Drug and Drugs Types

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DURG AND DURGS TYPES 2012

NOOR AHMED|M.A FINAL SOCIOLOGY, UNIVERSITY OF PESHAWAR|SESSION 2010-12 Page 1

A substance that has a physiological effect when ingested or otherwise introduced into the body,

in particular.

Nonfood physical material that alters an organism's normal functioning by affecting physiologic

processes. Preferred homeopathic terminology is medicine or remedy rather than drug.

Administer a drug to (someone) in order to induce stupor or insensibility

A drug

Any medicinal substance.

A narcotic.

To administer a drug.

Any substance that can be abused for its stimulant, depressant, euphoric, or hallucinogenic

effects.

NIH speak Any chemical compound that may be used on or administered to humans to help

diagnose, treat, cure, mitigate, or prevent disease or other abnormal conditions Regulatory


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definition An article or substance that is 1. Recognized by the US Pharmacopoeia, National

Formulary, or official Homeopathic Pharmacopoeia, or supplement to any of the above 2.Intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man oranimals 3. Intended to affect the structure or any function of the body of man or animals

Substance abuse Any medication; the word drug also carries a negative connotationimplying

abuse, addiction, or illicit use.

1. Designer drug a new drug of abuse similar in action to an older abused drug and usuallycreated by making a small chemical modification in the older one.

2. Mind-altering drug one that produces an altered state of consciousness.3. No steroidal anti-inflammatory drug (NSAID) any of a large, chemically

heterogeneous group of drugs that inhibit the enzyme cyclooxygenase, resulting in

decreased synthesis of prostaglandin and thromboxane precursors; they have analgesic,

antipyretic, and anti-inflammatory actions.4. Orphan drug one that has limited commercial appeal because of the rarity of the

condition it is used to treat.5. Psychoactive drug, psychotropic drug see under substance also called medicine. Any

substance taken by mouth; injected into a muscle, the skin, a blood vessel, or a cavity of

the body; or applied topically to treat or prevent a disease or condition.

DRUG TERMS,

1. Drug abuse, use of a drug, whether over the counter or prescription, for purposes otherthan those prescribed on the product label, often for recreational reasons.2. Drug action, in homeopathy, consequence of the application of a homoeopathic remedyin a living organism that is different from its potency at a biochemical level.

3. Drug interactions, negative (occasionally positive) health consequences arising from theways in which drugs, herbs, medications, and nutritional supplements interact with eachother when taken concurrently. Such interactions arguably represent the largest risk when

taking multiple medications and/or supplements.

4. Drug picture, a description of the symptoms resulting from a homeopathic remedy.These pictures can be found in the material medical and result from proving when theremedy was given to healthy people. Also called

remedy picture.

5. Drug, no steroidal anti-inflammatory, a family of medications that reduce symptomsassociated with inflammation, such as pain, swelling, and stiffness. It can also be used totreat other painful conditions like gout, tendonitis, bursitis, sprains, or menstrual cramps.

Also called

NSAID.6. Drugs, antiviral, a class of drugs used to combat illnesses, such as HIV, that are caused

by viruses.

7. Drugs, standardization of,
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1. in pharmacology, the establishment of consistent parameters for a given drug's

synthesis, composition, action, and toxicity.2. in homeopathy, the requirement that homeopathic remedy preparation be consistentwith respect to content and manner of preparation.

8. Drug, a substance used in the prevention, cure, or alleviation of disease or pain or as anaid in some diagnostic procedures..

9. Drug abuse, an excessive or improper use of drugs, especially through self-administration for nonmedical purposes. This term has increased significance because of

the enactment of the Comprehensive Drug Abuse Prevention and Control Act of 1970,which replaces the Harrison Narcotic Act. See also substance abuse.

10.Drug combinations, the use of drugs together to enhance the properties of both to thebenefit of the patient.

11.Drug dependence, a physical or psychological state in which a person displayswithdrawal symptoms if drug use is halted suddenly; can lead to addiction.

12.Drug Enforcement Administration (DEA), the federal agency charged with monitoringuse and abuse of narcotics. It provides the drug schedules used to determine the addiction

potential of dental drugs.13.Drug hypersensitivity, an allergic reaction that occurs after exposure to a suspect

medication. It may manifest with a fever or rash and in severe cases, organ damage or

death. It is classified as (1) immediate or occurring rapidly after exposure, or (2) delayedor occurring several days after exposure.

14.Drug idiosyncrasy an adverse drug reaction that occurs in a small number of persons andpresents no correlation to dosage or means of therapy.

15.Drug interaction, a modification of the effect of a drug when administered with anotherdrug. The effect may be an increase or a decrease in the action of either substance, or it

may be an adverse effect that is not normally associated with either drug.

16.Drug resistance, the capacity of a microorganism to build a tolerance to a drug.17.Drug stability, the length of time a drug retains its properties without loss of potency;usually referred to as shelf life.18.Drug therapy, the use of a drug in the treatment of a patient with a specific disease or

illness.

19.Drug tolerance, the body's ability to increasingly withstand the effects of the substancebeing used, thereby requiring larger quantities of said substance in order to bring about

the desired result.20.Drug toxicity, the critical or lethal reaction to an erroneous dosage of a medication.

Drug toxicity may occur due to human error or intentional overdose in the case of suicide

or homicide.

21.Drugs, antibiotic, the chemical compounds obtained from certain living cells of lowerplant forms, such as bacteria, yeasts, and molds, and from synthesis. They areantagonistic to certain pathogenic organisms and have a lethal effect on them.

22.Drugs, antimicrobial, the drugs, mainly penicillin and its derivatives, used to combatviral, fungal, and parasitic infections.

23.Drugs, antiseptic, the chemical compounds used to reduce the number ofmicroorganisms in the oral cavity.

24.Drugs, autonomic, the drugs that mimic or block the effects of stimulation of theautonomic nervous system.


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25.Drugs, desensitizing, the agents used to diminish or eliminate sensitivity of teeth,especially the dentin, to physical, chemical, thermal, or other irritants (e.g., strontiumchloride, silver ammonia Cal] or potassium nitrate, sodium fluoride, formalin, zincchloride). See hypersensitivity, dentin.

26.Drugs, endodontic, the drugs used in treating the dental pulp and dental periapicaltissues.

27.Drugs, nonofficial, the drugs that are not listed in the United States Pharmacopeia(U.S.P.) or the National Formulary (N.F.).

28.Drugs, official, the drugs listed in the U.S.P. or N.F.29.Drugs, officinal drugs that may be purchased without a prescription. More commonly

called over-the-counter (OTC) drugs.

30.Drugs, over-the-counter (OTC), the drugs that may be purchased without a prescription.Sometimes called nonlegend drugs because the label does not bear the prescriptionlegend required on all drugs that may be dispensed only on prescription.

31.Drugs, parasympathetic the belladonna alkaloids that inhibit glandular secretions of thenose, oral cavity, pharynx, and bronchi. This is the main reason for using atropine and

scopolamine for preanesthetic or preprocedural medication.32.Drugs, Para sympatholytic the drugs that block nerve impulses passing from

parasympathetic nerve fibers to postganglionic neuroeffectors.

33.Drugs, Para sympathomimetic the drugs that have an effect similar to that producedwhen the parasympathetic nerves are stimulated.

34.Drugs, proprietary the drugs that are patented or controlled by a private organization ormanufacturer.

35.Drugs, psychoactive the drugs or other agents that have the capacity to become habitforming because of their influence on mood, behavior, or conscious thought; may be

therapeutic or recreational.

36.Drugs, sympathetic, the agents that imitate the sympathetic autonomic nervous systemactions. They usually cause raised levels of alertness and anxiety. Various types are usedin dentistry as vasoconstricters in conjunction with local anesthetics. See also adrenergic

agents

1. STIMULANTSStimulants are drugs that stimulate the Central Nervous System. These substances tend to

increase alertness and physical activity. They include Amphetamines, Cocaine, Crack and some

inhalants like Amyl or Butyl Nitrites. Caffeine (present in tea, coffee and many soft drinks) is

also a mild stimulant drug.

