What are 'substances'?

It is important to remember that the effects of any substance will vary from one individual to another. This will depend on the quality and quantity of the substance and the person’s age, gender, weight, mood, culture, expectations and state of physical and mental health. Street drugs are almost always cut (mixed) with other substances to bulk out the drug and maximise profit. As a result, the appearance and potency of drugs varies widely. Unless a sample of a drug is tested it is not possible to know exactly what it is.

Stimulants (uppers)

These constrict blood vessels, speed the heart and raise blood pressure. Prolonged use of the stronger stimulants depletes energy resources, and triggers intense craving.

Stimulants can also cause or mimic mania, anxiety and/or depression or paranoid psychosis. Users appear not to become physically dependent, but may become dependent on it to feel better temporarily. Cocaine and amphetamine withdrawals can resemble a major depression. The direct effects of the stronger stimulants, combined with the exhaustion of withdrawal can cause or mimic a bipolar illness that includes manic delusions and then depression. Cocaine causes the most rapid stimulation and subsequent comedown of all the stimulants.

  • Amphetamines (speed, whizz, sulph, uppers):
    Signs of use: increased alertness and dry mouth, excessive fluid intake.
    Sought after effects: elevation of mood, boost of confidence, energy
    levels or wakefulness, suppression of appetite.
    Adverse effects: initial pleasurable rush followed by anxious feelings,
    exhaustion (leading to excessive sleep) and depression, irritability, and
    paranoia. Heavy users may experience severe weight loss and psychosis,
    hallucinations and delusions and may become aggressive.

  • Anabolic steroids (nadralone, dianabol, durabolin, primobolin, stanozolol, winstrol):
    These are synthetic drugs similar to natural hormones. They promote
    protein build up and therefore muscle gain.
    Signs of use: muscle growth and deepening of the voice.
    Sought-after effects: to build up muscle size and body strength.
    Adverse effects: Can be associated with mental health problems (eg mania and depression). They affect mood and can cause aggression and paranoia. Use is commonly used amongst young men who may have emotional problems and are drinking heavily. There is an increasing supply of counterfeit products which do not attract the same controls for quality or dose as for licit steroids.

  • Cocaine (charlie, coke, snow, foot, lady, C) & Crack Cocaine (rocks, ready wash, ice, base)
    Signs of use: same as above, but effects can be more pronounced.
    Sought after effects of cocaine and crack cocaine: a rapid intense high,
    Makes the user more confident and talkative. The high is only short lived
    leaving the user craving more. Can stimulate the sex drive.
    Adverse effects: anxiety and exhaustion, long periods of sleep, irritability,
    depression and paranoia. Sudden rise in blood pressure and slowing of heart
    rate. Overdose can cause sudden heart attack or strokes after prolonged
    use. Highly addictive. As tolerance grows, the margin narrows between a
    dose producing euphoria and one that is fatal. Heavy users may experience
    psychosis, hallucinations and delusions and may become aggressive.

Depressants (downers)

Overall, downers, particularly where there is excessive use, can cause or mimic a depressed mood. They may cause loss of motivation and interest in surroundings, other people or oneself leading to self-neglect and even self-harm, including attempted suicide. Effects are particularly dangerous if combined with other drugs. Excessive sleep may be one of the characteristics of a major depression.

It is easy to overdose on downers, particularly where there is alcohol use. Where there has been regular or heavy use of downers, it is important that the person does not suddenly stop. Rapid withdrawal (especially
combined with a withdrawal from alcohol) can cause serious problems including tremors, sweating, cramps, transitory hallucinations, stomach pains and even seizures or deliriums tremens called DTs.

  • Alcohol (booze, bevy)

    Alcohol is absorbed in the bloodstream and its effects depend on its strength and the individual. Food will delay absorption. Use is common among people with mental health problems.
    Signs of use: include slow or slurred speech, poor co-ordination.
    Sought after effects: if a person is not at risk (e.g pregnant, in recovery,
    or with mental or physical health problems) there are some benefits.
    In general, sedation, muscle relaxation and lowered inhibitions and increased confidence accompany low to moderate use.
    Adverse effects: with high doses, a range of effects occur from decreased alertness and exaggerated emotions to shock, coma and death. Effects are directly related to the amounts, frequency and duration of use and also depend on the tolerance of the user. Depending on a drinker’s habits and susceptibility, organ damage, particularly liver damage, nutrition deficits and sexual problems can occur.

    Alcohol affects co-ordination and reactions, so users are prone to accidents. It is also the leading cause of birth defects in those cases where a cause can be attributed. The effects of withdrawal from alcohol can be severe and requiring medical supervision for detoxification. These include hallucinations, seizures and DTs and in some cases death.

