be amplified. If someone has decided to take LSD, preparing for the the trip is a good idea. Are they with friends? Will they feel safe? Will someone know what to do if everything becomes too hectic? Will they be able to get to a telephone? If they want to leave, can they? Are they likely to be interrupted? Do they need to be somewhere else in the next 12 hours? Are they relaxed? Are they depressed?
Even if you feel great and you’re with friends you can’t guarantee having a good trip. Often trippers re-experience early memories, even pre-birth memories. ‘Bad’ trips can be triggered by a painful or difficult feeling that the user tries to avoid by resisting the effects of the drug. A bad trip is a bit like a nightmare, and can be extremely frightening. If someone is having a difficult time during their trip it is important to remember how open to suggestion they are. Trying to reassure a paranoid tripper by constantly asking them if they still feel paranoid is really not going to be very helpful.
It’ll just keep them feeling edgy and anxious. If you’re with a friend who’s used LSD and is having a bad time you could help by being there to listen to them. Remind them they’ve used LSD (they might have forgotten), and that they’re tripping. Help them to talk if they want to, but without constantly questioning them. If it’s possible it might be a good idea to change the environment – go for a walk, change the music.
Relaxation is the key. Go with the flow.
The Human Immunodeficiency Virus – HIV – is the virus that may lead to the development of Acquired Immune Deficiency Syndrome, or AIDS. AIDS is everybody’s concern. This page contains important information about HIV and AIDS, and how to reduce the risk of infection to a minimum.
HIV is a virus that affects the immune system of the human body. Someone who has been infected by HIV may appear and feel healthy, but they can pass the infection on to others.
People who have been infected by HIV are prone to other infections – their body’s natural defence system is weakened. Sometimes a mild illness can become more serious or an infected person may develop an illness that is usually rare. Contracting several of these opportunistic infections (or one of a number of specific infections) in the presence of HIV is the reason for a diagnosis of AIDS.
HIV is passed between people in three main ways
Through unprotected sexual intercourse with an infected person. ‘Unprotected’ means that there is an exchange of body fluids at some point. ‘Sexual intercourse’ may be penetrative or not, with someone of the opposite sex or the same sex, vaginal, anal or oral.
By sharing injecting equipment with an infected person. ‘Injecting equipment’ includes needles, syringes, water, spoon, filter – any thing that may have had any contact with blood of the other person. HIV doesn’t discriminate between the substances that are being injected – steroid users and heroin users share the same level of risk.
From an infected mother to her baby.
HIV has been passed on through blood products (like factor 8 which is used in the treatment of hemophilia), although now in the UK all blood products have to be screened before they can be used. Sharing injecting equipment may take place by accident – being stuck by a discarded needle for example. Any situation where body fluids can be exchanged carries risk – wiping up a spill of any body fluids should not be attempted without adequate protection.
People who are carrying HIV infection can look and feel healthy – they may not be aware of the infection themselves. All of the following steps should be taken to minimise the risk of infection: Always use an approved condom (for example a British Standard ‘kite marked’ brand) for any type of sexual intercourse. Condoms are available free from family planning clinics.
If you use a lubricant, never use an oil based one (like baby oil or Vaseline) as these can dissolve latex and cause condoms to break. If you use drugs and are injecting, always use a clean set of works. Needles and syringes are available free from needle exchanges including the SWOP scheme (through participating pharmacists). Remember, HIV and other infections can be passed on if you share any injecting equipment. If you use drugs (including alcohol) and aren’t injecting, your judgement may be affected – you may be more likely to engage sexually with another person or may decide that you don’t need to use a condom. Sex and drug use don’t always mix – some drugs will inhibit erection or orgasm, others may reduce sexual interest.
Always carry a condom and if you do have sex with someone else remember to use it! Many substances affect the human immune system; if you are using drugs you may well be more susceptible to all kinds of infections that a healthy immune system would fight off. If you aren’t eating or sleeping properly, or you’re suffering from stress for any reason then you are also less likely to fight off infections that you come into contact with.