The most widely abused stimulants are cocaine, crack (a pure form of cocaine) and

amphetamines. Cocaine has limited commercial use and its sale and possession are strictly

controlled. Nevertheless there is a huge worldwide illicit network for the manufacture and supply
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of this drug in its various forms. Doctors sometimes prescribe pharmaceutical amphetamines and

their availability makes them candidates for misuse but powdered amphetamine, manufactured in

illicit laboratories, is the most common type of amphetamine to be abused in the UK. Inhalants

such as amyl and butyl nitrates are legal at present. Because of their very short action time - the

effect lasts approximately 1-2 minutes - they are usually only abused in certain settings, such as

parties etc.

Stimulants appear in many forms. Pharmaceutical amphetamines are usually produced as pills or

capsules, whereas street amphetamines come in the form of a fine, white dull powder. Inhalants

can be prescribed or purchased in small glass vials which are crushed to release the vaporising

fluid inside, or in small bottles. Cocaine is a relatively fine, white crystalline powder. Crack is

seen as cloudy white crystals that are irregular and fairly large (pea-sized).

Different stimulants act on the body in different ways. For example, nitrate inhalants cause the

blood vessels to dilate (widen); cocaine and crack interfere with normal levels of the

neurotransmitter serotin; amphetamines cause the release of adrenalin. Nevertheless, broadly

speaking all these stimulants have a similar effect in that they cause either mental and/or physical

stimulation in the user. This may be felt as apparent increased physical energy and/or apparent

clarity and speed of thought.

A note on caffeine Caffeine is a mild stimulant that has the effect of making a person feel more

awake and alert. Tea, coffee and soft drinks are the three major sources of caffeine, although it

can also be purchased in tablet form. Each cup of coffee can provide approximately between


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65mg to 115mg of caffeine, a cup of tea usually has about 60mg of caffeine in it and a soft drink

contains between 30mg and 60mg of caffeine. Too much caffeine can cause anxiousness,

headaches, the 'jitters' and may prevent sleep. Caffeine is also addictive and a person who

abruptly stops drinking coffee may experience withdrawal symptoms.

2. DEPRESSANTSThese are substances that slow down or depress the Central Nervous System. Depressant drugs

include alcohol, barbiturates and tranquillisers. It's worth remembering that, although alcohol is a

legal drug and can be purchased by any person over 18 years old, it can be a dangerous drug,

particularly when abused.

Barbiturates and benzodiazepines are the two major categories of depressant drugs used as

medicines. Often these drugs are referred to as sleeping pills and tranquillisers or sometimes just

as sedatives. Some well-known barbiturates are secobarbital (Seconal) and pentobarbital

(Nembutal). Benzodiazepines commonly in use are Diazepam (Valium), chlordiazepoxide

(Librium) Nitrazepam (Mogodon) and Temazepam.

Alcohol is by far the most commonly abused drug in the UK. Abuse generally takes the form of

under-age drinking, drinking in inappropriate situations, or drinking in excess. Its easy

availablity and social acceptability may have enhanced this state of affairs. Although it is often

perceived as a pleasant social drug (and for some drinkers this is the case), many people become

either psychologically or physically dependent upon it.

Alcohol abuse is directly or indirectly responsible for many deaths through drunken driving,

accidents and illness. It is also a major contributing factor in most incidents of domestic and

other violence.

Barbiturates used to be common drugs of abuse in the 1950's and 1960's but because of their

addictive properties and association with suicides and accidental deaths, their use as medicines

has been reduced significantly since the 1970's. The illicit market in these drugs has become

smaller because of their reduced availablity.

Unfortunately, benzodiazepines - which were originally developed to provide a safe alternative

to barbiturates for the treatment of anxiety and insomnia - have now become a major category of

abused drugs. Vallium, Librium and Temazepam are the most commonly abused tranquillisers

and are often taken with alcohol as these two types of drug amplify each others effect.


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then injected, although it can be smoked. Most street preparations of heroin are diluted, or 'cut'

with other substances such as lactose or quinine.

Other analgesics, including all synthetics, come in a variety of forms including capsules, tablets,

syrups, solutions and suppositories.

Opiate and synthetic analgesics tend to relax the user. When they are injected, the user feels an

immediate 'rush' - that is a strong wave of pleasurable relaxation and relief from anxiety.

Unpleasant effects may include restlessness, nausea, and vomiting. The user may go 'on the nod'

-going back and forth from feeling alert to drowsy. With large doses, the user cannot be

awakened and the skin becomes cold, moist and bluish in color. Breathing slows down and death

may occur.

Where analgesics are taken as a syrup, tablets or capsules etc. the effects are similar to that after

injection but are milder and without any immediate 'rush'.

4. HALLUCINOGENSHallucinogens - or psychedelics - are drugs that affect a person's perception of sights, sounds,

touch, smell etc. Some of the stronger hallucenogenics can exert a powerful effect on a drug

users thinking and self-awareness.

A few hallucinogens come from natural sources, such as mescaline from the peyote cactus and

psilocybin, which is the hallucinogenic agent in so-called magic mushrooms. Others, such as

LSD, MDA (methylenedioxyamphetamine) and Ecstasy (methylenedioxymethamphetamine - or

MDMA) are either entirely synthetic or semi-synthetic. For example, LSD is derived from a

fungus that grows on rye grains but requires very substantial chemical processing to produce.

Hallucinogens do not have any legal medicinal uses and are therefore all classed as drugs of

abuse. The most commonly seen are LSD, Ecstasy and psilocybin (magic mushrooms). Other

hallucinogenic substances such as mescaline and DMT are not widely available in the illicit drug

market of the UK.

Some of the naturally occuring hallucinogenic materials are most commonly seen either in their

natural state or after minimal processing, such as drying. This includes all varieties of

hallucinogenic fungi.

Where natural materials have been refined to a large degree, such as in the production of

mescaline, the end product can take a variety of forms, including liquid, tablet or capsule.


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Synthetic or semi-synthetic hallucinogens are produced as tablets, capsules or liquids (dropped

on blotting paper, sugar cubes or gelatine sheets). When produced in tablet form, LSD - and

particularly Ecstasy - are often manufactured with a coloured or impressed logo upon them. This

can take the form of a cartoon character etc. - the better to appeal to young people. What are the

effects of hallucinogens? The effects of hallucinogens vary a great deal according to their

strength. Psilocybin for example is a relatively mild hallucinogen and its effects are usually

confined to relaxation, a sense of well-being and mild visual distortion of colour and distance.

LSD, in contrast, is far more potent (about 100 times stronger) and its effects can include very

vivid visual and audible hallucinations - almost literally an out of body experience - combined

with distortion of time, distance and personal integrity. This can be terrifying, as a user will be

unable to control his or her thought processes and any unpleasant aspects of the 'trip' can lead to

intense fear, anxiety and even psychosis. Hallucinogens such as MDA or MDMA (Ecstasy) are

midway between these two extremes in terms of potency. Some distortion of vision andperception may occur but not in the intense and uncontrollable manner as can happen with LSD.

5. ALCOHOLAlcohol is the common name for ethyl alcohol. It's a Central Nervous System depressant and is

one of the most widely used (and abused) drugs in our society. It's produced by the fermentation

of fruits, vegetables or grains by yeasts which converts the carbohydrates (sugars) of these plants

to ethyl alcohol. Alcoholic drinks consist mainly of various strength mixtures of water and ethyl

alcohol.

MEDICINAL USES

Alcohol is sometimes used as an external local anaesthetic and sterilising agent.

Alcohol depresses parts of the central nervous system - it slows down some of our brain

functions. Various parts of the central nervous system are depressed by alcohol, with all sorts of

consequences. For example, when the brain's speech centres are inhibited, this causes slurred

speech; when the vision centres are affected this produces distorted vision; when the co-

ordination centres are depressed this results in loss of balance and limb control.

The strong depressant effect of alcohol lasts for a few hours after drinking, but alcohol also

produces a weaker agitation (or irritation) of the nervous system that lasts much longer. This is

the cause of the "morning after" hangover and shakiness. It's due to the irritation of the nervous

system by alcohol drunk many hours before.


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This effect often leads heavy evening drinkers to drink again the next morning, as the (very

uncomfortable) agitation can be temporarily overcome by drinking more alcohol. Thus, a vicious

circle is set in motion, which can play a large part in alcoholic drinking patterns.

