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[drug info]

Everyone knows that the safest form of drug use is not to use them. But if you do use drugs, you can make more informed choices if you learn about the risks and effects first. Here you'll find some essential info about lots of the more commonly used drugs, things like their legal status, what they look like, how they affect your health and what to look out for to reduce the risks.

Addiction or dependency?

Many people use and understand the word 'addiction' when referring to problem drinking, drug using or gambling, so we've used the term on our website. But at NORCAS, we often use the terms 'dependency' or 'addictive behaviour' instead because they're preferred by the World Health Organisation, and because they're less judgemental too.

 

Amphetamines

Other names? Speed, whizz, billy, pink champagne, sulph, dexedrine, dexies, billy whizz, amphet, pep pills.

What does the law say? Class B (class A if prepared for injection). 'Prescription only' under the Medicines Act 1968.

Where does it come from? Most street amphetamine is produced illegally in laboratories. Some amphetamines (such as Ritalin and Dexedrine) are available on prescription and there are some illicit sales of these.

What does it look like? Street amphetamine is a white, off-white or yellow powder. Dexedrine tablets are small, white or yellow. Methamphetamine comes in the form of crystals, usually white or clear. Occasionally you might come across 'base', which is a purer form of amphetamine and looks like a grey putty.

How pure is it? Street speed is of very poor quality (5%-10% purity). Base is much more potent (50% - 90%).

How is it used? Usually snorted, but it can be swallowed, rubbed in to the gums or injected. Methamphetamine is usually smoked. Base may be dissolved in cold water and injected.

What are the effects? Amphetamines are a stimulant; they increase heart rate and blood pressure. Effects usually come on within 15 minutes, much quicker if the user is injecting. The user experiences increased alertness, becomes talkative, apparently more confident and has increased energy levels. They reduce the desire to eat, sleep and can lead to tightness in the jaw, which causes some users to grind their teeth and chew constantly. Over-use can lead to increased susceptibility to paranoia, anxiety, panic attacks and irritability.

What are the health risks? Amphetamines only help the body to access energy reserves and do not remove the need for food and sleep. Hence the comedown can be a bad experience with the user prone to aches and pains, hunger, depression and loss of self-esteem. The temptation then is to use a tranquillising drug to aid the come down process or simply to use more of the drug to pick oneself up again. The best option for recuperation is sleeping and eating. Overuse will also cause weight loss and the subsequent dangers that go along with that, including malnutrition and self-neglect. Depending on the method of use, amphetamines can cause the nasal lining to erode, gums to recede or stomach irritation. Obviously injecting carries all the usual risks associated with intravenous drug use. There is a particular risk of death from coronary problems with those already suffering from a heart condition. Amphetamines can dull sexual sensitivity and increase aggression. Psychologically, regular use can induce a state known as Amphetamine Psychosis, which is typified by an intense paranoia. This usually abates once amphetamine use has been discontinued for a while.

How can you reduce the risks? All stimulants suppress appetite. The body will need to sleep and be fed after a period of use.

With over-use, anxiety and agitation can turn to paranoia, psychosis and often violent and over-aggressive behaviour. If you recognise these symptoms in yourself or a friend, you should try to reduce their use and seek medical help.

Stimulants distort perception of risk and can make you over-confident. You may feel that you can drink more but the drink will still do its damage.

Similarly, the sense of personal effectiveness and confidence may be distorted. Research has shown that users of stimulants are more likely to indulge in unsafe sex. Always carry condoms if there is a chance you may have sex.

Stimulants make the heart work harder but constrict our blood vessels. This puts strain on the heart. Those with heart conditions should always avoid stimulants.

Another by-product of this is that erections are harder to sustain and sexual sensitivity will be dulled.

Those who share materials for snorting drugs are often not aware of the risk of contracting a blood borne virus. The nasal lining is often broken and blood-to-blood infection is a real possibility. Do not share any drug paraphernalia.

 

Benzodiazepines

Other names? Nitrazepam/mogadon (moggies), lorazepam/ativan, flurazepam/dalmane, clonazepam/rivotril, oxazepam, flunitrazepam, rohypnol (roofies), temazepam/normison (eggs, temazzies, jellies), bromazepam/lexotan, chlordiazepoxide/librium, diazepam/valium (vallies/yellows).

What does the law say? Class C. It is NOT illegal to possess them without a prescription but it is illegal to supply them without the due authority. Temazepam and Rohypnol are the two exceptions.

Where do they come from? Prescribed drug often sold illicitly - Valium and Temazepam are most often the ones sold on the street. They are very commonly prescribed for anxiety or depression, as an anti-convulsant and as a muscle relaxant. They are too often prescribed for depressive complaints even though they are not anti-depressants.

What do they look like? Varies depending on the producing pharmaceutical company. It is possible to get ampoules and liquid forms of Benzodiazepine drugs but they usually come as innocuous looking tablets or capsules. Valium comes as white, yellow or blue pills, depending on their strength.

How pure are they? If pills are correctly identified then quality will be guaranteed. On the street, however, no guarantee can be given.

How are they used? Orally, though some ill-advised users may crush them up and inject them.

What are the effects? Physical relaxation, drowsiness, and can induce sleep. Some users experience a loss of co-ordination, become forgetful and vague.

