Drug Harm Reduction Guide
Drugs can be found everywhere nowadays and seldom are there events without drugs in circulation. We've been working with The Loop to bring you this Drug Harm Reduction Guide to raise drug awareness and most importantly help people who already take drugs, take drugs as safely as possible. The Loop also provide up to date warnings of dangerous batches of drugs in circulation and also free drug testing.
The guide highlights the effects, risks and hard reduction advice on the following drugs:
Often drug users mix drugs to try and enhance the effects. However, some combinations can be extremely dangerous and damaging. TripSit have made this Guide to Drug Combinations to increase the safety and awareness of those already taking drugs.

1) MDMA (AKA: Pills, Beans, Mandy, Dizz, MD, Dizzle, E's)
MDMA/Ecstasy is a stimulant drug with euphoric and mildly hallucinogenic qualities. It became popular in the UK during the acid house and rave scenes of the late 1980s and early 1990s and has been a popular drug in dance clubs in the UK and elsewhere since then. It was first sold in tablet form with MDMA being the active ingredient but more recently people have buying MDMA crystal or powder due to its perceived higher purity than pills.




Legal status:
Class A drug. Maximum sentence for possession is 7 years and an unlimited fine. Maximum sentence for supply is life and an unlimited fine.
Effects:
Effects can be felt about 30-60 minutes after taking your first dose if swallowed but will be quicker if snorted and include:
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Increased energy
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Alertness
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Euphoria
-
Increased Empathy
-
Heightened awareness of lights and sounds
-
Increased body temperature
-
Dehydration
-
Lack of coordination
Risks:
-
Dehydration
-
Heatstroke
-
In rare cases people have suffered heart attacks and strokes
-
Some people report feelings of depression, anxiety and lethargy for a few days after using ecstasy (comedown) but these effects usually pass.
Harm reduction advice:
-
Be careful with your dose. Start with a low dose and give the drug time to take effect before redosing.
-
If dancing drink about a pint of water per hour to avoid dehydration but be careful not to drink too much. Some people have suffered problems from drinking too much water when taking ecstasy.
-
Take a break and chill out regularly to reduce the risk of heatstroke
-
If somebody is overheating, take them to a cool place, remove clothing and use water to try to cool them down.
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If somebody collapses or becomes unresponsive after taking ecstasy put them in the recovery position and call for immediate medical assistance
2) Ketamine (AKA: Ket, K, Kezzer)
Ketamine (Ketamine hydrochloride) is a dissociative or sedative drug which has been used in children’s and veterinary medicine. It also has mildly hallucinogenic properties. It is usually bought as a fine white powder which is usually snorted.




Legal Status:
Ketamine is a Class B drug. Maximum sentence for possession is 7 years and an unlimited fine. Maximum sentence for supply is 14 years and an unlimited fine.
Effects:
Ketamine is what is known as a dissassociative anaesthetic which gives users a sense of detachment from their body and surroundings and the effects include:
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Feeling light and bouncy
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Dizziness
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Delusions
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Visual hallucinations
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Vomiting (Especially if combined with alcohol)
In higher doses users can experience what is known as the K Hole. In this state people can come across as unresponsive whist at the same time experiencing vivid hallucinations
Risks:
-
Accidents (While intoxicated)
-
Dependence
-
Nasal damage
-
Bladder problems including urinary tract infections, severe cystitis and in severe cases amongst regular users, ulcerated bladder which requires bladder removal
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Vulnerability when intoxicated
-
Psychosis
-
Disturbing hallucinations
Harm reduction advice:
-
Be careful how much you use. The K Hole can be a very disturbing experience, especially if you take ketamine in a busy environment such as a nightclub or festival.
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Try not to use too often. People have reported dependence to ketamine and you can very quickly build up a tolerance which means you will need more of the drug to get the same effect.
-
If you develop persistent cystitis, ‘K-pains’ or other bladder/urinary tract problems seek medical advice and do not take ketamine to reduce the painful symptoms as this could make the condition worse.
-
Try to use in a calm and safe environment with people you know and trust.
-
If snorting, clean your nostrils with clean water regularly.
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Avoid mixing with other drugs, especially depressants such as alcohol.
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If someone collapses or becomes unresponsive after taking ketamine put them in the recovery position and call for medical assistance
3) Cocaine (AKA: Coke, Charlie, Bag, Gear, Marching Powder)
The coca plant grows naturally in mountainous areas of South America. The leaves of the plant have been chewed by indigenous populations for thousands of years to combat the effects of living and working at high altitudes. Cocaine is a powerful stimulant drug with anaesthetic qualities which is synthesized from coca leaves. It comes in 2 forms; powder (cocaine hydrochloride) and crack (cocaine freebase). It is a short lasting and potentially addictive drug with some regular users reporting intense psychological cravings to use cocaine.
Cocaine powder is the alkaline produced when the coca leaf is processed. Its use is widespread and is usually taken in pubs, clubs and party settings although social use can escalate into problem use for some people. It is usually snorted although some people do inject it.
Crack cocaine is produced when cocaine powder is processed (or “washed”) using ammonia or sodium bicarbonate. This forms rocks or stones which are a purer form of cocaine which has been freed from its base state (freebase) and can be smoked. When smoked it takes effects almost immediately but the effects are relatively short lasting which can lead users to experience an intense desire to use more. While cocaine powder use is found across society crack cocaine use is usually found in more disadvantaged groups and the social effects of crack use can be devastating for families and communities.