There has been a lot of fear about HIV and AIDS. Some of the things you may have heard about the virus will be true, and some will be based on misinformation, myth and rum our. By learning about HIV and AIDS you can separate myth from reality, and reduce the risk of catching or passing on HIV. These immune system dysfunctions have only recently been discovered and researched, and the use of drugs, an individuals lifestyle, diet and a history of chronic infections may be just as important precursors to AIDS as sexual behavior – if your immune system is not working properly you are less likely to be able to fight off viral infections whether they are sexually transmitted or not. Certainly people who become infected with HIV who lead otherwise healthy lives can stay well for longer.
Other names :Junk, Smack, Brown, Skag, H, Gear.
Heroin is usually sold as a brown powder. The powder starts life as the milky sap of the opium poppy Papaverum Somniferum. The sap is collected and dried to form a gum. The gum is washed and becomes opium. Opium contains two painkilling alkaloids, codeine and morphine. Morphine that has been extracted from opium can be further refined to create diamorphine, or heroin. Weight for weight, heroin is about forty times more powerful than raw opium.
All opiates – drugs that come from the opium poppy – are painkillers. People who use heroin describe feelings of relaxation, warmth and a sense of well-being. Nothing matters. Wrapped up in cotton wool. Initially, most people who use heroin feel nauseous and often vomit. This is followed by a period when the user is conscious but looks like they’re falling asleep. Breathing and heart rate decrease. Once this has passed the user is able to interact normally with other people, although to them their experience will have taken on a dream-like quality. Heroin is used in medicine (it’s called diamorphine when it’s prescribed) as an anaesthetic and powerful analgesic (for relief from severe pain). Regular use will cause dependence (see below) and constipation. Female users may have interrupted periods. It’s still possible to become pregnant, so it’s important to use contraception to avoid unwanted pregnancy. Using condoms for penetrative sex will protect against HIV and other sexually transmitted diseases.
There are two main risks with heroin. Overdose and dependence. Heroin depresses the activity of the central nervous system like alcohol, sleeping tablets (temazepam, for example) and tranquilizers (like Valium). This is what causes the breathing and heart rate to slow down. Someone who takes more of any depressant drug than their body can cope with (an overdose) will lose consciousness, drift off and may even stop breathing. Mixing depressant drugs increases this risk – you can overdose much more easily. Injecting heroin can easily lead to an overdose. If you don’t know how strong the heroin is, it’s ever so easy to take too much. If somebody is overdosing and starting to lose consciousness DON’T PANIC!
It is important to call an ambulance and stay with them until help arrives. Try to keep them conscious for as long as possible – talk to them. If they lose consciousness, put them in the recovery position. If they vomit, clear their airway. When the paramedics arrive tell them what drugs have been taken so the right medical attention can be given to the person as soon as possible. If anybody takes an opiate regularly they will develop a physical tolerance to the substance (they need to take more to get the same effect). It doesn’t make any difference whether an opiate is being smoked or injected, prescribed or taken without prescription. Their body starts to rely on the chemical being present, and without it they will become ill.
It’s not that unusual for someone with a heroin habit to find themselves using £25 – £100 worth of the drug each day. Finding the money for this kind of habit can become a problem in itself, and might lead to dealing or other criminal activity. Someone withdrawing from an opiate habit (clucking, or going cold turkey) is likely to experience several unpleasant physical symptoms. Hot and cold sweats, nausea, diarrhoea and confusion are accompanied by an intense craving to take more of the drug to make them well again. Heroin withdrawal is not physically dangerous, but will be unpleasant.
Seeking help from a doctor or drug dependence clinic could relieve some of the symptoms. Medication can be given to help someone through withdrawal, and other support will be available. Longer term users may be offered prescriptions for other opiates like methadone. It’s usually prescribed as a liquid to drink. It’s clean, it lasts for 36 hours and it costs a lot less than smack. Just like heroin and other opiates, if you take methadone regularly you’ll become dependent. Some people move from smoking heroin to injecting it. Injecting any drug involves extra risks. Overdose becomes more likely. Sharing injecting equipment (intentionally or accidentally) can expose a user to viruses like HIV (which can lead to AIDS) and Hepatitis B and C (viral infections of the liver).