What are the health risks? Dependence and tolerance can develop quickly. Many people are both psychologically and physically dependent. Withdrawal can be a dangerous process causing fitting convulsions - IT IS POSSIBLE TO DIE FROM BENZODIAZEPINE WITHDRAWAL. After a matter of weeks at a stated dose they cease to be effective without an increase in dose. Indeed they can cause sleeplessness and anxiety. Other noted effects include vertigo, hypotension, loss of libido, urinary retention and blood disorders. The risk of overdose is relatively low but unmonitored use carries all sorts of risks, especially if the user is drinking as well, as the cough reflex is inhibited and the breathing may become shallow. They are commonly used in conjunction with other drugs such as heroin and alcohol. This significantly increases the risk of overdose. Crushing and injecting tablets carries the risk of abscess-blocked veins and the usual risks associated with intravenous drug use. Withdrawal may occur some weeks after the cessation of use as they are fat-soluble and stick to receptors in the brain for longer.

 

Cannabis

Other names? Marijuana, THC, hash, pot, weed, blow black, shit, draw, herb, skunk.

What does the law say? Class B. The Government asked the advisory council if they should re-classify cannabis to Class B in Spring 2008 but despite being advised to keep it as a Class C they said they hope to re-classify it in 2009. This has now come into effect.

Where does it come from? From the bushy plant Cannabis Sativa that grows wild in any warm conditions. Increasingly, cannabis is cultivated either by individuals as 'home-grown' or on mainland Europe.

What does it look like? RESIN (hash): Cannabis plants contain and exude resin, which is collected and compressed to form hard blocks. These range in colour from black, brown, through to yellowish white. Resin may have a distinctive sweet, cloying smell when burnt and may be soft and malleable, crumbly or very hard. HERBAL (weed): Herbal cannabis is composed of small dried leaves, dried flowering heads, or a mixture of both. Dried leaves look like dried herbs. Flowering parts are often either yellowish or purple and may be dusted with pollen. Some stronger strains of herbal cannabis may be slightly sticky to the touch. It usually has a dry, pungent smell, especially when burnt. OIL: Much less common in the UK, pure oil is very strong and contains no solid matter. Usually comes in small vials and is light brown.

How pure is it? THC is the active chemical, the more of it that's present, the stronger the cannabis. Ranges from very strong to negligible THC content. Heavily cultivated strains (e.g. Skunk) are very high in THC. Some reports suggest that recent advances in hydroponics mean that today's cannabis is up to 30 times stronger than in the '60s and '70s. Dried leaves, mixed herbs etc may be passed off as herbal cannabis and mixtures of wax, henna, plastic or liquorice as resin.

How is it used? Primarily smoked or taken orally. Smoked in joints, pipes, or through paraphernalia such as 'hot knives' or bottles. Cannabis is often smoked with tobacco, though herbal cannabis can be smoked on its own. It is placed in cigarette papers and, if used, tobacco is added. A cardboard filter ('a roach') is added and the joint is smoked. Some people prefer to use small pipes in which a small amount of resin or herbal cannabis is placed and smoked. With hot knives, a small pellet of resin is placed between two knives that have been heated up and the vapour inhaled. Cannabis can be mixed with food and drinks, for example it may be made into cakes ('hash cakes'). When smoked, the effects are felt within a few minutes. Absorption though the stomach is slower taking up to an hour but some report a 'cleaner hit' when used in this way.

What are the effects? Not always very clearly defined. Some users report little or no effects, while others' experiences are intense. Certainly, the effects are often dependent on the experience and expectations of the user, the setting and mood at the time of use. At moderate dosages the most frequently recorded symptoms are anxiety, eye redness, enhanced appreciation of sound and colour, increased appetite and paranoia. Unwanted side effects such as nausea, palpitations and anxiety are sometimes made worse by alcohol.

What are the health risks? Smoking cannabis, especially with tobacco, carries health risks. These relate to lung damage, especially bronchial problems, with an increased risk of lung and throat cancers. Some studies indicate that cannabis smoke is more carcinogenic than tobacco. People smoking cannabis tend to hold the smoke in their lungs longer so more damage can occur. Using cannabis regularly can cause short-term memory loss, de-motivation, apathy or listlessness. The high level of use in younger people is pointing to increased risk of schizophrenic illnesses, which can endure into adult life. It is certainly not conducive to learning and interferes greatly with the ability to study. While it is not physically addictive, people can, and do, become psychologically dependent and find stopping difficult. Much attention has been given recently to the perceived health benefits attached to cannabis use. Some research has indicated it for a wide range of conditions including multiple sclerosis, glaucoma and intense pain.

How can you reduce the risks?