Legal Status:
Cocaine (in both forms) is a Class A drug. Maximum sentence for possession is 7 years and an unlimited fine. Maximum sentence for supply is life and an unlimited fine.
Effects: Cocaine powder is usually snorted and takes effect about 5 -10 minutes afterwards. The effects include:
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Increased confidence
-
Increased energy
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Euphoria
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A feeling of power
-
Sexual arousal
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Palpitations
-
Anxiety
-
Aggression (Especially when mixed with alcohol)
Risks:
-
Dependence/ addiction.
-
Nasal damage (some people have needed surgery to repair the damage done to their nose through excessive snorting of cocaine)
-
Heart failure
-
Overheating
-
Paranoia/ Aggression
-
Psychosis
-
There is a risk of contracting blood borne viruses such as Hepatitis C through the sharing of snorting paraphernalia
Harm reduction advice: (see below)
4) Crack cocaine (Freebase) (AKA: Crack, Rock)
Crack cocaine is usually smoked although it is sometimes injected. Smoking produces a quick and intense high although the effects do not last long, leading users to want to redose to maintain their high and avoid a “comedown”.




Effects:
-
Intense initial rush followed by crash or comedown
-
Euphoria
-
Increased confidence
-
Alertness
-
Increased Energy
-
Paranoia
-
Palpitations
-
Aggression
Risks:
-
Addiction
-
Lung damage (Crack Lung)
-
Heart failure
-
Overheating
-
Paranoia/Aggression
-
Psychosis
Harm reduction advice:
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If snorting cocaine powder, use your own note or tube and don’t share this with anyone.
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Rinse your nostrils with clean water between snorts to reduce the risk of nasal damage.
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Try to avoid mixing with alcohol. People are more likely to become paranoid or aggressive when the two drugs are combined and there are greater strains on internal organs such as the heart. There are also concerns that a third compound, called cocaethylene, produced when cocaine and alcohol mix in the body adds further strain to internal organs.
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If smoking crack use a glass pipe rather than an aluminium can to smoke.
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Avoid using too regularly.
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Be aware of your use. If you are beginning to find it difficult to contemplate a night out without cocaine it’s probably time to take a break or seek professional advice.
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As with all drugs, if someone collapses after taking cocaine put them in the recovery position and call for medical assistance.
5) Cannabis (AKA: Weed, Draw, Marijuana, Mary Jane)
Cannabis is a psychoactive plant which has been used in many cultures for thousands of years. It is a mildly hallucinogenic depressant drug although in lower doses and depending on the user, people may experience some stimulant-type effects, as with other depressant drugs. It is generally found in 3 forms, herbal cannabis includes the leaves and stems of the cannabis plant, skunk refers to the unfertilized buds of the female plant and hash is the processed resin of the cannabis plant. More rarely, cannabis oil can be found.
There are 2 active compounds in cannabis, delta-9-tetrahydrocannabinol (THC)and Cannabiniol. The relative amounts of the 2 compounds found in any given strain will determine the strength.
Cannabis is usually smoked in a cigarette rolled with tobacco (spliff/joint) and can be smoked in a pipe or bong. It can also be eaten or inhaled using a vaporizer.