Household products like glue, thinners, petrol, butane gas and anything in an aerosol can. The solvents used in contact adhesives and similar products evaporate at room temperature, giving off fumes which can be inhaled. Someone sniffing an aerosol is inhaling the pressurized gas which propels the product out of the can. An average home will contain about fifty sniff-able products.
Inhaled fumes rapidly enter the bloodstream (and then the brain) through the lungs. The effects start with disorientation and dizziness, and can lead on to feelings of euphoria and a sense of unreality – even hallucinations. Sometimes a group of people using together will experience a shared hallucination. The effects wear off after 15 – 30 minutes leaving the user feeling drowsy and unable to concentrate. This hangover can last for up to a day, and may include headaches.
Heart rate and breathing slow down, speech can become slurred, some people experience blurred or double vision. Most users experience dizziness, drowsiness and sometimes nausea. Repeated use or deep inhalation can cause confusion, loss of control and even loss of consciousness. Long term defects of solvent and gas inhalation include kidney and liver damage, and damage to the central nervous system (including the brain). Often the products containing the solvent contain other chemicals that can be harmful.
Some products contain chemicals that are irritant or sometimes even corrosive. Many industrial solvents are carbon based, like our bodies. Take note of any warning symbols on the packaging. Most of the products are also inflammable. Smoking or using matches or a lighter could easily lead to an accident. Sniffing glue out of a plastic bag can cause suffocation. If you pass out the bag can remain stuck to your face. If you throw up while you’re unconscious this could also cause you to choke. Never leave someone who’s been sniffing solvents or aerosols on their own – if they do choke, they’ll need your help quickly.
Many of the sudden deaths caused by solvent sniffing are due to inhaling butane gas – lighter fuel. The liquid gas cools tissues in the throat, which causes them to swell. If your throat swells up you can’t breathe. Other aerosols contain particles of the product that is being sprayed – like deodorant, hairs pray or furniture polish. If you spray these into your throat they will coat the inside of your lungs, and cause suffocation.
Someone wanting to sniff from an aerosol must filter these particles out before they can inhale the gas. Where someone sniffs can be a danger too. Busy roads, railways, building sites, canals and rivers become extremely dangerous if you’ve been sniffing solvents. You could fall in a river and not remember how to swim. You might think there’s plenty of time to cross the road, but there’s not. If you’re going to use these substances then make sure that somebody else is with you. If you do have any difficulties, help can be given much more quickly (as long as the other person isn’t in the same state).
Most people start sniffing solvents or aerosols ‘just to see what it’s like’. Nobody ever expects to come to harm, or to have a problem. If you know that you’re not feeling happy – maybe you feel alone, stressed, depressed, bored or something’s happened to you – then talk to someone about it. Some people get into sniffing regularly because they like the buzz better than being straight. They don’t think of it as ‘a problem’, it’s just something they do. Solvents and aerosols are just like other drugs. They change how you feel, but they don’t take problems away.
Other Names : GBH, Liquid E, Liquid X.
Gamma Hydroxy butyrate (GHB) was originally developed as an anesthetic, but withdrawn due to unwanted side effects. Other uses have been for the treatment of narcolepsy, for the relief of symptoms when withdrawing from dependent alcohol use and more recently as a growth hormone stimulant used by body builders. The substance is currently circulating within the dance music scene (at raves and night-clubs) as an alternative to Ecstasy or Amphetamine Sulphate (speed).
GHB is usually available as an odorless, colorless liquid which you drink (it tastes slightly salty). Sometimes the substance is available as a powder, or in a capsule. In its liquid form, GHB is sold in small (30ml) bottles; this would normally be enough for three doses. It is difficult to give a clear ‘safe‘ dose, as the concentration of the liquid will vary.
You can usually feel the effects of the drug ten or fifteen minutes after you have taken it, although it may take up to an hour. At small doses, GHB encourages a reduction of social inhibitions, similar to alcohol, and an increased libido. At higher doses, this euphoria gives way to feelings of sedation. Some users have likened the experience to taking mandrax (or ‘mandies’), a sedative (methaqualone) that was popular on the illegal market in the seventies.