  • Due to modern growing techniques cannabis can be stronger now than it used to be and is being smoked in higher doses - especially in pipes and 'bongs' which concentrate the amount of psychoactive THC entering the bloodstream.
  • Cannabis is hallucinogenic, meaning it distorts our perceptions. It is possible that mental health problems can occur when using cannabis - these can range from anxiety and paranoia to drug induced psychotic episodes. If a user is getting paranoid, this is often a warning sign that negative mental health symptoms may increase with prolonged use.
  • Long-term mental health problems can also result. Research shows that if you are a smoker of cannabis between the ages of 15-25 you are 3 to 4 times more likely to develop a schizophrenic illness than a non-smoker. It can also exacerbate existing schizophrenic symptoms.
  • If cannabis is eaten it takes longer to have an effect but it increases its hallucinogenic effect and the risk of the above.
  • When smoked cannabis produces a lot of tar. It is more carcinogenic than tobacco - which it is often smoked with.
  • Short-term cannabis use will decrease the ability to concentrate and has often been said to contribute to a de-motivational syndrome.
  • There are cannabis receptors all over the brain affecting many of its functions. These include learning and memory, movement and co-ordination and temperature control.
  • Cannabis users will often report pleasurable effects. However, it can stay present in the system for up to 30 days so residual effects can be hard to gauge. The negative effects of ongoing use are therefore harder for the user to perceive and attribute to the drug.
  • Drinking alcohol and smoking cannabis can make the user very nauseous and can induce vomiting.
  • Much of the cannabis resin that is on the market today is known as Soap Bar and is far from pure (up to 90% non plant material). Often it is cut with things like henna, turpentine, beeswax, pine resin, coffee and condensed milk. When smoked it can cause a heavy feeling and can give the user headaches from some of the more solvent-based additives.
  • Contrary to popular belief, there are some fairly common withdrawal symptoms associated with stopping heavy or prolonged cannabis use. These can vary in intensity and are characterised by some or all of the following: sleep disturbance, vivid dreaming, mood swings, irritability and possible aggression, headache, tiredness, sweating and discomfort. It may take a few weeks for a user to feel settled.
 

Cocaine and crack

Other names? Coca, coke, Charlie, snow, powder crack, rock, bones, stones, freebase.

What does the law say? Class A

Where does it come from? A naturally derived substance from the Coca bush, native to South America. The locals chew the leaves for effect but by the time it reaches this country it has undergone extensive laboratory processing. Crack has undergone a further relatively simple process to 'free' it from its base and is therefore concentrated in a smokeable form.

What does it look like? Cocaine is a fine white crystalline powder. Crack is white/ish, hard raisin-sized pellets.

How pure is it? Purity does tend to be higher than other street powders such as amphetamine but again is readily cut with glucose etc. Crack is a much purer form of cocaine having undergone a process to make it such.

How is it used? The popular way to use cocaine is to place it on a mirror, cut it into a finer powder with a razor blade and snort it up the nose in 'lines' with a rolled-up banknote. It can be injected or rubbed on the gums. The primary advantage of crack is that it can be smoked, typically through homemade pipes, cans and bottles etc. Some users have reported dissolving and injecting crack - this is especially common with heroin injectors who will often mix the two drugs on the same spoon - known as 'snowballing' or 'speedballing'.

What are the effects? Cocaine is probably the most powerful stimulant, offering the user an intense feeling of power, control, and a heightening of energy and awareness - the classic party drug. Heart rate and blood pressure increase and pupils dilate. The effects of crack are more intense still and the onset is almost immediate. However, the effects last for only a short time (snorted cocaine about 30 minutes, crack about 5 -10 minutes). This encourages the user to keep repeating the use therefore bingeing is a frequent occurrence, until either money or the drug runs out. The eventual comedown can be severe.

What are the health risks? Cocaine is not physically addictive but the intense highs and lows can create a powerful psychological dependence, even recreational users can quickly develop anxiety, paranoia and disrupted sleep bringing general fatigue and restlessness. Cocaine is an appetite suppressant, so there are obvious implications here. Habitual crack users will be almost certain to experience bronchial problems and those that snort cocaine regularly can end up with a perforated septum. Deaths have occurred from cocaine use, predominately from heart failure or haemorrhaging. Cocaine and crack use deplete levels of dopamine in the brain, a chemical which helps regulate mood. Someone who binges will quickly lose most of the dopamine in their system and can become suicidally depressed. Adrenaline is also being regularly pumped round the system with the use of these drugs and this can cause restlessness, extreme paranoia or psychosis, and sometimes violent aggression.

How can you reduce the risks?

  • All stimulants suppress appetite. The body will need to sleep and be fed after a period of use.
  • With over-use, anxiety and agitation can turn to paranoia, psychosis and often violent and over-aggressive behaviour. If you recognise these symptoms in yourself or a friend, you should try to reduce their use and seek medical help.
  • Stimulants distort perception of risk and can make people over-confident. You may feel that you can drink more, but the drink will still do its damage.
  • Similarly the sense of personal effectiveness and confidence may be distorted. Research has shown that users of stimulants are more likely to indulge in unsafe sex. Always carry condoms if there is a chance you may have sex.
  • Stimulants make the heart work harder but constrict our blood vessels. This puts strain on the heart. Those with heart conditions should always avoid stimulants.
  • Another by-product of this is that erections are harder to sustain and sexual sensitivity will be dulled.
  • Those who share materials for snorting drugs are often not aware of the risk of contracting a blood borne virus. The nasal lining is often broken and blood-to-blood infection is a real possibility. Do not share any drug paraphernalia.
  • Cocaine can produce intense cravings. It works on reward mechanisms and makes us believe that we will benefit from having more. We won't. What goes up must come down!
  • Anyone using crack cocaine should seek specialist help.
 

Ecstasy

Other names? MDMA, 'e', doves, XTC, mitsubishis, apples, rhubarb & custards, callies.

What does the law say? Class A - unlikely to be reclassified as some have suggested it should be.

Where does it come from? Derived from naturally occurring chemicals found in plants, including saffron and nutmeg. The processes involved are well documented but are beyond the means of most amateur chemists. It is produced both in the UK and Europe, in illegal laboratories.

What does it look like? Pure MDMA is a white powder. However, the number of different labs and processes that produce ecstasy means the appearance is very varied. Most commonly it comes as tablets or capsules. Tablets may be white, yellow, speckled, rough, smooth, imprinted with cartoons, corporate logos or just plain. Capsules also come in many colours. The appearance often gives rise to their street names e.g. tablets with pictures of apples on are called apples, those with doves on are called doves, etc.