What effect does it have? The impact of drinking alcohol depends on the state of the brain at thetime, and this in turn depends on the drinking environment. In a quiet environment (little brain

activity), perhaps at home in an armchair, an alcohol user will experience relaxation or

drowsiness at low to moderate doses.

In a social setting, with lots of sights, sounds and social interaction (lots of brain activity) low

doses of alcohol may feel stimulating. This is caused by depression of the higher brain centres,

which produces apparent stimulation by reducing anxiety and self-consciousness. A drinker may

become more talkative than normal and demonstrate increased self-confidence and loss of self-

restraint. So alcohol can feel like a stimulant - but it's not - these effects are a result of theinhibition of normal brain activity.

As the alcohol dose is increased, significant depression of brain activity can result in slurred

speech, loss of limb co-ordination and loss of emotional control. High doses of alcohol can

inhibit vital brain functions - this can produce deep sedation and slow down the breathing rate,

which can result in coma or death.

Alcohol intake is measured in units. One unit is is roughly equal to half a pint of normal strength

beer/lager/cider, a glass of wine or a pub measure of spirits. The list below shows the effect of

drinking various amounts of alcohol and also indicates blood alcohol concentration (as mg

alcohol per 100ml blood), as this determines whether an offence is committed by driving a motor

vehicle. The current UK alcohol limit for driving is 80mg/100ml.

It's important to remember that the concentration of alcohol in the blood and its effects depend

on a number of factors including body weight, type of drink, drinking environment, previous

exposure to alcohol, stomach contents and sex of the drinker.

Alcohol has its strongest effect on women. This is because women's generally lower body weight

means (for equal amounts drunk) they take in more alcohol per pound weight and also, as the

female body contains less blood volume, the same amount drunk will produce a higher blood

alcohol concentration in a woman than in a man.

After 1 to 2 units (0.5 to 1 pint of beer - or 20-50mg/100ml) there is not much effect, beside a

slight intensification of mood. After 3 to 4 units (1.5 to 2 pints of beer - or 50-80mg/100ml)

there is usually a feeling of relaxation and mild sedation. There may be a slight impairment of


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steady movement. This is the legal limit for driving a vehicle, and in fact 4 units of alcohol could

put some people over the 80 mg/100ml legal blood alcohol limit.

After 5 to 6 units (2.5 to 3 pints of beer - or 80-100mg/100ml) there is usually some loss of

physical and mental co-ordination. Judgment and memory may be affected, particularly theability to concentrate.

After 7 to 8 units (3.5 to 4 pints of beer - or 120-200mg/100ml) most people slur their speech and

are likely to have some difficulty in standing or walking. This level of intoxication can result in

irresponsible behavior and euphoria. After drinking 15 to 20 units (7 to 10 pints of beer - or 200-

300mg/100ml) most people will have passed out.

CONSEQUENCES OF ALCOHOL ABUSE

Most people will have some experience with alcohol. Many will experiment and stop, orcontinue to drink casually without significant adverse effects. Some people will use alcohol

regularly, with varying degrees of physical, emotional and social problems. Some will develop a

dependency and be destructive to themselves and others for many years. Some will die - and

some will cause others to die.

As there is no certain way to predict which alcohol drinkers will develop serious problems, all

alcohol use must be considered as potentially dangerous.

ALCOHOL DEPENDENCE

Alcohol drinkers may develop a physical or psychological dependence on alcohol. This can

cause great harm to the drinker, in terms of physical and mental health, financial problems,

employment difficulties etc. In addition, alcohol dependence is likely to cause great distress to

partners, children or other family members, who may be directly or indirectly exposed to the

consequences arising from compulsive alcohol consumption.

Physical dependence is often related to consistently heavy drinking. People who drink on a

regular basis become tolerant to many of the unpleasant effects of alcohol and are able to drink

more before suffering these effects. Many heavy drinkers may not appear to be drunk. Because

they continue to work and socialize reasonably well, harm to their physical health can go

unrecognised until severe damage develops - or until they are unable to drink for some reason

and suddenly experience alcohol withdrawal symptoms. These symptoms range from jumpiness,

sleeplessness, sweating, and poor appetite, to tremors (the "shakes"), convulsions, hallucinations

and sometime death.


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Deaths from suicide, accident and cirrhosis of the liver are very common among heavy drinkers.

Psychological dependence upon alcohol may occur with regular use of even quite small daily

amounts, such as a glass or two of sherry. It can also occur in people who drink alcohol only

under certain conditions, such as before and during social occasions. This form of dependence

results from a craving for alcohol's psychological effects, such as relief from anxiety, although

the drinker may not consume amounts that produce serious intoxication. For psychologically

dependent drinkers, lack of alcohol tends to make them anxious and prone to panic attacks.

DAMAGE TO HEALTH

The UK Government-recommended alcohol limits are presently 28 units per week for men (14

pints of beer) and 21 units per week for women (10.5 pints of beer). Sustained drinking in excess

of this level increases the chance of damaging our health. This can take the form of liver disease,

stomach ulcers, heart and circulation disorders - and in extreme cases brain damage.

25,000 people die in the UK each year from alcohol-related illnesses - this is 50 times the annual

rate of death from all illicit drugs put together!

FAMILY ABUSE

Excessive consumption of alcohol is commonly cited as a reason for difficulties within a family

or within a marriage. These may range from drunken violence directed toward a spouse or

children, to financial problems caused by compulsive purchase of alcohol or otherwise related to

that.

It is difficult to over-emphasize just how much stress a person who abuses alcohol may cause

within his or her immediate family. If a person continues to abuse alcohol over a period of time,

his or her behavior is likely to cause bitterness and resentment among relatives. While family

members may love the alcohol abuser, they are likely to hate his or her behavior. Eventually - the

love dies.

ACCIDENTS

While a person is under the influence of alcohol he or she is far more likely to have an accident

than while sober because alcohol adversely affects judgment and perception. Thirty percent of

vehicle drivers killed in road accidents within the UK were found to have been drinking alcohol

beforehand. Many of those who died in such a manner may well have caused the death or injury

of other road users. What a waste.


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6. AMPHETAMINESAmphetamine, dextroamphetamine, and methamphetamine are collectively referred to as

amphetamines. Their chemical properties and actions are very similar. These drugs stimulate the

central nervous system - that is, they increase activity in the brain.

MEDICINAL USES

Amphetamine was first marketed in the 1930s as Benzedrine in an over-the-counter inhaler to

treat nasal congestion. By 1937, amphetamine was available by prescription in tablet form.

During World War II, amphetamine was widely used to keep soldiers alert and both

dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) became readily available.

Medical use of amphetamines was common in the 1950's and 1960's when they were widely used

to combat mild depression and cause weight loss. However, due to their side effects andaddictive properties they fell out of favor and the majority of brands were removed from the

market. Doctors have now considerably reduced their prescription.

Used properly, amphetamines increase alertness and physical ability. They are prescribed to

counter the effects of narcolepsy, a rare disorder marked by episodes of uncontrollable sleep, and

to help children with attention deficit hyperactivity disorder.

ABUSE OF AMPHETAMINES

Prescription amphetamines (i.e. legally manufactured medicines) are sometimes stolen, acquiredby obtaining false prescriptions forms or by conning a doctor into writing a prescription. These

drugs then enter the black market in their tablet or capsule form. They have a number of slang

names (often related to their appearance) such as 'black beauties', 'black bombers', 'black 'n

whites', 'blues' etc. but are no longer common as a drug of abuse because of the reduced use of

such medications in recent years.

The most widespread type of amphetamine on the street is a white powder called Amphetamine

Sulphate. It's manufactured in illicit laboratories and then adulterated so the final product usually

contains between 6% and 10% amphetamine. The other 90% can comprise of just about

anything, from baking powder to laxatives. Amphetamine Sulphate costs between 5 and 10

pounds sterling a gram.

Amphetamine Sulphate can be swallowed, sniffed up the nose (snorted) or injected. Slang names

include 'sulphate', 'wizz', 'speed', 'Billy Wiz' etc.


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Amphetamines speed up the nervous system and cause adrenalin to be released. This increases

the heart and respiration rates, increases blood pressure and decreases appetite.

In a sense, Amphetamines (by causing a release of adrenalin) mimic the "fight or flight

response". This is a natural survival mechanism of man/womankind that operates in a dangeroussituation - such as the approach of a hungry lion (or headmaster, police officer, tax inspector etc.

