Introduction
A drug is a chemical substance that acts on the brain and nervous system, changing a person’s mood, emotion or state of consciousness.
Drugs are often classified by the effect they have.
- Stimulants, such as cocaine, make people feel full of energy.
- Depressants (or sedatives), such as heroin, make people feel relaxed.
- Hallucinogens, such as LSD, make people see, feel or hear things that are not real.
Drug misuse is when a person regularly takes one or more drugs to change their mood, emotion or state of consciousness.
Addiction
- Physical addiction, when there are withdrawal symptoms, such as nausea, vomiting or cramping, if the supply of the drug is suddenly withdrawn.
- Psychological addiction, when there is a psychological compulsion or need to regularly use a drug. If the drug is withdrawn, there are no physical symptoms but there may be psychological symptoms such as depression, anxiety and irritability.
Legal drugs
Under British law, most drugs are illegal. However, some drugs are legal, including:
- caffeine
- alcohol
- cigarettes
If a drug is legal, that does not mean it is harmless. In England each year, cigarettes and alcohol kill more people than all illegal drugs put together.
Prescription medication, such as strong painkillers or tranquillisers, is often misused by people who have no clinical need for it but use it for its mood-altering effects.
In many cases, it is illegal to posses certain types of prescription medication, such as morphine or methadone, without a valid prescription.
Risks to health
As well as the danger of addiction, drug misuse has serious health risks and is associated with a wide range of conditions and complications, both physical and psychological.
For example, cocaine can cause heart failure and heroin can cause respiratory failure (loss of normal lung function), both of which can be fatal. Each year in England and Wales, an estimated 2,000 deaths are caused by illegal drug abuse.
If a person uses a needle to inject drugs, they have a high risk of catching a serious blood-borne infection, such as HIV or hepatitis C.
The Department of Health estimates that, in England, 90% of all cases of hepatitis C and 6% of all HIV cases are caused by injecting drugs.
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Facts
Drugs and the law
In Wales, the Misuse of Drugs Act is the main law that covers illegal drugs.
Under the terms of the Misuse of Drugs Act, drugs are classified as A, B or C, with class A being the most dangerous and class C being the least dangerous (although class C drugs can still pose a serious risk to your health).
Examples of class A drugs include:
- heroin
- cocaine, and
- ecstasy.
Examples of class B drugs include:
- cannabis,
- most amphetamines (see below for more information), and
- barbiturates.
Examples of class C drugs include:
- ketamine
- gammahydroxybutrate (GBH), and
- tranquillisers.
The following activities are offences under the Misuse of Drugs Act:
- possessing a controlled substance (a controlled substance can either be an illegal drug or a prescription drug, such as morphine, for which you do not have a valid prescription),
- possessing a controlled substance with intent to supply,
- supplying or offering to supply a controlled substance (even if you do not ask for any money), and
- allowing a premises you occupy or manage to be used unlawfully for producing or supplying controlled substances.
Penalties
For class A drugs, the penalties are:
- For possession: up to seven years in prison or an unlimited fine, or both.
- For dealing: up to life in prison or an unlimited fine, or both.
For class B drugs, the penalties are:
- For possession: up to five years in prison or an unlimited fine, or both.
- For dealing: up to 14 years in prison or an unlimited fine, or both.
For class C drugs, the penalties are:
- For possession: up to two years in prison or an unlimited fine, or both.
- For dealing: up to 14 years in prison or an unlimited fine, or both.
Driving under the influence of drugs is illegal and carries similar penalties to drink driving.
Pattern of illegal drug misuse in England and Wales
Illegal drug misuse is widespread. The Home Office estimates that:
- one in three people have used illegal drugs at least once in their life,
- one in 10 people have used illegal drugs in the last year, and
- one in 20 people have used illegal drugs in the last month.
The most commonly misused illegal drugs are outlined below.
Cannabis
Cannabis comes from a plant that is found in most parts of the world. It is a class B drug and it comes in two forms:
- Herbal cannabis (often known as weed or grass) is made up of the dried leaves and buds of the cannabis plant.