How pure is it? The quality of all drugs is variable, and nowhere is this truer than with ecstasy. There are huge profits to be made passing off anything as ecstasy so there is a chance that any old tablet finds its way onto the streets - headache tablets, veterinary supplies, old capsules filled with any white powder. Even if the tablet/capsule contains a genuine illegal, psychoactive drug, it may not be true ecstasy, for example mixes of speed, acid, heroin and K have been found.

How is it used? Ecstasy is usually swallowed, though theoretically it is injectable. MDMA powder is snorted.

What are the effects? Starts working approx 1/2 hour after being swallowed. As an empathogen it works on the neurotransmitter serotonin - a brain chemical associated with the enhancement of mood and memory. Users may initially experience a warm glow spreading rapidly through the body, some slight dizziness, disorientation, breathlessness and exhilaration. Nausea may also occur. For about the next 6 to 8 hours the user may experience some of the following: increase in pulse-rate, feeling warm/flushed, restlessness, anxiety, paranoia, feeling increasingly friendly to other people and a sense that this friendliness is reciprocated, tightness and clenching of the jaw muscles, dilated pupils, increase in energy, suppression of the appetite, no desire to sleep, enhanced appreciation of visual and auditory stimulation, some mild visual distortion and a decreased desire to urinate. Of course, many individual's experience of ecstasy depends on the strength and quality of the drug, the user's mood and environment. The cumulative effect of ecstasy in the context of a club is of increased appreciation of music and light shows, the energy to dance all night, a sense of unity and friendship with other clubbers. The comedown can be considerable, leaving you tired and depressed.

What are the health risks? Generally the immediate health risks of ecstasy have been exaggerated in the media, especially ecstasy-related deaths. Much research is new and inconclusive but the following risks are apparent:

  • Toxic or allergic reaction to ecstasy itself - a few people are sensitive or allergic to ecstasy and this can result in illness or death. It may be possible to suffer a toxic or allergic reaction to substances that have been sold in place of ecstasy.
  • Injury or fatality caused by the effects, such as those with heart conditions who have seizures as a result of taking ecstasy.
  • Heat stroke - a risk especially when ecstasy is taken in a hot nightclub, especially if the user is dancing a lot. Heat stroke can cause death as internal organs cease working.
  • Water intoxication - in an attempt to reduce the risks of heat stroke, a user may drink lots of water. The combination of drinking too much water and restricted kidney function due to ecstasy can cause levels of fluid in the brain to increase, leading to unconsciousness, coma, and possible death.
  • The triggering of other conditions - ecstasy has been linked to a number of conditions which may have previously been latent, and triggered by taking ecstasy. Evidence is strong, for example, that ecstasy can trigger epilepsy in some people.
  • Long-term psychiatric damage - some users have experienced long-term depression, this is more common in regular users.
  • Long-term damage to internal organs may be possible. Organs more at risk include the liver, kidneys, heart and brain.
  • Some studies have suggested that mental health problems are more likely in long-term users of the drug and suggest that permanent damage could be caused to the areas of the brain that produce serotonin, but this is largely inconclusive.

How can you reduce the risks?

  • The feeling of friendship and camaraderie that often accompanies ecstasy use is because the brain is over-producing empathogens such as serotonin. This is an important chemical (neurotransmitter) that helps us regulate mood, feel contentment and have empathy with others. It is also quite delicate and the brain needs time to reproduce it once supplies have been depleted.
  • Some research suggests that ecstasy causes permanent damage to the parts of the brain that produce these important chemicals. The long-term effects of this are unknown but are unlikely to be good for your mental health.
  • Regular ecstasy users self-report more feelings of loneliness and restlessness. It is thought by some that users are also more prone to developing depressive illnesses.
  • The comedown from ecstasy use can be marked and often results in the user feeling tired, depressed and unsociable. The brain and body need to recover so food and sleep are necessary - more pills will only make the situation worse in the long run.
  • Some users of ecstasy (and other stimulants such as cocaine and amphetamine) have been known to 'soften' the comedown feeling with depressants like valium, heroin or some over the counter drugs. This is 'false recovery' and greatly increases risk of developing a cycle of dependence.
  • Ecstasy inhibits the body's ability to absorb water - over-drinking can cause water toxicity, which can kill.
  • Conversely, not drinking enough and dancing too much can cause the body to overheat. Heatstroke is the main cause of death in the ecstasy-using population.
  • The maxim for those determined to use - drink water little and often and avoid alcohol. Dehydration can be gauged from the shade of your urine - the darker it is the more dehydrated you are.
  • If you are dancing in a hot club make sure you take some time out in another area, most clubs have a chill out room. Here you will be able to assess more easily how you are feeling.
  • There is good evidence to suggest that ecstasy can trigger epilepsy in some individuals. Those with epilepsy should therefore refrain from using ecstasy.
  • There are also suggestions that in the long term the internal organs can be adversely affected - especially the heart but also the liver, kidneys and of course the brain.
  • Like any drug with hallucinogenic properties, anxiety and paranoia are not unknown - people change on ecstasy and this can be alarming for some. These symptoms usually subside when use stops.
  • Good websites for more info - www.ecstasy.org and www.dancesafe.org.
 

Heroin

Other names? Smack, brown, 'H', shit, gear, skag, harry, horse, jack, junk, brown sugar.