- depending on your situation!). At such times the body will automatically go into 'fight or flight'

mode. Adrenalin floods the system, this increases heart and respiration rates so that oxygenated

blood can be rushed to the muscles. Mental alertness is increased. The digestive system shuts

down to leave more blood for muscle use. The man or woman is now physically ready to fight

the lion - or run like hell!

When injected, amphetamines take effect immediately. Swallowing or sniffing powdered

amphetamines leads to onset of effects after 10-40mins. Prescription amphetamines may takeeffect after various lengths of time as some are designed as short-acting and some as time-release

medicines. The effect of a single dose of amphetamines generally lasts about 3-6hrs, although

that of pharmaceutical time-release capsules last for longer.

An amphetamine user may experience a temporary boost in self-confidence and feel far more

energetic than usual.

It's common for users to talk a lot and they often display a lot of physical activity - repeatedly

getting up, walking around etc. - hence the slang terms "speed" and "speeding" for the drug and

its use. When under the influence of amphetamines, users find relaxation difficult and sleep

impossible. They will have little or no appetite, although amphetamines simply postpone the

need for rest and food, they do not replace it.

SIDE EFFECTS

As amphetamine users tend not to eat or sleep and burn off a lot of energy by physical activity,

the body becomes exhausted - both physically and mentally - after a long period of amphetamine

use. As a result users often feel fatigued and depressed for a few days after using amphetamines

and may also feel irritable, anxious and restless.

Other side effects include blurred vision, sleeplessness, and dizziness.

Many women who use amphetamines find that their periods become irregular or even stop.


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To maintain the desired effect, regular users have to take increasing doses. When they eventually

stop they are likely to feel very depressed and lethargic. High doses, especially if frequently

repeated, can produce delirium, panic attacks, hallucinations and feelings of paranoia.

CONSEQUENCES OF AMPHETAMINE ABUSE

CONSEQUENCES FOR HEALTH

Amphetamines are psychologically addictive. Users often become dependent on the drug to

avoid the depression experienced when the drug's effect wears off. This dependence can lead a

user take larger doses of amphetamines - and more often - in order to maintain a "high". Of

course, this can also lead to users taking other - more powerfull - drugs.

Regular amphetamine users who take high doses may develop delusions, hallucinations and

feelings of paranoia. In addition, heavy amphetamine use can damage blood vessels and causeheart failure, especially among people with existing high blood pressure or heart trouble, or

amongst those who over-exert themselves while using the drug.

LEGAL CONSEQUENCES

Amphetamines are Class B drugs under the Misuse of Drugs Act. It is illegal to produce, supply

or possess them.

7. BARBITURATESBarbiturates are central nervous system depressants. They act in a similar manner to alcohol and

slow down many areas of the brain. Drugs of this class are known as sedative/hypnotics, in that

they can be used as sedatives to calm people and also (at higher doses) as hypnotics to assist

sleep.

MEDICINAL USES

Through the early 1900's barbiturates were prescribed widely for anxiety and insomnia and were

also used in conjunction with amphetamines to treat depression. Prescription of barbiturates

increased markedly in the late 1950's and 1960's, when up to 500,000 people in the UK were

estimated to be taking them, with nearly one quarter of these patients dependent upon them.

Their widespread availability resulted in many deaths through accidental overdose and they were

a common agent for suicide.

Concern about the addiction potential of barbiturates and the ever-increasing numbers of

fatalities associated with them led to the development of alternative medications. With the


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discovery of a 'safer' alternative - the benzodiazepines - (see Tranquillisers) the medicinal use of

barbiturates for treating anxiety and insomnia has been greatly reduced since the 1970's.

Nevertheless, phenobarbital is still widely used as an anti-convulsant to control Epilepsy and

other barbiturates are occasionally used to treat depression.

ABUSE OF BARBITURATES

Unlike many other drugs of abuse, barbiturates are rarely produced in clandestine laboratories.

Generally, legitimate pharmaceutical products are diverted to the illicit market through forged

prescriptions etc., although many barbiturates are also illegally imported from foreign

manufacturers.

Barbiturates are generally nicknamed "barbs" or "downers" by drug abusers - or called other

names, often based on the color of the capsule, such as "reds" or "yellows". Barbiturates that

used to be very commonly abused included amobarbital (Amytal), pentobarbital (Nembutal), and

secobarbital (Seconal). As they are not prescribed much these days, these drugs have only a

limited presence in the illicit drug market, where they may be available as capsules and tablets or

sometimes in a liquid form or suppositories.

Barbiturate sleeping pills are most often abused for their intoxicating effect. Abusers will usually

swallow the drug, often with alcohol to increase the intoxicating effect. However, they are also

sometimes injected by opening the capsules and dissolving the contents in water. Small particles

of undissolved material used as 'bulk' within the capsules can block or damage veins.

Barbiturates work by enhancing the action of a brain neurotransmitter (a chemical messenger)

that is in charge of inhibiting parts of the brain sometimes. For example, when we go to sleep,

some areas of the brain are inhibited, as they are not needed. As barbiturates facilitates the

activity of one of the main inhibiting neurotransmitters (Gamma ammino butyric acid - GABA),

they have an impact on many aspects of the body including mood, locomotion, co-ordination and

even breathing.

The effects of barbiturates are, in many ways, similar to the effects of alcohol. Small amounts

produce calmness and relax muscles. This combination of sedation and reduced anxiety are

features which made this type of drug popular as drugs of abuse.

Moderate doses will cause drowsiness, confusion, inability to concentrate, loss of co-ordination,

tremors and slurred speech. These effects make it dangerous to drive a car or operate machinery

as at these doses judgement is very seriously impaired.


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Large doses of barbiturates produce depressed pulse rate, dilated pupils and shallow breathing.

As vital life processes (such as heart and breathing rates) may be inhibited, such doses may

easily cause unconsciousness and death.

CONSEQUENCES OF BARBITURATE ABUSE


The use of barbiturates with other drugs that slow down the body, such as alcohol, multiplies

their effects and greatly increases the risk of death. Overdose deaths can occur when barbiturates

and alcohol are used together, either deliberately or accidentally.

Depending on the dose, frequency and duration of use, tolerance and/or physical and

psychological dependence on barbiturates can develop very quickly.

As a user becomes tolerant to barbiturates, the margin of safety between an effective dose and a

lethal dose becomes very narrow. So to obtain the same level of intoxication, a drug abuser who

is tolerant to barbiturates may raise his or her dose to a level that can produce coma and death.

Dependence (or addiction) to barbiturates can occur within a very short time and long-term

barbiturate users will require hospitalisation in order to safely undergo the withdrawal effects

from such drugs.

Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths. These

include suicides and accidental drug poisonings. Accidental deaths sometimes occur when a usertakes one dose, becomes confused and unintentionally takes additional or larger doses. With

barbiturates there is less difference between the amount that produces sleep and the amount that

kills. Furthermore, barbiturate withdrawal can be more serious than heroin withdrawal.

LEGAL CONSEQUENCES

Barbiturates are Class B drugs under the Misuse of Drugs Act. It is illegal to produce, supply or

possess them.

8. CANNABISCannabis is a Central Nervous System depressant obtained from the plant Cannabis sativa, which

grows in many parts of the world. It is available for use as a drug in three main forms: as the

dried leaves and buds, known as grass or marijuana, as a solid resin (hashish or hash) which is

collected from the buds and flower heads, and also as a thick liquid prepared from the flowers or

resin (hash oil).


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The main mind-altering (psychoactive) ingredient in cannabis is THC (delta-9-

tetrahydrocannabinol), but more than 400 other chemicals are present in the plant.

Hashish is made by taking the resin from the leaves and flowers of the cannabis plant and

pressing it into cakes or slabs. It is usually stronger than herbal cannabis and may contain five toten times as much THC.

Cannabis resin found in the UK comes from a variety of sources. Slabs of hashish from India,

Pakistan, Afghanistan and Nepal are usually dark brown or black and resinous, while traditional

hashish from Morocco and Lebanon take the form of green/brown or red/brown slabs that are

often dry and brittle. However, in recent years non-traditional forms of the drug have appeared,

particularly from Morrocco, where it can now be found as a dark brown or black resin in smaller

slabs than previously.

Hashish is often adulterated both within the producing country and also in Europe.