- Cannabis resin (often known as gear or hash) is a brown or black lump of resin that is taken from the cannabis plant.
Cannabis is usually smoked, either mixed with tobacco in a hand-rolled cigarette (joint) or by itself in a pipe.
Using cannabis can make you feel relaxed and happy and many users feel that they have a heightened sense of awareness. Adverse reactions associated with cannabis use include:
Amphetamines
Amphetamines are a group of synthetic (artificial) drugs that are powerful stimulants. They are often known as speed, billy or wizz.
Amphetamines usually come as a powder, which can be snorted through the nose, rubbed into the gums or wrapped in a cigarette paper and swallowed (speedbomb).
Some amphetamines are available in tablet form. There is also a very strong smokeable form of amphetamine known as crystal meth. Amphetamines can be injected.
Shortly after taking amphetamines, you will experience a rush (a sudden energy boost) and feel very energetic, talkative and excited. This rush, or high, will usually last between four and eight hours, depending on the amount of amphetamines taken.
Once the effects of the amphetamines have worn off, you will experience what is known as a crash, or comedown, and will feel:
- very tired but unable to sleep,
- anxious,
- irritable, and
- depressed.
These effects can last for several days.
Most amphetamines are class B. Crystal meth and amphetamines that have been prepared for injection are class A.
Cocaine
Cocaine is a stimulant that is extracted from the coca plant. It is often known as coke or charlie.
Cocaine comes in powder form and can be snorted or rubbed into the gums. There is a form of smokable cocaine that is often called crack. Crack is also known as rocks or base.
People who take cocaine will experience an intense feeling of wellbeing, self-confidence and energy. These feelings may only last for 20 to 30 minutes, which often leads people to take more cocaine.
The effects of crack are more intense than cocaine, but they do not last as long. Typically, a crack high will only last for 10 minutes.
Once a person has used up their supply of cocaine or crack, their high will soon end and they may feel very depressed, tired and paranoid.
Both cocaine and crack are class A drugs.
Ecstasy
Ecstasy is a class A drug. It is a synthetic (artificial) stimulant that is popular among clubbers. The chemical name is methylenedioxymethamphetamine (MDMA). Ecstasy is often known as pills or E.
Ecstasy usually comes as a tablet. Less commonly, a powdered form of MDMA used.
People who take ecstasy often experience a rush of energy that makes them feel alert, excited and happy. Sound, particularly music, and colours seem more intense and many people feel an increased sense of affection for people around them.
The ecstasy high usually lasts three to six hours, after which it is replaced by a comedown similar to that experienced after taking cocaine or amphetamines.
Hallucinogens
In England, the two most commonly used hallucinogens are:
- magic mushrooms, and
- lysergic acid diethylamide (LSD).
Magic mushrooms grow in the wild and have hallucinogenic properties. They are sometimes known as shrooms or mushies.
Magic mushrooms can either be eaten or boiled in liquid, which is then drunk.
LSD is a synthetic (artificial) liquid that is usually dropped on to small squares of blotting paper, which are then swallowed. LSD is often known as acid.
The effects of magic mushrooms and LSD are similar, but LSD tends to cause more intense, longer-lasting effects.
People who take magic mushrooms or LSD will experience a long-lasting series of hallucinations, known as a trip.
During a trip, sounds and colours can become distorted, emotions can become heightened and time can appear to both speed up and slow down.
A magic mushroom trip tends to last between four and 10 hours. An LSD trip lasts for about 12 hours.
Some people who take hallucinogens experience frightening and disturbing hallucinations. This is known as a bad trip. Bad trips can be intensely unpleasant.
Both magic mushrooms and LSD are class A drugs.
Tranquillisers
Tranquillisers are class C drugs. They are prescription medication designed to treat anxiety, depression and insomnia.
Many people misuse tranquillisers to lessen the effects of a comedown after taking stimulants as they can have a calming and sedating effect. Alternatively, some people may use them to ease drug withdrawal symptoms.