What does the law say? Class A. Related substances such as Pethidine and Dihydrocodiene are class B. Kaolin, Morphine and Codeine are available over the counter and on prescription.

Where does it come from? Extracted from the Opium Poppy. A large amount reaching the UK is currently produced in Afghanistan.

What does it look like? Usually sold as white, yellowy or light brown powder. 'China-white' is sometimes available (white and very pure).

How pure is it? Usually between 40% and 70%. Often adulterated with other substances such as paracetamol, talc, coffee or powdered glucose.

How is it used? Heroin is usually smoked or injected, but can be snorted or eaten. 'Chasing the dragon' is a method of smoking heroin from tin foil. The heroin is placed on the foil and heated from beneath. It congeals into a globule on the foil and begins to give off fumes, which are inhaled through a straw or similar. Injecting means less waste and a bigger hit. Known commonly as 'jacking' or 'fixing' the heroin is heated in a spoon with water and some form of acid (citric acid, or sometimes with vinegar or lemon juice, which is more dangerous) and this helps the heroin to dissolve. The liquid is then drawn up into the barrel of the needle through a cigarette filter or something similar in order to remove the lumps that have not dissolved in the heating process. Veins are often raised with the use of a tourniquet and the drug is then injected straight into the blood stream.

What are the effects? Heroin is a powerful physical and psychological painkiller, this combined with a euphoric quality, creates a sense of warm wellbeing - described as 'feeling safe in a warm blanket'. Heavy use results in sedation, sleepiness and slurring incoherence. Often the user is seen to slump or 'gouch'. First-time users often report nausea and vomiting.

What are the health risks? Numerous and complex. Pure heroin itself is not a particularly health-threatening substance (except for overdose). Most risks are around the lifestyle and self-neglect that goes with habitual use and with the dangers of infections and abscesses from injecting behaviour. Some of the impurities are also of obvious risk to health. Often a user's cough reflex is suppressed for long periods of time leaving the user open to chest infection. Constipation is also common among regular users. Heroin is very physically addictive and though withdrawal is not fatal it is nonetheless unpleasant and the fear of it can often keep most dependents using. Tolerance can build quickly, meaning that more heroin is needed to regain the high or eventually, to just feel something like normal and stave off withdrawal. After a period of abstinence, tolerance drops and the risk of suppressed breathing and overdose is more real. Death from overdose remains a significant cause of mortality among the heroin-using population, especially if the user has been drinking or is under the influence of other depressant drugs.

 

Ketamine

Other names? 'K', special 'k', vitamin 'k', kettle, Kit Kat, 'liquid heroin'.

What does the law say? Class C. Classified in January 2006.

Where does it come from? First synthesised in an American laboratory in 1962, Ketamine is a close relative of Phencyclidine ('angel dust') and has medical uses as a 'disassociative anaesthetic'. It is now predominantly used in this country as a veterinary tranquilliser for anaesthetising large animals such as horses.

What does it look like? In pharmaceutical form Ketamine appears as a clear liquid for injection. On the street it is more commonly sold as a fine white crystalline powder. It can also be contained in pills sold as ecstasy.

How pure is it? The pharmaceutical variety is unlikely to have been adulterated. However, It is impossible to determine the amount to which a pill sold as ecstasy may contain Ketamine.

How is it used? Most commonly Ketamine is snorted, but it can also be swallowed and injected intramuscularly or intravenously.

What are the effects? Effects are very dependent on users' personalities and the environment in which the drug is taken. More often than not Ketamine users report varying degrees of disorientation and dissociation from their physical selves. Low doses can bring on a sense of euphoria and mild hallucinations, together with a sense of numbness and a lack of co-ordination. Some suggest they have been 'thrown' into a place with no time, shape or structure definable by the reality that we normally inhabit. Nausea, headaches, loss of bowel control and even temporary sensations of paralysis are not uncommon. 'K'-holing is a common reported effect, meaning the sensation of travelling outside the body towards a tunnel of light. Numbness is said to increase with oral application, as it has to be processed via the liver where the derivative Norketamine is produced. The effects of oral use last longer than if the drug is snorted. Effects should not last for more than 3 hours.

What are the health risks? Because Ketamine is an anaesthetic, physical damage may be incurred without the user realising until the effects have worn off. The risks to a user's mental health are also extremely marked, as a Ketamine experience is way beyond our usual frame of reference. It has been said that a hot loud club is probably the worst place to take the drug because it is so disorientating, and some unwitting ecstasy users have reported nightmarish experiences. Alcohol and other depressants taken in conjunction with Ketamine increase the risk of heart failure, unconsciousness, vomiting and choking. The usual risks of infection associated with intravenous use apply if the user is injecting.

 

Legal highs

Other names? Herbal highs including Spice, Sence and Magic. Other legal highs include: salvia divinorum, party powders, party pills, kratom, GBL, BZP.

What does the law say? Currently legal substances. The Advisory Council on the Misuse of Drugs (ACMD) has called for a generic ban to be put in place. The Government announced in August 2009 that some legal highs such as Spice, GBL and BZP will be classified as Class C drugs by the end of 2009.

What are the effects? Legal highs are substances that have the same or similar effects to criminalised drugs. This may be because, for example, a herbal mixture is coated with a chemical, or because a substance is being used in an unlicensed way. Hundreds of Internet sites sell a wide range of legal highs.