Herbal cannabis has become more popular in recent years. It is imported from many countries

within Africa, Asia, South America and the Caribbean. Herbal cannabis as commonly sold in the

UK includes nearly all parts of the plant (stalk, leaves, seeds, flowering parts) that are dried and

then cut or crushed. It may be imported into the UK as compressed bales or blocks of various

sizes.

In recent years 'home-grown' grass has become more common in the UK and Europe. This is

partly due to the increased sophisticated of growing equipment and illicit producers and partlybecause more potent strains of C. sativa have been developed for home cultivation.

Strains of particularly strong grass are now often available, which have a far higher content of

THC than was present say, in the 1960's or 1970's home-grown herbal cannabis market. 'Home-

grown' herbal cannabis is usually seen as finely cut leaves, stalks etc. of the C. sativa plant that

are sold loose, rather than in any compressed form.

Cannabis oil is extracted from the flowering parts of C. sativa or from cannabis resin by using

some form of solvent (such as acetone, alcohol or petrol). The solvent is then evaporated off and

the thick sticky liquid left behind is known as hash oil. This oil contains a high concentration of

THC and is smoked in a similar fashion to the resin. Hash oil is not very common in the UK,

mainly because it is difficult to weigh or to carry it, it's fiddly to prepare for smoking and it's

more expensive than herbal or resinous cannabis.


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MEDICINAL USES

Cannabis has been used as a herbal medicine in many countries of the world for a very long time.

It has been used as a mild sedative or painkiller and for treatment of insomnia and gastric upsets.

In the UK it was legally prescribed up until 1928.

The beneficial effects of cannabis as a mild analgesic and sedative, which may relieve the

symptoms of multiple sclerosis, hypoglycaemia, and other disorders, is widely attested. In some

cases it has found use as a medication for the terminally ill, where other treatments have failed to

relieve distress. However its possession or use in the UK is nevertheless illegal at present and

doctors are not able to prescribe cannabis in any form.

CANNABIS USE

Cannabis is the most widely used illicit drug in the UK, with up to 3 million consumers per year.It is most commonly smoked, usually by mixing it with tobacco and rolling it up with cigarette

papers into a cannabis cigarette (called a 'spliff', 'joint', 'jay' etc.). However, it can also be smoked

with or without tobacco in various forms of pipes or smoking devices such as 'bongs' or 'water

pipes'. Smoking Cannabis produces fairly instant intoxication, the effects lasting from 1 to 3

hours depending on the potency of the drug and the amount used.

Cannabis can also be taken orally, either eaten direct or mixed with food preparations, such as

cakes, biscuits (hence 'hash cookies') or hot drinks. Taking Cannabis orally means that the active

ingredients are absorbed slowly into the bloodstream and take an hour or two to produce theirstrongest effect, which may then last for 2 to 6 hours, again depending on potency and amount

ingested.

The effects of cannabis depend upon the amount used, its potency, the circumstances and the

expectations/mood of the user.

The most common (and desired) effects are talkativeness, cheerfulness, relaxation and greater

appreciation of sound and colour. Cannabis users frequently report perceiving an enhanced

performance for tasks involving creativity (art, music etc.), although no scientific evidence

indicates that the drug improves hearing, eyesight or skin sensitivity. Many users also experience

a compulsion for binge eating (known as the 'munchies').

Some immediate physical effects of cannabis use include a faster heartbeat and pulse rate,

bloodshot eyes, and a dry mouth and throat. Studies of cannabis's mental effects show that the


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drug can impair or reduce short-term memory, alter sense of time and reduce the ability to do

things that require concentration, quick reactions and/or effective co-ordination.

A common bad reaction to marijuana is an acute anxiety attack. People describe this reaction as

an extreme fear of "losing control," which causes panic. The symptoms usually disappear in afew hours.

High doses of cannabis can cause hallucinations and sensory distortions that can be very scary.

Those who use the drug when anxious or depressed may find these conditions made worse. Panic

and paranoia could then result.

YOUNG CANNABIS USERS

Over the past few years there appears to have been an increase in cannabis use among young

people. Several factors appear to be involved:

Public, government and media attention given to heroin, cocaine and ecstasy in recent years may

have led some adults and young people to assume that cannabis is of less concern.

Many of today's parents may have experimented with cannabis earlier in their lives and could

now be uncomfortable about warning their children against its use. Some of those arguing for

legalization have promoted the idea that cannabis is "no big deal," or that its use may even have

some benefits.

Today's youth are often told that using drugs - including cannabis - is "cool" and they may cometo believe that it's OK to "have a blow" - or whatever. These messages reach them from many

sources, such as some rap and rock music videos, marijuana-emblem clothing and other

products, and positive references to its use in various media. Cannabis availability is at an all-

time high.

CONSEQUENCES OF CANNABIS USE

HEALTH

There is no conclusive evidence at present that long-term use of cannabis causes lasting damage

to physical or mental health. However, some recent studies have found that prolonged heavy

cannabis use does cause physical damage to the brain and short-term memory loss has been

reported in several investigations.


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A long-term health risk arises from the common method of cannabis use. Smoking any substance

over a long period of time is a bad idea and frequent inhalation of cannabis smoke can lead to

bronchitis or other chest related disorders and may cause lung cancer.

Some women have found that heavy cannabis use can make their periods irregular, whilstcannabis smoked with tobacco during pregnancy produces the same risks to the mother and child

as smoking cigarettes.

The fact that cannabis use does not represent an immediate serious risk to a persons health does

not make this a harmless drug, or make the damage that can result from its use any less

significant than harm caused by other illicit drugs.

Cannabis is a drug that impairs. It impairs co-ordination and may contribute to such potentially

fatal events as accidents in the home, at work or while driving a motor vehicle.

It impairs attention and memory, reducing the user's ability to concentrate, solve problems, learn

and retain new information.

It impairs development of healthy social relationships, possibly alienating and isolating young

people from bonding with mentors and positive role models and peers.

It could also impair a young person's ability to make good decisions. Statistics show that young

people who use cannabis are more likely than those who don't to use other illicit drugs or engage

in other dangerous behaviour.

DEPENDENCE

Cannabis is not physically addictive but as with many other drugs, including alcohol, some

cannabis users do develop a psychological dependence on the drug. They may have difficulty

limiting their cannabis use or they may need more of the drug to get the same effect. These

cannabis users may develop problems with their jobs and personal relationships that are directly

attributable to their drug use. Obtaining and using the drug can become a central aspect of their

lives.

Cannabis use may lead on to use of other drugs, including those that are physically addictive.

Among teenagers, those who smoke cigarettes are more likely to drink alcohol. Those who

smoke and drink are more likely to use cannabis. And those who use all three are more likely to

use other illicit drugs.


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anaesthetic for minor surgery but this role today is fairly limited as synthetic anaesthetics are

more widely used. Cocaine has no other medicinal application.

ABUSE OF COCAINE

In the 1970's and 1980's the high cost of cocaine and its rarity in the illicit marketplace meant

that it was regarded as a drug of wealthy people such as rock stars or film stars. In the 1990's it

has become relatively inexpensive and easier to buy. The street price of cocaine in the UK is (as

of mid-1999) as low as 40 Pounds Sterling per gram and its low cost, easy availability and (false)

reputation as a non-addictive drug has led to widespread use among young people, where 9% of

those aged 20-24 who were asked in 1998 said they had taken it.

Cocaine is generally sold on the street as cocaine hydrochloride - a fine, white crystalline

powder, soluble in water, known by slang names such as "coke", "C", "Charlie" etc. It is often

cut with inert substances such as talcum powder or fine sugar; with other local anaesthetics such

as procaine and benzocaine, or other stimulants such as amphetamines. Nevertheless, street

cocaine has become purer in recent years and today averages around 60% or more pure.

Cocaine in powder form is usually sniffed, or "snorted", up the nose through a rolled-up bank

note or any other similar type of tube, after a line of the powder (about the size of a large

matchstick) has been spread out on a smooth surface - commonly a mirror. To experience

cocaine's effects more rapidly and to heighten their intensity, some users inject the drug directly

into their veins.