Tranquillisers come as tablets, gel capsules, in injection form and as suppositories (tablets that you insert into the anus).
Tranquillisers are often known as mazzies, benzos or jellies.
It is possible to accidentally overdose on tranquillisers, particularly if they are taken with alcohol.
Solvents
Solvents are household chemicals. Some people, particularly teenagers, abuse them by sniffing the fumes they give off.
There are over 200 different types of solvent. Some common household solvents include:
- glue,
- hairspray,
- lighter re-fillers,
- paint,
- deodorants, and
- cleaning fluids.
When inhaled, solvents have an effect that is similar to being drunk, such as feeling giddy, uninhibited and giggly.
Solvent abuse is potentially very dangerous because it can cause heart failure.
Although solvents are not illegal, it is illegal to sell certain solvent products to people under 18.
Ketamine
Ketamine is a class C drug and a powerful synthetic anaesthetic. It comes in a powdered form that can be snorted or as a liquid that can be injected. It is often known as special K or vitamin K.
People who use ketamine experience LSD-like hallucinations and often report feeling that their mind is floating outside their body.
Ketamine abuse has been linked to an increased risk of depression, panic attacks and bladder problems, such as having to pass urine every 15 minutes.
Heroin
Heroin is a class A drug. It is a powerful painkiller and sedative that is derived from the opium poppy. Drugs, such as heroin and codeine, that are derived from the opium poppy are called opiates.
Heroin comes as a powder and can be smoked or dissolved in water and injected. It is often known as brown, smack or skag.
People who use heroin experience an intense feeling of relaxation and wellbeing. Heroin is highly addictive, both physically and psychologically.
Heroin carries a high risk of overdose. This is because the purity of heroin can vary dramatically between different batches of the drug, so people often take a stronger dose of heroin than their body can cope with.
Other drugs
For more information about drugs that are not included in this section, visit the FRANK website.
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Risks
Risks of drugs misuse
Drug misuse can be dangerous for three main reasons:
- you could become addicted to the drug,
- the drug could cause physical and psychological harm, and
- drug abuse can have a negative effect on your quality of life.
Addiction
How addictive a drug is likely to be is determined by two things:
- how pleasurable taking the drug is, and
- how quickly the drug reaches your brain.
Drugs that are smoked, injected or snorted can reach the brain very quickly and are usually more addictive than drugs that are swallowed.
In 2007, the medical journal The Lancet commissioned a number of drug experts to asses how potentially addictive the most popular illegal drugs are. The results, in order of addictiveness with the most addictive at the top, were:
- Heroin.
- Cocaine.
- Tranquillisers.
- Amphetamines.
- Ketamine.
- Cannabis.
- Hallucinogens.
- Ecstasy.
Physical and psychological harm
Cannabis
The short-term effects of cannabis include:
- dizziness and sickness,
- dry mouth, lips and tongue,
- panic and paranoia (when you are suspicious of people and situations),
- feeling hungry, and
- loss of co-ordination.
Long-term effects of regular cannabis use include:
- lung disease and lung cancer,
- respiratory problems, such as bronchitis and asthma,
- high blood pressure (hypertension), and
- infertility.
There is some evidence that long-term cannabis use can increase your risk of mental health conditions, such as depression and schizophrenia.
Amphetamines
Amphetamine use can lead to:
- short-term dizziness,
- hallucinations,
- burst blood vessels that, in very rare cases, can lead to paralysis (muscle weakness) and may be fatal,
- insomnia, and
- depression.
As your body becomes more tolerant to the drug, larger amounts are needed to get the same effect. This increases both the risks to your health and the chance of becoming addicted.
Cocaine and crack
Cocaine raises blood pressure, causes the heart to beat irregularly and increases body temperature. As well as causing heart failure when taken in large doses, the long-term use of cocaine can lead to:
- depression,
- insomnia,
- extreme paranoia,
- extreme weight loss and malnutrition,
- impotence in men, and
- serious damage to the nasal passages.