What are the health risks? Herbal highs are described on websites and packaging as herbal incense or herbal blends. They are described using phrases such as 'aromatic pot pourri', 'an exotic blend' or 'spices that have been used by ancient cultures'. However the reality of these substances is far from innocuous. As well as the listed ingredients which are typically things like baybean, blue lotus, dwarf skullcap, Indian warrior, lion's tail and marshmallow, they also contain one or more synthetic chemicals, which mimic the effects of cannabis on the body. The mixture and quantity of the chemicals is generally unknown to the user, giving the potential for harm. These herbal highs are generally marketed as not for human consumption, but they are generally considered a herb for smoking. Although herbal highs are currently legal, they are not licensed and little is known about how humans react to them, but there are concerns that they can be as powerful as skunk (a potent form of cannabis).

  • Salvia divinorum: This is a rare plant, found in the Mexican mountains. It is smoked or chewed to give hallucinations. It recently drew controversy after the suicide of an American teenager who had used it.
  • Party powders: These attempt to mimic drugs that are snorted, principally cocaine. They often contain caffeine, although the active ingredients vary. The effects last about 30 minutes and they may cause dehydration and increased heart rate. Some product names include 'Raz', 'Charge' and 'Snow Blow'.
  • Party pills: These include a wide range of products that may be chemically similar to amphetamines or ecstasy but are not controlled under the Misuse of Drugs Act, such as 'Happy Caps', 'Blessed', 'Diablo', 'Doves' and 'Summer Haze'. The active ingredients are not known but they may state that they contain geranium extract, caffeine and ketones. They are marketed to boost energy and heighten awareness. It is advised not to mix these with alcohol. They are sometimes sold as 'plant food'.
  • Kratom: This is the powdered extract from plants grown in South East Asia. Its effects vary from person to person. It has stimulant qualities, though can work as a depressant for some people.
  • GBL (gamma-butyrolactone): This is a solvent used in cleaning fluids, stain removers, plastics and pesticides. It is closely related to GHB, which was banned five years ago. It is a fast-acting drug, with hypnotic and euphoric effects, especially when mixed with alcohol. GBL can also cause nausea, coma and death.
  • BZP (benzylpiperazine): also known as Pep pills, A2, Nemesis, Frenzy and Legal E. This was originally used as a worming treatment. Its effects are similar to ecstasy, with decreased appetite, increased heart rate and tingling skin. Senses of taste, sound and colour may be enhanced and effects last between 4-8 hours. There may also be an inability to sleep for as long as 10 hours after taking the drug, hangover like symptoms, a possibility of some memory loss, development of tolerance and overstimulation of the brain, causing anxiety and possible convulsions. BZP contains the component Piperazine, which is a prescription only medicine in the UK and so requires a license to be sold for manufacture and supply, therefore selling BZP as a party drug is illegal. However a loophole in the law allows it to be sold as a soil fertilizer.
 

LSD

Other names? Lysergic acid diethylamide, tabs, trips, microdots, strawbs, blotter, acid.

What does the law say? Class A.

Where does it come from? Produced relatively simply and cheaply in illegal labs.

What does it look like? Its pure state is crystalline but dissolved in distilled water it makes a clear, odourless liquid which is soaked into sheets of paper ('blotters') and cut into small squares ('tabs') less than 1cm square. Tabs are often over-printed with popular designs such as cartoon characters, smiley faces, penguins and dollar signs.

How pure is it? It's impossible to predict the strength of LSD tabs and, although you can buy a piece of cardboard soaked in nothing, this is not very common. However, it is not a very stable compound and degrades in sunlight or warm conditions, so it can range from very weak to very strong.

How is it used? Usually dissolved on the tongue but can just be chewed or swallowed. Any surface membrane that absorbs will take LSD into the system e.g. the eyes.

What are the effects? LSD takes between 30-60 minutes to take effect. The effects can last 8-12 hours. Trips are unpredictable and vary hugely from person to person. The drug works on the brain causing changes to thoughts, senses and perceptions. Visual disturbance can range from slight e.g. seeing traces of lights and moving objects, through to hallucinations, which may be visual or auditory. Most common, especially at lower doses, is visual distortion of real objects, such as walls becoming distorted, changes in the way people or objects look and floating patterns in the air. The effects on a user's thought processes are also very pronounced. Users can enter a dream-like state, become very self aware, feel as though they are experiencing moments of enlightenment, or having mystical experiences. However, they can also experience high levels of anxiety, dizziness or disorientation. The way that LSD works is poorly understood, but it is evident that it has a capacity to exacerbate underlying fears, tensions or memories so it's possible that LSD could trigger anxiety or unhappy thoughts, even if the user wasn't aware of them prior to using. Some factors may lessen the chance of having a very bad trip, such as only taking LSD when you are in an environment where you feel safe, with people that you trust and at a time when you feel content and relaxed.

What are the health risks? The most common health risk is causing either short or long-term psychological damage. LSD can trigger a range of psychiatric problems, so anyone with a history of mental health problems would be advised to avoid LSD. Frequent long-term use can leave people seeming disorientated for quite a long time; such cases were known, especially in the sixties, as 'acid casualties'. Some studies suggest that LSD use can cause permanent eye damage. There is a risk that someone using LSD could injure themself while delusional. Some users report experiencing 'flashbacks' re-living a few seconds or minutes of an LSD-induced trip, weeks, months or rarely years after taking the drug. LSD is not physically addictive; if used every day for 3 or 4 days, it would cease to be effective unless the user abstained for a further few days. LSD interacts badly with both alcohol and cannabis; while not dangerous, the risks of unpleasant side effects, especially nausea and anxiety, seem to increase.