CRACK COCAINE

Pure cocaine is a chemical 'base'. A base can combine with an acid - in this case hydrochloric

acid - to form a salt. Cocaine hydrochloride is a salt of cocaine. This powdered form of cocaine

is soluble in water and so can be snorted, where it dissolves into the blood system via small

capillaries in the nostrils, or injected into a vein.

The cocaine hydrochloride salt can be changed back into its base form by a fairly simple

chemical process. This is called 'free basing' and is potentially dangerous because the solvents

used are highly flammable. The resulting form of cocaine is called 'free base' - or crack - and

takes the shape of relatively large crystals. It's pure cocaine (i.e. without the hydrochloride) and

as it is not soluble in water, it must be smoked in order to be taken. It's called 'Crack' because it

makes a crackling noise as it is smoked.


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Crack is absorbed into the body much faster than when cocaine powder is snorted and therefore

it takes effect very quickly. It's a very powerful form of cocaine and is highly addictive. It has

become fairly common in the UK since the mid 1980's.

Cocaine - like most drugs - acts on neurotransmitters in the body. These are chemical messengersthat send signals between one nerve cell and an adjacent one. Some neurotransmitters switch

nerve cells on - or speed them up, some switch nerve cells off - or slow them down. If any

chemical - such as a drug - interferes with these neurotransmitters, this can have all sorts of

consequences.

Cocaine interfers with the normal action of at least two neurotransmitters, one is Seretonin and

the other is Dopamine. When cocaine is taken - in any form - brain activity speeds up, as does

heart rate and breathing rate.

Blood pressure increases and so does body temperature. Physical symptoms of cocaine use may

include chest pain, nausea, blurred vision, fever, and muscle spasms. These symptoms result

from an overworked heart and high blood pressure.

Generally, cocaine produces feelings of mental well-being, and exhilaration. A user may feel

energetic, talkative and mentally alert - especially to sensations of sight, sound, and touch. At the

same time cocaine inhibits appetite and the desire for sleep. In some respects the effect of

cocaine is grossly similar to that of amphetamines and like those drugs, cocaine use can produce

anxiety or panic attacks. The after-effects of cocaine can include tiredness and depression.

Excessive doses can sometimes cause death from heart failure.

SHORT-TERM EFFECTS

When cocaine is snorted, its euphoric effects appear soon after it is taken, peak in about 15-30

minutes and disappear completely within one half to two hours. As the 'high' is short lasting, this

often encourages users to repeat the dose in order to maintain the effect. It's common for cocaine

users to take cocaine again after about half an hour or so after they last took some. Many

repeated doses taken over a short period can lead to extreme states of agitation, anxiety or

paranoia.

The compulsion to repeat cocaine use is even more evident when the drug is taken as crack. The

effects of crack cocaine occur and peak immediately the drug is smoked and begin to fade

shortly afterwards. Crack users commonly repeat the dose at short intervals in an attempt to

maintain the 'high'.


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When large amounts of cocaine are taken (several hundred milligrams or more) the 'high' is

intensified up to a point, but such doses can also lead to bizarre, erratic and violent behaviour.

These users may experience severe tremors, vertigo, muscle twitches and paranoia.

LONGER-TERM EFFECTS

If cocaine is taken over a period of time, users experience the drug's long-term effects. The

euphoric 'high' is gradually replaced by restlessness, extreme excitability, insomnia, and paranoia

- and eventually hallucinations and delusions. These conditions are very similar to amphetamine

psychosis and paranoid schizophrenia; although they disappear in most cases after cocaine use is

ended.

While many of the physical effects of heavy continuous use are essentially the same as those of

short-term use, the heavy user may also suffer from mood swings, loss of interest in sex, weight

loss and insomnia.

TOLERANCE

Tolerance to any drug exists when it becomes necessary to take higher doses to achieve the same

effects once reached with lower doses. At present there is no evidence to suggest tolerance to

cocaine's stimulant effect occurs.

Users may keep taking the original amount over extended periods and still experience the same

euphoric effects.

However, some users do increase their dosage in an attempt to intensify and prolong the effects.

CONSEQUENCES OF COCAINE USE

PHYSICAL DEPENDENCE

At present, it's unclear if physical dependence upon cocaine hydrochloride can occur. However,

when some regular heavy users stop taking the drug, they experience a powerful negative

reaction, which may indicate physical dependence.

Crack cocaine does produce a strong physical dependency. With regular heavy use increasingly

unpleasant symptoms occur. Euphoria is replaced by restlessness, over-excitability and nausea.

With continued use this can lead to paranoid psychosis. Regular users may appear chronically

nervous, excitable and paranoid. Confusion as a result of exhaustion, due to lack of sleep, is

common.


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PSYCHOLOGICAL DEPENDENCE

Psychological dependence exists when a drug is so central to a person's thoughts, emotions, and

activities that it becomes a craving or compulsion. Among heavy cocaine users, an intense

psychological dependence can occur; they suffer severe depression when the supply of cocaineruns out, which lifts only when they take it again.

Experiments with animals have suggested that cocaine is perhaps the most powerful drug of all

in producing psychological dependence.

When not taking cocaine, many regular users complain of sleep and eating disorders, depression

and anxiety, and the mental craving for the drug often compels them to take it again.


Death from a cocaine overdose can occur from convulsions, heart failure, or the depression of

vital brain centres that control breathing.

Chronic cocaine snorting often causes stuffiness, runny nose and eczema, and commonly

damages the nasal membranes and the structure separating the nostrils.

Severe respiratory tract irritation has been noted in some heavy users of crack cocaine.

Users who inject the drug not only risk overdosing but also getting infections from unsterile

needles and hepatitis or AIDS from needles shared with others.

The risk to mental health of using cocaine is high. As mentioned above, regular use can lead to

anxiety, paranoia and psychosis - which can sometimes produce permanent mental health

problems.

LEGALCONSEQUENCES

Cocaine in any form is a Class A drug. It is illegal to produce, supply or possess it. It is also

illegal to allow premises to be used for the supply, production or consumption of cocaine.

Penalties are high.

Cocaine is not a cheap drug and it is expensive to maintain a regular intake. Many regular users

resort to crime of one kind or another to fund their drug use. Obviously, such behaviour can

result in a criminal record or imprisonment.


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10.ECSTASYEcstasy is an hallucinogenic stimulant. It is a man-made drug with both hallucinogenic and

amphetamine-like properties. The chemical name for ecstasy is 3,4

Methylenedioxymethylamphetamine - or MDMA in short form. It's chemically similar to twoother synthetic drugs, MDA and methamphetamine.

MEDICINAL USES

None.

USE OF ECSTASY

Ecstasy has only been used as a drug of abuse in the UK since the mid 1980's. It is now very

common and is taken regularly by many thousands of people. It's mainly associated with the

dance culture or disco scene and so is often perceived as a 'party' drug, or a 'weekend' drug,

unlike for example heroin or amphetamines, which are usually taken more regularly.

This perception can give rise to a false understanding that ecstasy is safe to use. This is simply

not true - as the long term effects are largely unknown.

Ecstasy is seen in tablet or capsule form, or very rarely as a powder. Slang jargon includes 'E',

'Eccies', 'Love Doves', 'Disco biscuits' etc., although tablets are sold under a variety of so-called

'brand names' and are often embossed with a logo. A single dose costs 10-15 Pounds Sterling.

The type of tablets available changes from week to week, and counterfeit tablets are common.

According to police analysis, half of all Ecstasy tablets seized contained no MDMA (the active

ingredient). Some tablets contained LSD, amphetamine, MDA, and Ketamine, others had no

drug content whatsoever.

Ecstasy interferes with the concentration and action of seretonin in our brains. Serotonin is a

'messenger substance' or neurotransmitter that affects the peripheral and central nervous systems.

It acts through 'receptors' that are located on the outside walls of cells. Amongst other things it's

involved in the regulation of mood, sleep, sexual behaviour, temperature and appetite.

Ecstasy acts to increase the natural level of seretonin. The result is a change of mood, repression

of libido and appetite, mental stimulation and increased body temperature.

Ecstasy produces a relaxed, euphoric state without marked hallucinations.


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It takes effect 20-40 minutes after taking a tablet and wears off after about 3-4 hours. The peak

effects are felt 60 to 90 minutes after taking the drug.

A user first feels rushes of exhilaration that can be accompanied by nausea.

Sensations of sight, sound and touch are enhanced. Music - particularly when it contains a strong

repetitive rhythm - exerts a powerful influence on the user.