Legal Status:
Cannabis is a Class B drug. Maximum sentence for possession is 5 years and an unlimited fine. Maximum sentence for supply is 14 years and an unlimited fine.
Effects:
The effects of cannabis vary greatly depending on the strain used, how it is used and the person using it. The main effects of cannabis are:
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Feeling drowsy
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Happiness
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Pleasant confusion
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Increased appreciation of art and music
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Mild auditory and visual hallucinations (pleasant or not)
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Giggles
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Hunger (Munchies)
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Anxiety
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Paranoia
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Dry mouth
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Red eyes
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Palpitations
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Nausea and Vomiting (Whitey)
-
Risks
-
Accidents and falls
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Anxiety
-
Paranoia
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Cannabis Psychosis
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Lung damage
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Cancer
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Relapse of pre existing mental health conditions
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Psychological dependence
Harm reduction advice:
-
Cannabis is carcinogenic, as is tobacco. Inhaling cannabis through a vaporizer will expose your lungs to less damage as the active compounds vaporize without causing smoke to be inhaled.
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Try not to smoke daily; this will increase your chances of developing lung problems or a psychological dependence
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Cannabis can be very demotivating for some people. Don’t use if you are busy or have a deadline to meet.
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Don’t drive after smoking cannabis.
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If you are somebody who is pre disposed to suffering from anxiety or hearing voices and these conditions get worse after smoking then you probably need to reconsider your cannabis use.
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Try to use with people you know and trust to reduce your chances of experiencing anxiety/ panic attacks.
6) Alcohol (AKA: Bevs, Booze)
Alcohol (ethyl alcohol, ethanol) is a depressant drug found in thousands of drinks which can vary from about 4% to 60% in strength. It is one of the oldest known drugs in existence and has been used by different cultures for thousands of years. If Alcohol was invented today, it would be a Class A drug.



Legal status:
In the UK it is legal to buy alcohol over the age of 18 in pubs, clubs and other licensed premises.
Effects:
The effects of alcohol are dependent on many factors, including the amount consumed, the environment in which it is taken and the person who is taking it.
In lower doses drinkers may feel:
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Relaxed
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Chatty
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More animated
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More social
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Giddy
In higher doses drinkers might experience:
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A lack of coordination
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Impaired memory
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Poor judgement
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Some people might become more emotional or aggressive after drinking alcohol.
Risks:
In the short term risks can involve:
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Accidents or falls
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Arguments or fights
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Unsafe sexual practice
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Nausea and sickness
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Dehydration (leading to hangover)
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If used in large enough quantities alcohol can cause death due to its toxicity.
Longer term risks can be:
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Physical and psychological dependence
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Increased risks of a range of cancers
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Liver damage
-
Diabetes
Harm reduction advice:
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The government recommend that an adult male should not consume more than 3-4 units a day and an adult female 2-3 units a day. A pint of 5% lager contains 2.8 units.
-
Try not to drink daily, this increases your risk of dependence. Try to have at least 2 alcohol free days a week.
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Know who you’re drinking with and have a plan for getting home safely.
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Try to alternate between alcoholic and non alcoholic drinks on a night out.
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If somebody collapses or passes out after drinking put them in the recovery position and call for medical assistance. Stay with them until you know they are safe.
7) Magic Mushrooms (Psilocybin Mushrooms) (AKA: Shrooms, Mushrooms, Mushies)
There are over 180 species of mushrooms containing Psilocybin found in the world today. They are commonly known as “magic mushrooms” and are taken for their hallucinogenic effects, with Psilocybin being the magic ingredient. They grow in the wild and some people grow them at home. When taken, the effects begin within 10-60 minutes and last for 4-6 hours.