As an anesthetic (thus mixed effect drug), GHB works as a sedative rather than a painkiller. Most reported physical side effects are actually connected with taking more GHB than a normal recreational dose, when the drug starts to work as an anesthetic. Common unpleasant reactions are nausea, drowsiness, amnesia, vomiting, loss of muscle control, respiratory problems and occasionally loss of consciousness. After excessive use, some users have experienced seizures and coma.
The amount of GHB you need to take to feel the effects is very close to the amount needed for anesthesia, and this is very close to the amount that can cause seizures or coma. If you decide to use GHB, start by using a couple of capfuls and see how you go.
Many of the people who have collapsed whilst using this drug don’t remember being ill, but actually think they have been dancing around and having a great time – you will be safer if you are with friends who can help if you get into difficulties. If you are with someone who is using GHB and they become ill (they collapse, or start vomiting) call an ambulance and take them to hospital. Let the paramedics or doctor know what they have taken so that help can be given quickly.
The people who have been hospitalized after this sort of reaction have made a full recovery – in this country there have been no confirmed deaths from taking GHB. As a sedative drug, there is far more likelihood of serious illness or overdose if other sedative or depressant drugs are used – if you do use GHB, do not drink alcohol. Drinking alcohol on top is far more likely to lead to a distressing reaction such as respiratory collapse or coma.
GHB is easily made from chemicals that you do not need a license to obtain. Because of this, it is often made in ‘underground laboratories‘ (usually someone’s kitchen) and the concentration is consequently variable. ‘Safe‘ doses vary, depending on the source, and the physiology of the user – their weight, sex and general state of health.
Drugs are substances of natural or synthetic origin which can be used to alter someone’s emotional state, perception, body functioning or behavior. Antibiotics are drugs which help us to fight infections; this kind of drug is seen as positive and medically helpful. Coffee and tea contain Caffeine; use of this stimulant drug is widely accepted in society. Generally, drugs which are taken for pleasure are psychoactive, that is drugs which alter the psychological state of the user. The term “Substance Misuse” is employed to describe the use of drugs illegally, or without medical supervision. Many people who misuse drugs do so occasionally, not on a daily basis. People who are addicted to the substances that they use are in the minority. Drugs that are misused generally fall into one of the five categories below. The substances in bold print are examined in more detail in other information sheets. Please ask for these if you would like to know more.
Substances that stimulate the Central Nervous System, including Amphetamines, Amyl Nitrite, Cocaine and Crack.
Substances that depress the Central Nervous System, this category includes Alcohol, Barbiturates and Benzodiazepines like Temazepam.
Powerful pain killers that may be an opium derivative or synthetically produced. Includes Morphine, Diamorphine (Heroin), Methadone, Pethidine and Buprenorphine (Temgesic).
Substances that alter perception, hallucinogens have also been known as Psychedelics. This category includes LSD, Psilocybin (Magic Mushrooms), Cannabis and Ecstasy, a hallucinogenic stimulant.
MIXED EFFECT SUBSTANCES
Most substances actually have a variety of effects. Some substances are difficult to place in one of the above categories, for example Solvents, Propellants (in aerosols), and GHB. These substances will generally either stimulate or depress the activity of the Central Nervous System, and will also have some hallucinogenic affect.
The media often ignore issues regarding drugs and their users, or report stories using stereotypical images of the “drug addict”. Many aspects of the government’s campaigns to help people avoid trouble with drugs centre around fear (“Heroin screws you up”) rather than education. This can make it very difficult to engage in open and honest discussion about drug issues, and has led to mistaken beliefs and misinformation circulating within society. Some common myths are “smoking Cannabis leads to Heroin addiction”, “if you smoke free based Cocaine (Crack) once you are hooked”, “everybody at raves uses Ecstasy”, that “outside every school gate there is a drug “pusher””. All of these statements are false, and have grown from fear and misconception, and a lack of freely available information about drugs and their use in society. All the drugs listed above either currently or at some time have been used therapeutically, within the medical field. For many people who use drugs illegally, the drugs they buy are the medication that makes them feel better, and they will continue to use drugs until they discover other ways of taking control of their lives.