Users report that the experience is very pleasant and highly controllable. Even at the peak of the

drug's effect, people can easily bring themselves down to deal with an important matter.

The effect that makes Ecstasy different from other drugs is the sensation of understanding and

accepting others (it should be remembered that this is a drug-induced sensation and does not

correspond to reality!). Users feel as though interpersonal barriers have disappeared and are

likely to feel uninhibited.

SIDE EFFECTS

Many of the side effects users encounter with Ecstasy are similar to those found with the use of

amphetamines and cocaine. They include increases in heart rate and blood pressure, nausea,

blurred vision, faintness, chills and sweating. Psychological problems such as confusion,

depression, insomnia, severe anxiety, paranoia, and psychotic episodes can occur.

CONSEQUENCES OF ECSTASY USE


Ecstasy is not physically or psychologically addictive. However, the drug can often take on great

importance in the lives of users.

A major risk to health from taking ecstasy is hyperthermia - or heatstroke. Some people who

have died after taking this drug died as a result of the body overheating, which can cause failure

of vital organs.

Overheating is particularly likely to occur when the drug is taken at a music venue or disco,

where the user is dancing. The stimulant effect of ecstasy can enable people to dance vigorously

for long periods, leading to exhaustion and heatstroke. When an ecstasy user dances to music

with a repetitive rhythm, it seems that the person can 'lock in' to that repetition and simply go

though the same movements over and over again for hours. This is a bit like Pavlov's dog - a

reflex reaction. It is particularly dangerous as the user may be unaware of impending heatstroke.


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Although many discos provide 'chill-out' rooms for dancers to cool off in, the availability of such

facilities does not make the act of taking ecstasy safe. Some users have died from drinking fluid

in excess to combat the overheating caused by ecstasy and made worse by dancing.

A few ecstasy users have died from brain haemorrhages, which have been caused by theincreased blood pressure and heart rate associated with this drug. Some others have died from

unknown reasons after taking ecstasy.

The long-term effects of ecstasy use are not yet known. Ecstasy's chemical cousin, MDA,

destroys cells that produce serotonin in the brain. These cells help to regulate aggression, mood,

sexual activity, sleep, and sensitivity to pain. Methamphetamine, also similar to Ecstasy,

damages brain cells that produce dopamine. It is quite possible that ecstasy can also damage

brain cells.

Scientists have found that ecstasy makes the brain's nerve branches and endings degenerate. It

also makes them re-grow abnormally - failing to reconnect with some brain areas and connecting

elsewhere with the wrong areas.

These reconnections may be permanent, resulting in damage to various brain functions, changes

in emotion, learning or memory.

LEGAL CONSEQUENCES

Ecstasy is a Class A drug under the Misuse of Drugs Act. It is illegal to produce, supply or

possess it. The offence of supply - in the eyes of the law - can be committed by giving a single

tablet to another person. Penalties are high.

11.GHBGHB or as it is often known 'GBH' has an anaesthetic effect. Its chemical name is Gamma

Hydroxybutyrate. It's usually seen as a colourless, odourless, salty-tasting liquid.

Medicinal uses

GHB has been used in Europe as a general anesthetic, a treatment for insomnia and narcolepsy (a

daytime sleeping disorder), an aid to childbirth (increasing strength of contractions, decreasing

pain and increasing dilation of the cervix) and a treatment for alcoholism and alcohol withdrawal

syndrome.


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Prior to 1990 GHB was available as an over-the-counter pill or powder in the USA, sold mostly

in health food stores. It was banned as such in 1990 by the FDA because of deaths or serious

illnesses related to its use, and is now illegal for any person to produce or sell GHB in the USA.

GHB is not prescribed or made available in the UK because of its side effects.

GHB is found naturally in every cell in the human body. Some scientists believe it acts as a

neurotransmitter, although the jury is still out on this. It is very similar to another natural

chemical in our brains called Gamma Amino Butyric Acid, or GABA. GABA is a

neurotransmitter in our brain that slows down or inhibits certain activities. GHB is thought to act

like GABA, perhaps indirectly affecting the same receptors.

ABUSE OF GHB

GHB is easily made from fairly common chemicals and it's often manufactured in 'kitchen-sinklaboratories'. As such, the potency varies, since it will be home made to various strengths. It's

sometimes available as a powder or in a capsule, but most commonly seen as a liquid. In this

form, GHB is sold in small bottles (30-40ml), which would be enough for about two or three

doses. Bottles cost between 10 and fifteen pounds sterling. It is usually drunk although rarely it is

injected.

GHB first appeared on the UK club scene in 1994, starting with London gay venues and is now

becoming more generally available in discos and raves etc.

Body builders have also been known to use the drug, as it is supposed to assist the production of

muscle-building growth hormones by the body, but there is no evidence to support this claim.

The effects of GHB can generally be felt within five to twenty minutes after ingestion. They

usually last no more than one and a half to three hours, although they can be indefinitely

prolonged through repeated dosing. The effects of GHB are very dose-dependent. Small

increases in the amount taken lead to significant intensification of the effect.

The effect of GHB at lower doses are a cross between alcohol and the hypnotic sedative

Methaqualone Hydroxide (mandrax) that was popular in the 1970's but is no longer prescribed.

Inhibitions are lowered in a similar fashion to moderate doses of alcohol.

Most users find that low doses of GHB induce a pleasant state of relaxation and tranquillity.

Frequent effects are placidity, sensuality, mild euphoria and a tendency to talk. Anxieties and

inhibitions tend to dissolve into a feeling of emotional warmth, wellbeing and pleasant


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LEGAL CONSEQUENCES

In the UK, GHB is classed as a medicine, and the Medicines Act regulates its manufacture. The

manufacture of GHB by unlicensed persons is illegal. A conviction for illegal manufacture of a

medicine carries a maximum sentence of two years imprisonment and a fine of two thousandpounds.

It is not illegal to possess or use GHB in the UK as of mid-1998. However, this situation is likely

to change in the near future as efforts are underway to place this drug within the remit of the

Dangerous Drugs Act.

12.HEROINHeroin is an opiate. Pure heroin is a white powder with a bitter taste that is made from the milky

'sap' of the opium poppy (see right). This plant is grown as an illicit crop in countries across theMiddle East, Asia and South America.

Heroin is a powerful painkiller that depresses the Central Nervous System. This produces a

feeling of relaxation, security and well-being.

MEDICINAL USES

Although opium has been known and used as a sedative and intoxicant in some cultures for

several thousand years, heroin is a relatively new substance. It was first synthesized from

morphine in 1874 in Germany and given the name heroisch - meaning 'powerful'.

Heroin was not extensively used in medicine until around the beginning of this century. At that

time it then received widespread acceptance from the medical profession as a sedative and

anaesthetic. Physicians remained unaware of its potential for addiction.

When the dangers of heroin came to be appreciated many governments around the world took

steps to control its manufacture and it came under very strict prescription controls.

Today heroin does not have many legitimate medical applications, as synthetic sedatives and

anaesthetics have replaced the opium-based compounds that were used in the past.

ABUSE OF HEROIN

Illicit heroin comes in the form of a powder that may vary in colour from white to dark brown

because of impurities left from the manufacturing process or the presence of adulterants. The


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powder can be sniffed or dissolved in water and injected. It can also be smoked by mixing with

tobacco or heating on tin foil and inhaling the fumes, or swallowed after being wrapped in paper.

Heroin on the streets is usually diluted with other substances - ranging from lactose to

paracetemol. However, the amount by which the drug is 'cut' varies from purchase to purchase orday to day and so its purity in any particular locality can vary enormously - depending pretty

much on the mood of the dealers. Many deaths have resulted from overdosing on a batch of

unusually pure heroin.

A few years ago powders sold as illicit heroin only actually contained 1 to 10 percent of the

drug. In recent years street supplies have become stronger and the UK national average purity of

heroin is now around 40 percent, although it can range from 1 to 98 percent (hence the likelihood

of accidental overdose).

Along with an increase in purity, the cost of heroin has fallen. A gram of the drug now costs

around 60 Pounds Sterling on the street.

Until recently, most heroin users took the drug by injection - either into a vein, under the skin or

into a muscle. This is the most practical and 'efficient' way to take impure heroin.