Legal Status:
Magic mushrooms are a class A drug. Maximum sentence for possession is 14 years and an unlimited fine, maximum sentence for supply is life imprisonment and an unlimited fine.
Effects:
The effects of magic mushrooms depend on factors such as the environment in which they are taken, the amount used and the mood of the person taking them. Effects include:
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Intense visual hallucinations
-
Auditory hallucinations
-
Distortions of perceptions of reality
-
Distortions of time
-
Dilated pupils
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Stomach cramps
-
Nausea
-
Unpleasant and sometimes frightening hallucinations
Risks:
-
Accidents (when intoxicated)
-
Confusion
-
Anxiety
-
Unpleasant or “bad” trips
-
Poisoning (If the wrong type of mushroom is picked and consumed)
-
Flashbacks
Harm reduction advice:
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Start with a low dose. Trips can last for hours and once you have taken the drug you won’t know how strong it is until the effects begin to be felt.
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Use with people you know, trust and feel comfortable with.
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Don’t use if you are worried or depressed, this will increase your chances of experiencing a “bad trip”
-
Try to use magic mushrooms in a calm, safe environment, especially if you are new to them.
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Consider having a friend along who isn’t using. They will be able to offer comfort and support to somebody experiencing a bad trip.
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If somebody becomes distressed after taking magic mushrooms and can’t be calmed by talking to them in a calm and supportive manner consider requesting medical treatment.
8) LSD (AKA: Acid, Tabs, Microdots)
LSD (d- lysergic acid diethylamide) is a powerful hallucinagenic drug which was first discovered by the chemist Albert Hoffman in 1943. It is usually found as a small, square piece of paper which has been dipped in LSD. It became very popular in the hippy and psychedelic movements of the 1960s and was immortalized in the writings of people such as Aldous Huxley and Timothy Leary. More recently a new synthetic substance known as BOM25 has appeared which is similar in potency and effects to LSD.



Legal Status:
LSD is a Class A drug. Maximum sentence for possession is 7 years and an unlimited fine. Maximum sentence for supply is life and an unlimited fine.
Effects:
The effects of LSD vary greatly depending on factors such as the environment in which it is taken, the mood of the person taking the drug and the dose taken. The main reported effects of LSD include:
-
Intense visual hallucinations
-
Auditory hallucinations
-
Distortion of perceptions of reality
-
Distortions of time
-
Synesthesia (Seeing sounds, tasting colours etc)
While the hallucinations brought on by taking LSD can be enjoyable, funny and even profound, there is a risk that users will experience disturbing and frightening hallucinations and lose touch with reality.
Risks:
-
Bad Trips. For some people, taking LSD can be a frightening and disturbing experience
-
Accidents while intoxicated
-
Flashbacks. Some people report experiencing hallucinations similar to those brought on by LSD, sometimes many years after taking the drug
Harm reduction advice:
There are few, if any, physical dangers linked to LSD (apart from accidents). You can limit your chances of experiencing a distressing psychological reaction to LSD by following some simple steps:
-
Take a low dose. Trips can last up to 12 hours and once you have taken the drug you won’t know how strong it is until the effects begin to come on.
-
Use with people you know, trust and feel comfortable with.
-
Don’t use if you are worried or depressed, this will increase your chances of experiencing a “bad trip”
-
Try to use LSD in a calm, safe environment, especially if you are new to LSD.
-
Consider having a friend along who isn’t using. They will be able to offer comfort and support to somebody experiencing a bad trip.
-
If somebody becomes distressed after taking LSD and can’t be calmed by talking to them in a calm and supportive manner consider requesting medical treatment.
Amphetamine (AKA: Speed, Whizz, Billy, Phet, Paste, Base, Throttle)
9)
Amphetamine sulphate is a stimulant drug and usually comes on the form of powder or a higher purity paste. There was large scale usage during the Second World War when soldiers were given amphetamine tablets to keep them awake and alert for longer. After the war amphetamines were widely prescribed for depression and weight loss and crossed over into recreational use. Amphetamines have been linked to many youth and music scenes from rock’n’roll to punk and rave.



Legal Status:
Amphetamine Sulphate is a Class B drug unless it is prepared for injection in which case it becomes a Class A drug. Class B drugs carry a maximum sentence of 5 years and an unlimited fine for possession and up to 14 years and an unlimited fine for supply.
Effects:
If swallowed the drug takes effect in about half an hour. If snorted or injected it takes effect much more quickly. Effects include:
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Increased energy
-
Increased alertness
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Agitation
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Euphoria
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Increased chattiness
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Raised blood pressure
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Constricted blood vessels
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Dilated Pupils
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Insomnia
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Mood swings
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A comedown which may last for several days
Risks:
-
Heart problems
-
Dehydration
-
Anxiety/ Paranoia
-
Physical and psychological dependence
-
Psychosis
Harm reduction advice:
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As with all illegal drugs, there is no quality control and one batch of amphetamines will probably vary in strength from another. Therefore it is better to start with a small amount and wait for the effects before considering redosing.
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If you are using amphetamines in a dance environment sip water regularly (no more than a pint an hour) and take regular breaks from the dancefloor.
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Try not to use too regularly to reduce the risks of physical and psychological dependence.
-
Use with friends or people you know and trust
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If snorting, rinse your nose with clean water regularly to reduce the risk of nasal damage.
10) Mephedrone (AKA: Meth, Mcat, Meow Meow, Bubble)
Mephedrone (4-methylmethcathinone) is a stimulant drug which has effects comparable to MDMA and amphetamine. It is usually snorted or swallowed but more recently there have been reports of some users injecting mephedrone.