 

Methadone

Other names? Meth, linctus, green, juice, physeptone, amps.

What does the law say? Class A if possessed without a prescription in your name.

Where does it come from? Prescribed drug often sold illicitly. Originally synthesized in the Nazi era in Germany as a treatment for opium addiction.

What does it look like? A liquid mixture, usually green and looks a bit like the common 'Night Nurse' medication but can also be orange, yellow, brown, blue or clear (rare). Pale green tablets and injectable ampoules (physeptone) are also less commonly available.

How pure is it? Methadone mixture is usually 1 mg (methadone sulphate) to 1ml of liquid. Tablets are 5 mg each. Ampoules come in different sizes - 1ml (10mg), 2ml (20mg), 3.5ml (35mg) and 5 ml (50 mg). Purity is rarely questioned as it is a pharmaceutical product.

How is it used? Methadone is predominantly prescribed as a heroin substitute and though not the only alternative to street heroin it remains, in the current climate, the main substitute treatment for those with significant addiction. The mixture is designed to be taken orally and contains an irritant to deter injecting. Ampoules are designed for injection. Tablets are taken orally though they have been known to be crushed and injected - an extremely dangerous practice.

What are the effects? Methadone has similar effects to heroin (see heroin) though longer acting (24 hours) and less intense. Some users experience an intense allergy like itchiness.

What are the health risks? Methadone is physically addictive and withdrawal is said to be longer and more unpleasant than that of heroin, though tolerance takes longer to develop. Suppressed breathing and cough reflex carry the same risks as heroin and overdose is also common in users who are not used to the drug or have lost their tolerance. The injection or undiluted 50mg ampoules can lead to vein damage and injecting crushed tablets carries serious risk of vein blocking and abscesses. Mixing methadone with alcohol carries increased risks of passing out and, as with heroin, the cough reflex is suppressed leaving the user prone to choking on their own vomit. Methadone is extremely toxic to children.

 

Mephedrone

Other names? M-Cat, MMCAT, MC, mieow, meow, 4MMC, plant fertiliser.

What does the law say? As of April 2010, mephedrone and its related compounds have been defined as class B. Anyone found carrying mephedrone can face up to five years imprisonment and dealers can receive up to 14 years.

Where does it come from? It's a totally manmade chemical related to cathinone, the active drug in the African shrub 'Khat'. There are a number of different variations on the market, including methylone, which has similar effect but is more 'trippy'.

What does it look like? Mephedrone is supplied as a crystalline powder. The colour varies from white or off-white to yellow or brown. Early supplies in the UK tended to be a drier white, fluffy powder but many current supplies are more crystalline. The crystals may have a damp consistency that makes it harder to divide the mephedrone into lines. It may also have an unpleasant smell that's a mixture of crabs or shrimps with a sweeter, coconut smell.

How pure is it? Before mephedrone was classified as a class B drug, retailers claimed it was 95% pure. It's likely that purity levels will now drop rapidly as the remaining stocks decrease.

How is it used? It's snorted or swallowed.

What are the effects? Mephedrone is being used as a stimulant drug because it has similar effects to cocaine, amphetamine (speed) and MDMA (ecstasy). It starts working after about 10 to 20 minutes if snorted or 20 to 40 minutes if it's swallowed. The effects can come on in a head rush and be quite overpowering, causing some people to be or feel sick - this is more likely if you've been drinking or smoking weed. The effects of a single dose can last for at least an hour, although some people report it going on for much longer. It's difficult to give a precise timing because many people who use mephedrone do so regularly throughout the night with some reporting that they loose all sense of time, otherwise known as 'mephedroning'.

As with other stimulants like ecstasy, mephedrone can cause jaw clenching and teeth grinding which can damage your teeth. Keep sugar free gum on you and chew it if you start grinding or clenching.

Some say there is a gentle comedown from mephedrone, but most report the usual symptoms of feeling exhausted, depressed, confused and disorientated, with a sore head. You won't be able to sleep properly after mephedrone. It's a good idea to drink a pint of water before you go to bed to help prevent dehydration.

As with any drug, the exact effects vary from person to person and depend on:

  • how much you take
  • the purity (or adulterants)
  • how often you take it
  • what other drug you take with it
  • how you take it (snorting, swallowing)
  • your mood, who you're with and where you are

What are the health risks? The biggest risk of mephedrone is heart failure, so those with existing heart problems or high blood pressure should avoid use altogether, as should anybody on prescribed medication as some of these may interact badly with mephedrone. Drugs such as ecstasy can also occasionally cause death because of a direct toxic (poisonous) effect on the body, so it is likely this will also apply to mephedrone.

Is mephedrone addictive? Most people who use mephedrone use it on an occasional basis, although, like with any drug, it seems that some use it daily and pick up a mephedrone habit. It's not thought that mephedrone has a physical withdrawal, but as yet we don't know much about the long-term use of mephedrone. If you're experiencing problems controlling or stopping your use please contact us.

How can you reduce the risks? Mephedrone is not a 'safe' drug. There's a level of risk with any relatively unknown substance. And from what is known of it so far, there's a significant level of risk and so mephedrone should be treated with great caution. The risks will almost certainly be greater where large doses are used, the drug is used for extended periods of time, or mephedrone is combined with other drugs - especially other stimulants or drugs that elevate serotonin or dopamine. Even when used with care and at moderate doses, some experienced users are reporting negative symptoms.

 

Over-the-counter drugs

What does the law say? Legal substances.