The availability of higher purity heroin has meant that more users can now snort or smoke the

drug and still achieve the desired effect. Smoking and sniffing of heroin appears to be on the

increase in the UK as of 1997/8.

Although this may seem like 'good' news, as sniffing or smoking heroin eliminates the health

risks associated with injecting drugs, it has a downside. Many people that may try heroin by

sniffing or smoking may not have tried the drug if they had to inject it.

Sniffing or smoking heroin is likely to be more appealing to new users because it eliminates both

the fear of acquiring syringe-borne diseases such as HIV/AIDS and hepatitis, and the initial

distaste regarding self-injection.

It would certainly be a cause for concern if the reduction in the cost of heroin and increase in its

purity leads to the drug becoming more acceptable to young people.

All opiates tend to relax the user and kill pain to some degree. Heroin is the most powerful opiate

and when it is injected, the user feels an immediate 'rush' of relaxation and well-being. Physical

pain is completely removed - and so is emotional pain.


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It can be hard for non-users to understand the attraction of drugs - particularly heroin - but a

major reason why any individual may feel drawn to use heroin again after an initial experience is

that it produces such a powerful sense of security and tranquillity. It produces a state of mind

where all cares and worries seem far removed. Nothing matters. Perhaps it's like being in the

womb.

The best description this writer has ever found is:

"But with heroin, ahhh. You can just sit in a sewer all day and be soooo happy and feel

soooo good"

("Junk" - Melvin Burgess, 1996 Penguin Books)

Of course, these pleasant sensations have nothing to do with reality. No matter how good a user

may feel, the reality is the sewer - or whatever other situation exists - and this is usually quiteunpleasant - hence the need to escape from it.

Side effects from heroin use - particularly for new users - include restlessness, nausea and

vomiting. The user may go 'on the nod' or 'gouch out' - going back and forth from appearing

fairly alert to almost falling asleep. The pupils of the eye are reduced to pinpricks.

TOLERANCE

If heroin is used regularly over a period of time then a tolerance to the drug builds up. It makes

no difference what method of taking heroin a person may employ - and regularly can mean usingmany times each day, or only two or three times each week.

Users have to take larger amounts of heroin in order to get the same effect as previously.

Tolerance can build up quite quickly - over a matter of weeks - although it continues to increase

as long as a user takes heroin regularly.

If a person is abstinent from heroin for a time, their tolerance to the drug decreases. If they

should use heroin again in the same amounts as previously, an overdose could easily occur.

CONSEQUENCES OF HEROIN USE

RISKS TO PHYSICAL HEALTH

One of the most obvious risks of taking heroin is that of overdose. This can occur whatever

method is used to take the drug, although intravenous injection is most dangerous in this respect

as the whole dose is delivered directly into the blood system.


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Heroin is a Central Nervous System depressant and when it's taken vital functions such as higher

brain activity, breathing and heart rate are inhibited - or slowed down. If a large dose is taken - or

the heroin is exceptionally pure - the user may become comatose and the skin feel cold and

clammy. Breathing becomes shallow and intermittent and death may occur.

Other physical health risks related to heroin use are associated with the means of taking the drug.

Users who inject heroin might often employ contaminated needles or syringes. This can lead to

severe blood infection and damage the heart.

Injecting heroin - or any drug - in situations where shared needles are used, perhaps accidentally,

leaves the users open to infection from the HIV virus that causes AIDS. Hepatitis B or C, both of

which are serious infections, can be spread in this way and are common among intravenous

heroin users.

Another immediate physical danger associated with heroin use exists if the drug is combined

with other substances. Other depressant drugs, such as alcohol, benzodiazepines and barbiturates

are particularly dangerous as they are all CNS depressants. As heroin is also a powerful CNS

depressant, the combined effect of mixing these drugs can depress breathing or heart rate to such

an extent as to cause respiratory failure or heart failure.

DEPENDENCE

Physical and psychological dependence upon heroin is likely to occur, especially if a person uses

a lot of the drug or even uses it occasionally over a long period of time. The method of takingheroin makes no difference here - a person who sniffs or smokes heroin can become dependent

on the drug just as easily as a person who injects it.

Heroin use can result in a powerful physical addiction.

Coming off the drug can be very difficult because withdrawal symptoms - although lasting for

only a few days - are fairly severe. Abstinence can bring on symptoms such as chronic diarrhoea,

muscle cramps, vomiting, insomnia, sweating, anxiety, and tremors. The prospect of going

through such a painful withdrawal puts many heroin users off the idea of trying to stop using the

drug.

Once the physical withdrawal is over, a craving for the drug may still persist for a long time and

relapses are common. Generally speaking, a heroin user who wishes to stop using the drug

completely needs a strong support network to help him or her overcome the craving for the drug.


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SOCIAL CONSEQUENCES

It costs a lot of money to maintain a regular intake of heroin. Many regular users resort to crime

of one kind or another to fund their drug use. This has serious implications for our society, as the

social costs of drug-related crime are enormous. The UK Home Office provided an estimate ofthe size of the problem in research in 1997, which found that 20 percent of all people arrested in

Britain were on heroin.

EFFECT ON PREGNANT WOMEN

Researchers estimate that nearly half of the women who are dependent on heroin suffer anaemia,

heart disease, diabetes, pneumonia or hepatitis during pregnancy and childbirth. They have more

spontaneous abortions, breech deliveries, caesarean sections, premature births and stillbirths.

Infants born to these women often have heroin withdrawal symptoms which may last severalweeks or months. Many of these babies die.

LEGAL CONSEQUENCES

Heroin is a Class A drug. It is illegal to supply or possess it. Penalties are high.

Drugs similar to heroin, such as morphine, opium, methadone, dipapanone and pethidine are also

Class A drugs.

Codeine and dihydrocodeine (DF118) are Class B drugs unless they are prepared for injection

when they become Class A drugs.

13.INHALANTSInhalants are chemicals that produce mood-altering vapors. Many people don't usually think of

inhalants as drugs because most of them were never meant to be used that way. There are more

than a thousand different commercial products that can be abused for their mood-altering

properties.

THEY CAN BE DIVIDED INTO THREE MAIN CATEGORIES:

VOLATILE GASES AND SOLVENTS:

Such as cigarette lighter gas, cleaning fluids, spray paint, paint thinner, correction fluid, nail

polish remover, petrol and glues.


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AEROSOLS:

Such as hair spray, deodorants and other spray products that are abused more for the propellant

gas, than for the contents.

NITRATES:

Such as Amyl nitrite, which has medical applications for heart patients and Butyl nitrite, which is

used in room deodorizers.

MEDICINAL USES

Amyl nitrite was widely used in the past as a treatment for angina in heart patients and for

diagnostic purposes. It is now rarely prescribed as a medicine as more effective compounds have

been developed. Its availability to the public is controlled within the UK.

None of the other commonly abused inhalants, such as those examples listed above, have any

medicinal application.

ABUSE OF INHALANTS

Young people are particularly likely to abuse inhalants because they are easily available,

inexpensive and their abuse carries no criminal penalties. These factors make inhalants, for some

young people, one of the first substances to be abused.

Inhalant vapours can be sniffed or sucked in directly from an open container or aerosol, or from arag soaked in the substance and held to the face. Alternatively, the open container, substance or

soaked rag can be placed in a paper or plastic bag and the vapours inhaled from that.

Some sniffers strengthen the effect by sniffing from inside a plastic bag placed over the head.

This is very dangerous because the user may suffocate and become unconcious or even die.

Once inhaled, the large surface of the lungs allows rapid absorption of the vapour into the

bloodstream. The effect of inhalants on the brain is so fast that sniffing these substances can

provide an 'instant high' - in a similar fashion to that of intravenous injection of other drugs.

A NOTE ON NITRATES

Amyl nitrite was first prescribed for use in small sealed ampoules. When these were broken, they

made a snapping sound and illicit users nicknamed these ampoules 'snappers' or 'poppers'. This

slang is often used today.


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Amyl and butyl nitrites are sometimes abused by nightclub customers who inhale the fumes for

the rush whilst dancing. They are also popular as a sex drug, sometimes said to be used for its

muscle relaxant properties, but more often for added stimulation at the time of orgasm. The

purchase of Amyl nitrite is controlled but Butyl nitrite can be bought fro

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