Legal Status:
Mephedrone is a class B drug. Maximum sentence for possession is 5 years and an unlimited fine, maximum sentence for supply is 14 years and an unlimited fine.
Effects:
Mephedrone is similar to a short lasting amphetamine and include:
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Increased energy
-
Talkative
-
Increased empathy
-
Increased heart rate
-
Muscle clenching
-
Anxiety
-
Paranoia
Risks:
Mephedrone has been described as a contributing factor in a number of deaths, especially when taken in high doses or mixed with other drugs.
-
Depression/anxiety
-
Heatstroke
-
Dehydration
-
Heart/Organ failure
Harm reduction advice:
-
Be careful with your dose. Start with a low dose and give the drug time to take effect before redosing.
-
Take regular breaks from dancing to avoid heatstroke.
-
Drink water, no more than a pint an hour, to avoid dehydration.
-
Avoid mixing mephedrone with other drugs.
-
Take it with people you know and trust.
-
If somebody collapses after taking mephedrone put them in the recovery position and call for medical assistance
11) GHB/GBL (AKA: Liquid Ecstasy, G, Fantasy)
GHB (Gamma-hydroxybutuyric acid) is found naturally in the body and GHB bought on the street is the same chemical. GBL (Gamma-butyrolactone) is an industrial solvent which converts to GHB in the body. The effects of the 2 drugs are pretty much identical. GHB/GBL is a central nervous depressant with some stimulant effects in lower doses, as with alcohol.



Legal Status:
Class C drug. Maximum sentence for possession is 2 years and an unlimited fine. Maximum sentence for supply is 14 years and an unlimited fine.
Effects:
-
In lower doses the effects are not dissimilar to alcohol and include:
-
Feeling relaxed
-
Reduced inhibitions
-
Feeling chatty
-
Increased sexual feelings
-
Confusion
-
In higher doses the depressant effects of the drug become more pronounced and include:
-
Increased confusion
-
Vomiting
-
Collapse and coma
-
Risks:
-
Addiction/dependence
-
Overdose (the line between an active dose and a dose which is sufficient for somebody to overdose is a fine one, and easily crossed, especially by inexperienced users)
-
Dangerous sexual activity
-
Accidents and falls
-
Sexual assault
Hard Reduction Advice:
-
Try to avoid mixing with other drugs, especially depressant drugs such as alcohol as this increases the chance of overdose.
-
Be aware of your dose. It is very easy to use too much GHB/GBL and the dose needs to be carefully measured
-
Use with people you know and trust. There have been several reports of being being sexually assaulted after taking GHB/GBL. Due to its disinhibiting effects you are more likely to make decisions you might later regret.
New Psychoactive Substances (NPS) or Legal Highs (AKA: Legals)
12)
New Psychoactive substances (NPS) have become popular in recent years for people looking to experience new drugs or take substances which aren’t banned under the Misuse of Drugs Act. They were formally known as ‘legal highs’ but this is not an accurate description of the substances available as tests have shown that many so called ‘legal highs’ actually contain illegal substances. They are available on line and through head shops and stalls at festivals. NPS’s can generally be separated into 2 categories: stimulant-type pills and powders, and cannabis-type smoking materials.