  • Cannabis (weed, dope, draw, blow, resin, grass, skunk)

    Like tobacco or a dark brown resin. Cannabis can have hallucinatory effects and stimulant properties, but is regarded mainly as a depressant or relaxant.
    Signs of use: blood-shot eyes, hunger pangs.
    Sought after effects: some users experience an intense feeling of relaxation. If eaten, effects last longer than when smoked.
    Adverse effects: can include lethargy, demotivation, panic, paranoia and
    short term memory loss. Heavy use, particularly if strong varieties such as
    some forms of skunk are used regularly, can lead to psychosis. There are
    also health risks associated with smoking.


Hallucinogens

The most commonly used hallucinogens are LSD, MDMA (“ecstasy”), PCP, mescaline and 'magic mushrooms'. Hallucinogens cause intensified sensations, mixed-up sensations (visual input becomes sound), illusions,
delusions, hallucinations, stimulation and impaired judgement and reasoning. LSD is very potent and can cause delusions.

Hallucinogens generally are unpredictable and can trigger a latent mental illness. They can also cause or mimic delusional hallucinations and paranoia associated with a major psychosis.

  • Ecstasy or MDMA (E, adam, XTC, doves)

    Tablets, powder and capsules in many shapes and colours.
    Signs of use: increased energy, slurred speech.
    Sought after effects: 20-60 minutes after use, user experiences euphoria
    which plateaus for 2-3 hours before wearing off. Feelings of empathy,
    meaningfulness and relaxation.
    Adverse effects: tiredness, confusion, anxiety, depression and paranoia. Sudden death through overheating and dehydration or drinking too much water. A minority experience liver damage and strokes. Some users report panic attacks, paranoid psychosis and depression. Dependence is possible if taken frequently.

  • LSD (acid, tabs, trips)

    Small tablets or printed squares of paper impregnated with the drug.
    Also comes in liquid form.
    Signs: being detached from reality, giggly, unable to communicate coherently, slurred speech, lack of co-ordination.
    Sought-after effects: to induce an altered state of consciousness. LSD distorts shapes, colours and sense of time, producing hallucinations,
    laughter or exhilaration.
    Adverse effects: can include flashbacks, anxiety and paranoia. Can precipitate relapse in those already susceptible to schizophrenia. Users often underestimate the length of a trip and feel exhausted physically and psychologically after a 12-36 hour experience. A lack of control and ability to stop the experience can frighten users.

  • Mushrooms (magic mushrooms)

    Mushrooms, a variety of wild growing fungi, native to the UK, such as
    the Liberty Cap. International varieties are becoming more widely available
    through specialist shops and the internet. The key constituent is psilocybin.
    Signs of use: being detached from reality, giggly, unable to communicate
    coherently, slurred speech, lack of co-ordination, vomiting.
    Sought after effects: similar to LSD, but the trip is often milder and shorter.
    Adverse effects: can include stomach pains, sickness and diarrhoea.
    Misidentification can lead to users eating poisonous varieties which can
    prove fatal.

Opiates and Opioids

Opiates and opioids are natural, semi-synthetic, and synthetic derivatives of the opium poppy. The principal opiates and opioids are heroin, codeine and morphine. Others include methadone and other analgesic (painkillers), which are widely used.

  • Heroin (smack, H, skag, brown, gear, junk)

    Sold illicitly as a powder, usually brown, but can be white.
    Signs of use: slow shallow breathing, drowsiness and constricted (small) pupils, watering eyes & nose, itching, fidgeting.
    Sought after effects: provide powerful relief from physical pain (for which
    they are used medically) and also of psychological pain. It induces euphoria, which may wear off but use continues to avoid withdrawal symptoms.
    Adverse effects: running nose and eyes, irritability, tremors, chills. Sudden
    withdrawal leads to cramps, sweating and diarrhoea and “goose bumps.”
    Dependence develops after repeated use over several weeks. Not all users
    are dependent, but heroin is difficult to manage recreationally. Tolerance
    develops quickly.

  • Methadone (doll, red rock, juice, 'script')

    Usually in the form of white tablets or liquid.
    Signs of use: slow shallow breathing, drowsiness and constricted (small) pupils, watering eyes & nose, itching, fidgeting.
    Sought after effects: the effects are similar to heroin, however methadone
    tincture cannot be injected which helps to reduce the associated risks of
    this practice. Provide powerful relief from physical pain (for which they are
    used medically) and also of psychological pain. It induces euphoria, which
    may wear off but use continues to avoid withdrawal symptoms.
    Adverse effects: Some people are sick the first time they take drugs like
    Methadone. For women, use can cause irregular periods (although conception is still possible). It can cause constipation.


Other substitute drugs for opiate dependency may also be used such as Subutex, with less of a buzz or sense of euphoria that methadone provides. Naltrexone is an antagonist, it prevents the neuro-receptors in the brain from picking up the effects of opiate drugs.