Because cocaine is so addictive, users experience withdrawal symptoms, such as intense irritability and restlessness, if they go for longer than usual without taking it. This period of time becomes shorter and shorter as the body becomes more tolerant to the drug, and larger quantities are required to experience a high. As the effects of the drug wear off, users will get symptoms such as exhaustion and depression.
Women who use cocaine while pregnant put the health of their baby at risk because the drug can cause low birth weight and birth defects. Their baby may also be born addicted to cocaine.
Ecstasy
Very few ecstasy tablets are pure ecstasy. Most contain other substances, such as talcum powder. Some ecstasy tablets have even been found to contain dog-worming medicine. More dangerous substances, including anaesthetics and tranquillisers (such as ketamine), may also be added to ecstasy tablets.
Dehydration is a major risk when taking ecstasy. Ecstasy raises your body’s temperature and the amphetamine contained in each tablet encourages you to behave energetically for long periods of time, for example by dancing in a club all night.
If your fluid levels drop dramatically, dehydration can cause unconsciousness, coma and even death. In England and Wales, there are an average of 27 deaths a year from people taking ecstasy.
If you take large amounts of ecstasy, you may experience feelings of anxiety, panic and confusion and it can be difficult for other people to calm you down. Other unpleasant side effects include:
- dry mouth,
- nausea,
- raised blood pressure, and
- depression.
Some users say that their body stiffens after taking ecstasy, often causing them to clench their jaw and grind their teeth. Another common symptom is an increased heart rate, which can feel like your heart is pounding or hammering in your chest.
The use of ecstasy became widespread during the late 1980s, so it is too early to know whether regular users, or those who used to use the drug regularly, will experience long-term side effects.
Tranquillisers
Many tranquillisers are addictive if they are used regularly. Tranquillisers are physically addictive, so you may have withdrawal symptoms if your supply is stopped suddenly.
Withdrawal symptoms can include:
- severe headache,
- nausea,
- anxiety, and
- confusion.
Some people who abuse tranquillisers try to inject crushed-up tablets or melted-down gel capsules to increase the potency of the drug.
This can be very dangerous because the chalk contained in many tablets can cause veins to collapse. This can lead to serious infections and, in the most extreme cases, the death of tissue (gangrene). Gel capsules that are melted down can sometimes solidify inside blood vessels, which can be fatal.
Solvents
Many solvents contain chemicals that have a toxic effect on the body, particularly the heart.
Every time you sniff a solvent, you are at risk of having a heart attack, which may be fatal. In the UK, there are an average of 50 deaths a year from solvent abuse.
Other adverse effects of solvent abuse include:
- vomiting,
- blackouts, and
- in the case of long-term abuse, liver, kidney and brain damage.
Ketamine
Ketamine is a powerful anaesthetic. It is possible to badly injure yourself during a ketamine high without realising it as you will not feel any pain.
Mixing ketamine with stimulants, such as ecstasy or amphetamine, can cause a dangerous rise in your blood pressure.
High doses of ketamine can suppress your normal brain and breathing functions and can cause you to become unconscious. Once unconscious, there is a risk that you will choke on your own vomit.
There is an increasing amount of evidence that long-term ketamine misuse can cause serious damage to your kidneys and bladder. This can lead to a range of unpleasant symptoms, such as:
- a frequent urge to urinate,
- pain when urinating,
- urinary incontinence, and
- blood in your urine.
Hallucinogens
Hallucinogens are very unpredictable and it is possible to have a ‘bad trip’ even if all your previous trips have been enjoyable. A bad trip can feel like being trapped in a nightmare.
There is a risk that somebody may act irrationality or impulsively during a trip and place themselves in physical danger, for example by suddenly running into a busy road.
While hallucinogens are not thought to cause mental heath problems, they could make an existing mental health condition more severe.
With magic mushrooms, there is a risk that you or your supplier may mistake poisonous mushrooms for magic mushrooms. Mushroom poisoning can be very serious and is often fatal.