As said before, the drugs that are used in a non-medical setting are generally psychoactive, substances which can affect the psychological state of the user. The first time that someone uses a drug, they do not know what the substance will do, how they will feel or what changes there will be to their perception, and the experience will be guided by what the person believes will happen whilst affected. A lot will depend on the user’s emotional state, the environment that they are in and who they are with. Contrary to popular belief, the initial use of any substance is not always an enjoyable experience, and can be the only time that a person uses that drug. If someone continues to use, it is because they have made a decision that what the drug had to offer them was an experience which they interpreted as “good“. Everybody’s experience of a drug is different; there are similarities and recognizable aspects of each experience, but the perceptual changes that happen are individual.
Ecstasy is usually sold as a tablet or capsule that contains a variety of chemicals. A ‘pure’ E would only contain 3,4-Methylenedioxymethamphetamine (or MDMA). Most pills contain other drugs too – MDA or MDEA (both similar to MDMA), amphetamine (speed), Ketamine (an anaesthetic) or even LSD (acid). Some pills contain no MDMA at all.
Someone taking ecstasy will experience a loss of inhibitions, excitement, euphoria, talkativeness and a rush of energy. MDMA encourages people to feel closer, more open and empathic towards the people they are with. Some people call this being ‘loved up’. These effects usually start after about half an hour.
Someone who hasn’t’t used E before might experience some confusion or anxiety. High doses can initially cause a lack of coordination and dizziness. If this happens, it’s a good idea to sit down until the rush passes. Ecstasy is a hallucinogenic stimulant. Some pills can cause a distortion of sound and vision. Hallucinations will be caused by pills that contain drugs like LSD or Ketamine.
The effects usually last for three to four hours, peaking after about two hours. If someone takes a pill that lasts for longer than this then it probably contains amphetamine (speed). They’d feel ‘up’ and have loads of energy, but wouldn’t feel the closeness associated with MDMA.
While someone is on an E their pupils are dilated, their mouth and throat will feel dry, there is a rise in heart rate and blood pressure, their jaw feels tense (often people chew gum to ease this), sweating increases and appetite is suppressed. MDMA interferes with the body’s temperature regulating mechanism, so body temperature can increase to potentially damaging levels. It also encourages the body to increase production of a hormone called ADH (anti diuretic hormone) which prevents your body from excreting urine. You don’t pee as much as you would normally.
Everyone wants to know what the long term effects of ecstasy are. Some research suggests brain damage and liver damage. Some research discounts this. It’s difficult to provide clear information when different pills contain different chemicals. The truth is, no-one knows for sure whether E is harmful in the long term. Taking lots of E, using it regularly or not acting on the risks we do know about is more likely to lead to damage.
The main risks with ecstasy are overheating and dehydrating. Ecstasy is often used at clubs or parties where people are dancing and getting hot and sweaty. Someone using E in this kind of environment needs to drink about a pint of liquid (water and fruit juices, NOT alcohol as this also dehydrates) over the course of each hour to replace the fluid they are losing through sweating. Eating salty snacks will replace the minerals that are also lost. Ecstasy prevents people from going to the toilet (to pee) as much as they might do normally. If someone isn’t sweating they don’t need to take as much fluid on board; drinking a lot could actually be very dangerous.
Drinking too much water can cause the brain to swell, leading to collapse, coma or even death. The after effects of ecstasy use can include insomnia, anxiety, irritability and paranoia. The range and severity of after effects depends on the amount of ecstasy that is being used, and the regularity of use.
Sleeping and eating will help the user to recover. Essential nutrients, particularly vitamin C and calcium, will need to be replaced. If you’ve been taking E every weekend and are starting to find that the days in between are becoming unbearable it’s time to take a break. Some people have developed short term mental health problems (like anxiety, depression, low self esteem and paranoia) that clear up once they stop using. It need not be forever. The same applies if you find yourself needing more pills to get the effect you want. Once you’re taking more than two pills in an evening the effects are more like speed. If you’re going to use E, it’s safer to use small amounts occasionally with a long enough gap between uses to enable your body to recover.
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