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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

Club Drugs

 

Club DrugsAbout this leaflet

This leaflet looks at the effects of club drugs (or ‘recreational’ drugs), including legal highs. These are substances which primarily act on the brain to make people feel euphoric, energised or relaxed. They are commonly taken in nightclubs, at festivals, parties and are sometimes used by members of the lesbian, gay, bisexual and transgender (LGBT) community as part of their sex- lives.

 

This leaflet is aimed at:

  • people who use them
  • people who know someone who uses them
  • professionals who may be supporting someone who uses them.

The research about club drugs is limited. However, this leaflet presents a summary of what is known about:

  • their good and bad effects
  • how users can reduce the risk of harm if using them
  • identifying who may need help
  • how to get help.

What are club drugs?

Club drugs are a group of drugs that primarily act on the brain. Some club drugs are well known, like cocaine, MDMA (ecstasy), mephedrone and ketamine.  Groups of new club drugs are emerging all of the time. These are called ‘new psychoactive substances’ (NPS), the so called legal highs. These are made specifically to mimic the effects of established drugs.

 

It is estimated that one new drug appears on the European drug market each week. Since these drugs are not regulated, it is hard to know exactly what each dose of drug contains. Even people selling them don’t know this for sure. These are some of the reasons why the scientific evidence is limited.

 

Club drugs and the law.

In 2015 the UK government made it illegal to produce, supply, offer to supply, possess with intent to supply, import or export psychoactive substances, including club drugs. The maximum sentence will be 7 years’ in prison.

 

Who uses club drugs?

Up to 1 million people may use club drugs each year in the UK. This figure is increasing, and some drugs like mephedrone and ketamine are more and more popular.  These drugs are most commonly used by students, members of the LGBT community, and people who identify themselves as ‘clubbers.’

 

How do club drugs affect us?

People typically use club drugs for their positive effects. They can increase energy levels, lift mood or alter the sensations they experience, which is why they are popular in social settings. 

 

Because many of them are quite new, the harmful effects are still unclear. However, it is increasingly clear that they can be as harmful as well-known drugs, such as heroin and crack cocaine. In 2013, over 400 people in England and Wales died after taking club drugs, some of whom were taking club drugs for the first time.

 

Toxic reactions, damage to internal organs, overdoses, heart problems, mental health problems and dependence have all been seen in club drug users. 

 

The table below shows examples of club drugs and effects.

 

Type of club drug Why people take them Short-term use negative effects Long-term use negative effects
Stimulants (cocaine, MDMA/ecstasy, mephadrone, some NPS, methamphetamine)

Increased energy

Intense euphoria

Increased sex drive

Increased social confidence

Nausea

Anxiety

Severe agitation

Paranoia

Very high blood pressure

Heart attack

Stroke

Death

Depression

Anxiety

Craving

Dependence

Sedatives (ketamine, GHB/GBL, some NPS)

Feeling relaxed and sociable

Out of body experiences

Reduces the agitation from a stimulant when used in combination

Confusion

Nausea

Loss of co-ordination

Drowsiness

Confusion

Seizures

Coma

Death

Dependence

Cravings

Withdrawals

Poor memory

Ketamine can cause severe bladder damage

Hallucinogens (LSD, 2-CB, some legal highs, magic mushrooms)

Hallucinations or changed perception

Intense spiritual experiences

Intense fear, known as a "bad trip"

Confusion

Accidental injury

Persistent hallucinations or perpetual disturbances

Impairment of brain functioning

Synthetic cannabinoids (Spice, K2)

Relaxation

Increased social confidence

 

Hallucinations

Difficulty concentrating

Hunger pangs

Loss of co-ordination

Vomiting

Anxiety

Confusion

Loss of motivation

Paranoia

Tolerance

Dependence

Can the risks of harm be reduced?

The simplest way to avoid the risks of taking club drugs is not to take them. For people who use these drugs, there are simple rules that can reduce, but not remove the risk of harm.

  • Tell someone what/how much you are taking.
  • Don’t use alone.
  • Look after one another.
  • Start with a small test dose and wait at least an hour before taking anything else.
  • Avoid mixing drugs and avoid drinking alcohol at the same time.
  • Drink sips of water: don’t drink more than 1 pint per hour.
  • Ask for help if you are feeling unwell, be honest about what you have taken.
  • Sleep on your side and put sleeping/unconscious friends in the recovery position. Information about how to put someone in the recovery position can be found on the NHS choices website.
  • Think about the essentials: condoms, money to get home safely.

Have I got a problem?

You may want to think about your drug use, and whether it is something to worry about. Here are ten questions for you to answer about your drug use (excluding alcohol) over the past 12 months. Circle the response that is mostly right.

 

1. Have you used drugs other than those required for medical reasons?  Yes  No
2. Do you use more than one drug at a time?  Yes  No
3. Are you always able to stop using drugs when you want to?  Yes  No
4. Have you had 'blackouts' or 'flashbacks' as a result of drug use?  Yes  No
5. Do you ever feel bad or guilty about your drug use?  Yes  No
6. Does your partner/family/friends ever complain about your involvement with drugs?  Yes  No
7. Have you neglected your partner/family friends because of your drug use?  Yes  No
8. Have you engaged in illegal activities in order to obtain drugs?  Yes  No
9. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?  Yes  No
10. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding etc...)  Yes  No

 

Taken from DAST-10 (see references).

 

Score 1 point for each ‘yes,’ except for question 3, for when a ‘no’ scores 1 point.

 

 Score  Level of problem  Suggested action
1 - 2   Low  Keep an eye on your drug use.
3 - 5   Moderate  You are beginning to experience problems and it is time to cut down.   You may want to seek help.
6 - 10   Severe  Your drug use is worrying. Seek help from a health professional.

 

Finding help

  • Have you tried to cut down but not been able to?
  • Would you like to use fewer club drugs?
  • Have you experienced health problems that worry you?
  • Are you worried about a partner, friend or family member using club drugs?

If so, there is lots of information about club drugs on the internet. However, some of it is wrong or out of date.

 

Here are some good places to get quality information:

 

For drug information

For specialist services

For LGBT communities

For parents or friends that are concerned:

 

References

1.         Bowden-Jones O FC, Hilton C, Lewis J, Ofori-Attah G. One new drug a year. Royal College of Psychiatrists. 2014;Report number: FR/AP/02.

2.         Home Office. Psychoactive Substances Bill 2015 2015 [02/07/15].          

3.         Statistics OfN. Deaths related to drug poisoning: results for England and Wales,            1993-2013. Health Statistics Quarterly: 2013. 2013.

4.         Skinner H. The drug abuse screening test. Addictive Behaviors. 1982;7:363-71.

 

Series Editor:  Dr Philip Timms, Chair, Royal College of Psychiatrists' Public Education Engagement Board

Expert Review:  Dr Amy Green, Ms Sophie Swinhoe and Dr Owen Bowden-Jones

Service User & Carers input: members of the Royal College of Psychiatrists' Public Education Engagement Board

This leaflet reflects the best available evidence available at the time of writing.

 

© July 2015. Due for review: July 2018. Royal College of Psychiatrists. This leaflet may be downloaded, printed out, photocopied and distributed free of charge as long as the Royal College of Psychiatrists is properly credited and no profit gained from its use. Permission to reproduce it in any other way must be obtained from permissions@rcpsych.ac.uk. The College does not allow reposting of its leaflets on other sites, but allows them to be linked directly.

 

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For a catalogue of public education materials or copies of our leaflets contact: Leaflets Department, The Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB, Telephone: 020 7235 2351x 2552

 

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