Heroin
Most heroin that is bought on the street is only 10–60% pure. It is usually mixed with other substances to increase the quantity and to make it more profitable. It is often the substances that are used to bulk up heroin that are the most harmful, causing allergic or toxic reactions. Users can never be sure that the heroin they buy has not been mixed with dangerous substances.
Because it is impossible to know how pure heroin is, it is easy for the user to take an overdose. Overdosing on heroin can cause heart failure, unconsciousness and coma. There is also a risk that the user will choke on their own vomit if they are sick while unconscious.
Injecting heroin has additional risks. Sharing needles increases the risk of contracting serious diseases, such as hepatitis C and HIV. Long-term injecting may cause damage to veins, serious infections, such as abscesses (pus-filled swellings), and severe constipation.
The wider impact of drug misuse
As well as the impact on your health, drug misuse can have a negative effect on your quality of life and relationships with others.
Many drug abusers find that they lose touch with their family and friends or that their family and friends lose patience with them due to their unreasonable behaviour.
Hobbies, interests and ambitions can be forgotten as drugs become more and more important. It can become increasingly difficult to hold down a job if you have a drug problem.
People with a serious drug addiction, such as a heroin, cocaine or crack addiction, often resort to desperate, illegal and dangerous activities to find money to pay for their drugs. Examples include:
- begging,
- burglary,
- shop-lifting,
- street crime, such as mugging or bag snatching, and
- prostitution.
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Recovery
There are two types of treatment for drug misuse:
- pharmacological treatment, where medication is used to ease drug withdrawal symptoms, and
- psychological treatment, where a range of different therapies are used to help you stay off drugs.
Pharmacological treatments
Pharmacological treatments are only available for people with a heroin or tranquilliser addiction. There are currently no pharmacological treatments for other types of drug.
Heroin
If you have a heroin addiction, there are two different medications that can ease your withdrawal symptoms. These are:
- methadone, and
- buprenorphine.
Both medications are synthetic (artificial) opiates that replicate some of the effects of heroin on the brain. The brain is ‘tricked’ into thinking that it is receiving a dose of heroin, so you do not have withdrawal symptoms.
Methadone and buprenorphine can be used in two ways:
- withdrawal therapy, where the doses of medication are gradually reduced over time before the treatment is withdrawn, and
- maintenance therapy, where you receive regular doses of medication on a long-term basis.
Many people choose to have maintenance therapy for several months so that their health and general wellbeing can improve. Once they are physically and psychologically stronger, they choose to withdraw from the treatment.
Because there is a possibility that a person may not use the medication as directed (for example, by selling their methadone to others), you may have to take the medication under supervision. You may also be required to have regular urine tests to check that you are not taking heroin.
Naltrexone
Naltrexone is a medication that can be used when you have not taken heroin for several weeks but are worried that you may relapse and take heroin again.
Naltrexone blocks the effects of heroin on your brain, so even if you take heroin you will not experience a high.
Tranquillisers
Depending on how addicted you are, you may be prescribed a course of tranquillisers to ease your withdrawal symptoms. The dose will gradually be reduced over time until treatment is withdrawn.
Psychological treatments
Self-help groups
Many people who have a drug misuse problem join a self-help group, such as Narcotics Anonymous.
Most of these groups are based on a 12-step programme to overcome addiction (created by Alcoholics Anonymous), which includes the following points:
- You admit that you are unable to control your addiction or compulsion.
- You recognise that you need a power greater than yourself to restore your strength.
- You examine past errors in your life with the help of a sponsor (an experienced member of the group).
- You make amends for those errors.
- You learn to live a new life with a new code of behaviour.
- You help others who have the same addiction or compulsion.
Contingency management
Contingency management uses a series of techniques to change a person’s behaviour. You will be offered incentives, in the form of shopping vouchers, if you manage not to take drugs.
You may be given a £2 shopping voucher if urine tests show that you have not taken drugs for a week. The longer you stay free from drugs, the more vouchers you will receive.
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