Legal Status:
The laws surrounded NPS are complicated and the authorities are continually adapting to respond to rapid developments amongst manufacturers and retailers. In an attempt to control NPS the UK government have recently introduced Temporary Class Drug Orders which allow time for evidence to be collected about possible physical and social harms. During this time it is illegal to supply any substance subject to a Temporary Class Drug Order but possession is not illegal. However, the chances are that if you are found with a white powder by the police you will most likely be arrested and bailed while the substance is tested for any illegal compounds. Effects differ widely.
1. Pills and Powders:
Generally speaking pills and powders are either stimulants, hallucinogenic or a mix of the two. It is very difficult to verify the content and strength of many of these substances and it is not uncommon for drugs that are marketed as legal to be found to contain illegal substances.
Effects:
Pills and Powders’ effects mirror those of the more established illegal drugs and include:
-
Increased Heart Rate
-
Energy
-
Confidence
-
Hallucinations
-
Talkativeness
-
Anxiety
-
Paranoia
Risks:
It is important to note that for some of these substances only a tiny dose is needed to get the desired effect and it is easy to take too much. For example, users of “Ivory Wave” have reported psychotic episodes lasting days. It is also worth noting that there have been very few opportunities to study these substances in humans or animals and so we have no idea about the potential long term dangers. Other risks include:
-
Heart/ organ failure.
-
Overheating
-
Psychosis
-
Paranoia
-
Chest Pain
-
Delusions
-
Vomitting
-
Unconsciousness
2. Cannabis-type smoking mixtures (synthetic cannabinoids):
Synthetic cannabis-type smoking mixtures tend to be smokable plant matter that has been sprayed with a psychoactive chemical. The active dose needed is tiny and it is very easy to use too much. Some people have reported severe physical and psychological reactions to these products.
Effects:
The effects of these products, both positive and negative can be similar to cannabis and include:
-
Relaxation
-
Drowsiness
-
Chattiness
-
Hunger
-
Anxiety
-
Paranoia
Risks:
-
Paranoia
-
Anxiety
-
Psychosis
-
Breathing difficulties
-
Skin Rashes
-
Heart problems
-
Unconsciousness
Harm reduction advice:
-
Many professionals in the drugs field offer general advice about NPS. For instance, if the substance is sold as a stimulant (such as Benzo Fury or Gocaine) then the advice offered will be similar to advice offered around the safer use of ecstasy or cocaine.
-
Be careful with your dose. For some NPS the effective dose is very small.
-
Research your choice of NPS before you use it. There are many internet message boards where people discuss the relative merits and disadvantages of a wide range of NPS. But remember, information found on message boards cannot be verified for accuracy.
-
Try to use with people you know or trust.
-
If somebody becomes unwell after taking an NPS seek urgent medical attention. If you can, make sure you tell the medics what the person has taken and if there is any left or an empty package ensure that this is passed on so that appropriate treatment can be given.
13) Nicotine (AKA: Cigs, Blems, Snout, Fags, Smoke, Burn)
Tobacco (Nicotiano tabacum) was first brought to Europe five centuries ago. It is a short acting stimulant which is usually smoked in cigarettes, pipes or cigars although other forms of tobacco include chewing tobacco and snuff, which is powdered tobacco.



Legal Status:
Tobacco products can be bought legally by anyone aged 18 or over. It is illegal to smoke in enclosed public spaces such as pubs, clubs, shops and offices.
Effects:
-
Nicotine affects people differently depending on if they are a novice or experienced smoker.
-
For the inexperienced, smoking can be an unpleasant experience causes dizziness and nausea along with a mild, light headed buzz.
-
Someone who has been smoking for longer and might be addicted will probably experience cravings to smoke. When these cravings have been satisfied by smoking the smoker might report feelings of calm, relaxation and focus. It is important to remember that when experiencing cravings a person is in a heightened state of stress and smoking is merely a relief of these cravings rather than a relaxing or calming activity in itself.
Risks:
The health risks associated with smoking are very well documented and include:
-
Asthma
-
Cancer
-
Cardiovascular disease
-
Deep vein thrombosis
-
Addiction
-
High blood pressure
-
Erectile disfunction
Harm reduction advice:
There is no safe way to smoke but there are products available to help a smoker quit while attempting to minimize the unpleasant cravings. These include nicotine patches, lozenges, gums and inhalators. These products can help to minimize cravings, allowing a person to change their behaviours which are linked to smoking to give themselves a better chance of quitting for good.
More recently, Electronic cigarettes have come onto the market. These products give a vaporized puff of nicotine without containing the carcinogenic chemicals produced when tobacco is burned. These products are new and there has not been too much research done on them but it is thought that they may be a less harmful alternative to smoking tobacco.