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| Introduction |
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Almost everyone takes drugs for non-medical reasons - either
for pleasure or to use their effects in other ways. For instance,
people have drinks containing caffeine to get them going in
the mornings or keep them going at night, or they have a couple
of alcoholic drinks to help them wind down after work or feel
relaxed in company. These habits are both legal and socially
acceptable, and people who regularly drink tea, coffee or alcohol
in moderation are very unlikely to think of themselves as drug users.
However, legal drugs such as alcohol, nicotine and even caffeine
can lead to psychological dependence and physical withdrawal
symptoms. Nicotine is one of the most dependence-forming of
all drugs, and tobacco is one of the most damaging substances.
In his book Licit and Illicit Drugs (Little, Brown
1972), Dr Vincent Dole concludes that 'cigarette smoking is
unquestionably more damaging to the human body than heroin'.
Alcohol also causes serious concern. According to a major government survey
in 1995, about 1 in 25 adults, making a total of around 1.8 million, are
dependent on it. This is more than twice the number dependent on illegal
drugs. And like dependence on 'hard' drugs such as heroin, alcohol dependence
can lead to serious personal and social problems, serious damage to mental
and physical health, and even death, either by overdose or through associated
problems.
So it's hardly surprising that many people who use illegal drugs feel
that double standards apply in this area - in the law, in general attitudes
and in the media. An alcohol-related death scarcely rates a mention in
the local paper, but an ecstasy-related death can be major national news
- partly, of course, because of the very rarity of the event. An estimated
28,000–33,000 people die each year from alcohol-related causes; since
1985 the total number of deaths related to ecstasy is put at 60–70.
And there's little more consistency in attitudes to drugs within the illegal
categories. Deaths related to amphetamines or opiates aren't big news
either, perhaps because these drugs have been around for longer than ecstasy.
The crusial point is that, however illegal drug users are treated by the
law or perceived by other people, the experience of many is that you can
smoke cannabis or even take ecstasy, amphetamines or LSD without harming
yourself or anyone else. This Website isn't concerned with arguments about
the legal control of different drugs. But given that a growing number
of people regard taking certain illegal drugs as a normal part of their
lives, and (according to the British Crime Survey 1996) 29% of the adult
population have tried illegal drugs, sources of straightforward information
about the effects and risks are crucial. The ABC of Drugs aims
to provide one such source and tell you about the others.
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| Drugs and general safety |
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All drugs, legal and illegal, have side-effects and may involve risks.
The special problems associated with different types of drugs are dealt
with under the drugs' individual headings. However, some risks apply more
or less across the board or are associated with the way drugs are taken.
- Taking
drugs on your own increases the risks. If you get into difficulties or
simply have a bad time, friends may be able to help.
- Though
it may be tempting to take drugs (including alcohol) when you feel anxious,
depressed or unable to cope, they may make you feel worse, particularly
in the longer term. Also, if you're using drugs as a way of escaping
from problems, you're more likely to become dependent.
- Some
drugs can alter the way you approach, negotiate and enjoy sex. But always
remember that unprotected sex carries risks of unwanted pregnancy and
infection with HIV and other sexually transmitted diseases.
- Some
drugs affect your ability to perform mental and physical tasks more than
others, but they all change your mental or physical state to some degree.
The only safe rule is not to drive, operate heavy machinery, or do anything
that may put yourself or others at physical risk when you're under the
influence of illegal drugs or alcohol. Consult your doctor or chemist
if in doubt about prescription or over-the-counter medicines.
- Drugs
can affect unborn babies. You should get advice on any drugs you are
taking, legal or illegal, if you're pregnant.
- Mixing
drugs (including alcohol or prescription medicines with illegal drugs)
can be particularly dangerous.
- Injecting
is without doubt the most dangerous way of taking drugs. This is partly
because it's easier to take an overdose if you inject, but also because
of the risk of contracting HIV and hepatitis through sharing injecting
equipment. People who inject drugs should therefore never share
equipment. There are also particular dangers in injecting crushed tablets.
For more information about safe injecting, contact one of the organisations
listed in sources of help.