What are the most commonly misused? The most commonly misused over-the-counter drugs are Codeine-based painkillers and cough and/or cold mixtures. The top five misused medications in the South East of England are:

  • Nurofen Plus
  • Co-codamol
  • Solpadiene
  • Syndol
  • Paracodol

What are the effects? Reports indicate that abuse of these products mimics the classic symptoms of a clinical drug addiction, with both physical and psychological effects. Not all are dependent on regularly taking large daily quantities of their specific drug. Many reported that they have become dependent on having to take a daily amount which is under the maximum daily recommended dosage, but have a history of having done so over many years. Reports also indicate that the majority have become unintentionally addicted to their specific over-the-counter product, having first bought the product to treat a legitimate physical complaint and are completely unaware that the product had any addictive properties. The table below shows the three main types of effect and the ingredients that may cause them.

DEPRESSANTS STIMULANTS SEDATIVES
Effect Mild euphoria, relaxation detachment, decreased heart rate and blood pressure, increased effects of alcohol, often physically addictive Excitement, alertness, possible agitation and anxiety, increased heart rate and blood pressure Sleepiness/drowsiness (even at normal dosages), increased effects of alcohol
Active ingredients Morphine, Tincture of Opium, Codeine, Codeine Phosphate Dihydrocodeine Tartrate, Dextromethorphan Ephedrine Hydrochloride, Pseudoephedrine Hydrochloride, Caffeine, Phenylpropanolamine, Phenylephrine Diphenhydramine Hydrochloride, Promethazine Hydrochloride, Diphenhydramine, Doxylamine, Chlorpheniramine, Cyclizine
Used in Cough/cold linctuses, painkiller analgesic capsules, diarrhoea preparations Cough/cold treatments, decongestants - especially those marketed as 'non-drowsy' Anti-histamines, cough/cold treatments, some night time sleep aids
Example products Nurofen Plus, Paracodol, Feminax, Syndol Actifed Expectorant, Sinutab, Sudafed Piriton, Night Nurse, Benylin, Contac 400

 

Volatile substances

Types of substances? Gas, glue, lighter fuel, thinners, chroming, petrol, solvents, hairspray, butane, all aerosols.

What does the law say? Using these substances is not prohibited by law. The law treats some solvents like alcohol, putting the responsibility onto the vendor to decide if the products are going to be used for intoxicating purposes. However, it is an offence to knowingly sell lighter fuel to persons under 18 regardless of the belief about the person's intent.

Where do they come from? Any number of household materials can be deliberately inhaled to induce intoxicating effects. Broadly speaking they are likely to contain either BUTANE or TOLUENE, though a number of other chemicals can be effective.

What do they look like? Depends largely on the packaging of the product. Ones to look out for most are liquid butane refills for cigarette lighters, often in small yellow or tall white and red cans.

How pure are they? With lighter fuel, Butane is both the fuel and the expellant so represents a pure source. With other substances, the chemical is mixed with any number of other chemicals depending on the product. Toluene is the substance in glue that keeps it liquefied.

How are they used? Solid substances such as glue are usually placed in a bag, placed over the nose and mouth and the vapours are inhaled. Liquids are placed on material such as a cuff or a handkerchief and fumes are inhaled through the mouth. Gas products are inhaled after being sprayed into a closed room or, far more dangerously, directly into the mouth.

What are the effects? The onset of effects is almost immediate and has been described as very like being extremely drunk i.e. lack of co-ordination, dizziness and disorientation. Nausea is not uncommon. With further use, the user may experience auditory and visual hallucinations, which might be very vivid indeed. Experiences can vary widely and effects are largely unpredictable. Often after the effects have worn off (between 15 - 45 minutes) users can experience a 'hangover' effect i.e. headache, neck stiffness and chest pains.

What are the health risks? These substances are a massive health threat - especially to young people, who tend to be the most common users. At least one person dies from volatile substance misuse in the UK every week and many are first time users. Death or serious injury is usually due to one of the following:

  • Toxic reaction
  • Heart failure (especially after physical exertion soon after use) - Palpitations and Arrhythmia are common
  • Suffocation/Asphyxiation - butane inhaled into the mouth can cause swelling of the trachea
  • Unconsciousness and vomiting - choking on own vomit
  • Volatile substances can damage the liver, lungs and kidneys and there is evidence that they impair brain function, especially memory and concentration abilities.

How can you reduce the risks? There is no safe way to inhale chemicals and the risks are as high for those sniffing for the first time, as they are for someone who has been sniffing for many years.

  • Don't sniff alone or in hard to reach areas such as derelict land or canal paths. If a problem does occur e.g. the user slips into unconsciousness (there is also a danger of choking on their own vomit) or has an accident due to their intoxication, help will be unavailable or take a long time to arrive.
  • People should learn the recovery position so they can stop unconscious friends choking.
  • Volatile substance use, especially followed by exertion e.g. being chased, can cause an abnormal heart rhythm due to the heart becoming over sensitive to the increased adrenaline. This can result in Sudden Sniffing Death Syndrome. Don't excite a volatile substance user by chasing them.
  • Volatile substances should not be sprayed directly into the throat as this can cause the tissue to freeze and swell, in turn causing suffocation.
  • Some users place a plastic bag over their head - this is extremely dangerous as suffocation and asphyxiation can occur. Never use this method if you are on your own.
  • Volatile substances are flammable so users should not go near naked flames such as cigarette lighters.
 

How to get some help

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