What
to do if someone is in difficulties
If someone who has taken drugs gets very anxious or panicky, take
them somewhere quiet and warm, and reassure them that they will gradually
feel better. Don't leave them alone.
If someone is overheating and becoming dehydrated after dancing a lot
(symptoms may include fainting, feeling sick, headache, sudden tiredness,
cramps and stopping sweating) they should immediately take a rest and
slowly sip about a pint of water. Splashing cool water on the face
and neck can help lower the body temperature. People who use drugs such
as ecstasy and amphetamines and go dancing are advised to take regular
breaks and sip water throughout the evening - about a pint an hour is
recommended by the Health Education Authority.
If someone seems on the verge of passing out, don't leave them alone to
sleep it off - they may throw up while unconscious and choke. Put them
in the recovery position, loosen any tight clothing
that might restrict the breathing, and try to keep them awake by talking
to them. Never give someone black coffee to wake them up - it may have
the opposite effect, speeding up the body's absorption of the drugs they've
taken. If the person shows no signs of revival, call an ambulance.
If someone actually passes out, put them in the recovery
position, loosen any clothing that might restrict the breathing and
call an ambulance. If you know what sort of drugs they've been taking,
tell the crew. You won't get into trouble for doing this, and it could
save someone's life.
Mouth-to-mouth resuscitation can also save someone's life if they have
stopped breathing. First-aid courses teaching this and other techniques
are available from St John Ambulance (0171 235 5231) or the Red Cross
(0171 235 5454).
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| What is drug dependence/addiction? |
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The vast majority
of people who try drugs, or even use them repeatedly, do not become dependent
on them. The question of why some people do become dependent is complicated.
Different drugs have different potentials for leading to dependence, and
this is dealt with under the separate headings for each drug or group
of drugs. But the personality, state of mind and circumstances of the
user - and the way they use a drug - are also crucial.
The words 'dependence' and 'addiction' are shorthand for a complex set
of changes that can occur over time with repeated use of a drug. These
changes involve the way someone thinks and behaves and the way in which
their bodies adapt to and handle the drug. No one feature alone spells
dependence, though individual features may be a clue or warning sign.
Becoming dependent on a drug is often a long and subtle process, and it's
difficult to identify the exact point at which repeated use slips into
dependence.
People who are dependent on a drug continue to use it despite clear and
repeated evidence that it's causing significant problems. They also spend
increasing amounts of time obtaining the drug, taking it and recovering
from it. Their thoughts tend to be dominated by a craving for the drug,
which often results in neglect of their health, family and work. They
may make repeated unsuccessful attempts to cut down their use or stop
using altogether. All of this points to the main feature of drug dependence
- a loss of control over drug taking. The drug is controlling the person
rather than the other way around.
By the time this happens, a drug user's body has often (but not invariably)
developed increased tolerance for the drug and also shows characteristic
withdrawal symptoms if they stop taking a drug or reduce their
consumption.
Tolerance to a drug means that someone gradually needs more to get the
same effect. Over time this can result in their taking doses that would
harm or even kill an inexperienced user.
Withdrawal symptoms result from the fact that the body has adapted to
the presence of the drug, so it reacts to its absence. The characteristic
withdrawal symptoms associated with alcohol, for instance, include the
shakes, sickness and sweats. With heroin they include chills and sweats,
cramps and aches and pains. These symptoms can be severe enough for people
to want to make sure their bodies are never without the drug for too long.
The early morning drink for someone dependent on alcohol is one example
of this; a dependent heroin user's sometimes desperate search for the
next fix is another.
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| Drug groups |
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Not all the drugs listed fit neatly into these categories, but many can be broadly classed as:
- Depressants, which reduce
brain activity (for example alcohol, gases and glues, tranquillisers)
- Stimulants, which increase
brain activity (for example cocaine, amphetamines, ecstasy, nitrites,
anabolic steroids, nicotine)
- Hallucinogens, which alter the
way you perceive things (for example LSD, magic mushrooms, cannabis)
- Analgesics, which reduce
physical and emotional pain (for example heroin and other opiates)
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