Facts to help you have a good time when you're out at pubs and clubs and to help keep you safe.

Whether you are taking drugs, alcohol, medicines or herbal substances, this guide will tell you their effects, the risks you take, and how to deal with problems, whether they happen to you or a friend. You should know what the law says, what medics say, how to stay safe and how to come down safely.

This guide is for you and your friends. No myths. No hype. Just facts. Keep it handy – the First Aid information alone may just save someone’s life. But please remember, we have space for only limited information - you can get more details from the agencies listed in the Links section.

The new online guide has been set up so it works offline too. This means that once you have accessed it for the fist time via an internet connection, it will be downloaded onto your device and you can bookmark it to your home screen for easy access - just like a regular app. Subsequently you will be able to access it whether or not you are connected to the internet and will also receive alerts about any updates.

We will make updates on an annual basis but we will also add any new information at more regular intervals if it needs to be brought to our readers’ attention.

A PDF of the booklet is available on the London Drug and Alcohol Policy Forum website: www.cityoflondon.gov.uk/ldapf

Look after yourself, look after your mates.

Keeping Safe

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To help you stay safe you should know as much as possible about drugs and the risks if you take them.

Before you go out

  • Clubs are hot, so wear cool clothes for dancing. Take warm clothes for queuing and going home.
  • Eat something – food provides energy for dancing and lines the stomach
  • Remember to sip about a pint of water an hour when dancing non-stop. Any pub or club should provide you with tap water free of charge.
  • Try and sort out how you’re getting home and who you’ll be going with. Sorting out to leave with a mate before you go out can help ensure you both get home safely.

If you are going to take drugs +/-

We need to make it clear that there are risks associated with taking any drugs, and the risks of taking any substance are unpredictable.

The typical effects and risks of taking different substances are listed under the specific drugs pages in this guide. See the menu at the top of the page to find the drug you are interested in. This section gives general practical advice which applies to any drugs you might take:

Buying Drugs +/-

Whether you buy your drugs from a dealer, a friend, off the Internet or from a Head Shop, the only thing you can be sure of is that you don’t know what you’re getting. We know from tablets analysed at festivals and from clubs’ amnesty bins that a large proportion of drugs aren’t what they’re supposed to be. This applies to drugs bought in person and over the Internet. Not only can drugs be fake, they can also be stronger/purer than usual. This is particularly true of some of the “new” drugs – sometimes known as New Psychoactive Substances (NPS) or "legal highs" - which have often been used by very few people.

The golden rule is to be guided by the reaction of your own body, not by what you think you’ve bought.

It’s easy to end up making drugs a more central part of your life than you mean to – set a limit on the money you spend on drugs and try not to borrow from friends, and definitely avoid buying on credit from dealers.

Using Drugs +/-

  • If you are going to use drugs, make sure you are with friends. It’s not a good idea to be on your own - being with friends also helps when you come down.
  • Always tell each other what you’re taking, so if one of you runs into trouble of any sort, the others will know what to do. (See First Aid ).
  • With all drugs, but particularly 'legal highs' or other substances you’re not familiar with, it’s a good idea to 'test dose' – take a very small amount initially and wait to gauge whether the effect is pleasurable and how strong it is and whether you have any unwanted effects.
  • The effects of drugs can vary according to where you are, who you’re with, how you’re feeling emotionally at the time and how physically fit you are. Also, the less you weigh, the more powerful the effect. Women may be affected more than men.
  • Try not to mix drugs or take drugs with alcohol, the effects are hard to predict and often not what you expect. Be especially careful if you’re taking drugs you’ve not tried before – you may accidentally produce reactions you’re not prepared for. Drugs can interact badly with medicines that you have been prescribed by a doctor or have been bought in a pharmacy or chemist.
  • It's best to avoid drugs if you're feeling depressed or anxious (particularly if you are on medication for these as the interactions can be very serious) - they often make you feel worse.
  • If you are pregnant, you may experience effects from drugs you don’t anticipate. They could also affect your baby. The same applies if you are trying to get pregnant as drugs might affect your baby before you even know you are pregnant. It’s best not to take drugs when you’re pregnant or trying to become pregnant.

Staying Safe/Getting Home +/-

  • Remember, you can be much more vulnerable after taking drugs and you should make sure your mates look out for you. Many people are mugged or taken sexual advantage of when off their heads and you are more likely to have an accident on the way home.
  • Many drugs make you feel more confident or stimulated sexually, so you may need to make an extra effort to practise safer sex for obvious health reasons - to avoid sexually transmitted infections, HIV infection and an unwanted pregnancy. See Sex and Drugs for more advice.
  • Don’t drive. Alcohol and drugs affect your perception and reaction times - you could drive dangerously. Drug driving is just as illegal as drink driving. The police are looking out more for drivers using drugs and you could lose your licence or worse.

Coming Down +/-

  • The comedown is the price you pay for taking drugs. If you can’t deal with the comedown, reduce or stop your use. Don’t try to escape the comedown by taking more drugs - you can never outrun it.
  • Some people take different drugs to chill out, hoping to come down more gently. Mixing drugs can have serious health implications. Some people take heroin or tranquillisers for this purpose. This can be dangerous in two ways. Firstly, your body needs to recover from any drugs and alcohol you have been taking. Secondly, it is very easy to start increasing the amount you use of these ‘come down’ drugs which are often more addictive than many recreational drugs. Many people have ended up dependent in this way.
  • Some drugs have effects that last well into the following day or even longer (this appears to be more common with some of the newer drugs see Legal Highs - New Drugs Check the appropriate pages in this guide for details. As a general rule, it is wise to relax and give yourself time out the day after taking any drugs. If paranoia or anxiety occurs, being with good friends can help.

Amphetamines

  • Speed
  • Whizz
  • Paste
  • Sulph
  • Crystal Meth
  • Ice

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Amphetamine, (often referred to as speed) is a stimulant drug. It wakes you up and keeps you going. Its effects are like an adrenaline rush; your heart beats faster and you feel you have more energy. With speed, many people feel very confident and alert and feel they can dance for longer without resting.

Methamphetamine is another type of amphetamine. It is a less common drug in the UK scene but is seen more on the gay chemsex scene. It causes similar effects to speed but these effects last longer.

What happens when you take speed +/-

Taking speed, your mouth will probably go dry and you may grind your teeth. Your appetite disappears and you won't want to sleep. Be aware that speed may make you feel that you are able to drink more alcohol than you'd normally be able to - this can be dangerous. The effects of a dose of speed can last for 6-8 hours.

The strength of speed varies considerably. It is the UK's least pure drug, typically 5% or less.

Methamphetamine is also known as Crank, Meth, Crystal Meth, Base or Ice. It comes in both a powder which is normally snorted and a crystal form which is smoked/injected. Its effects last 12 hours or more.

Negative effects +/-

The negative effects of speed can be serious, they include agitation, a fast heart rate, high blood pressure, strokes, epileptic-like convulsions and a high body temperature. It’s easy to become paranoid, agitated and/or aggressive/very violent and experience hallucinations – users particularly report this with use Crystal Meth use, although these effects can happen with any amphetamine type drug.

The day after +/-

Ups bring downs. Speed makes your body work harder and use its resources faster. When speed wears off, you come down. A come down almost always makes you feel very tired. You will also probably feel anxious or panicky, depressed and perhaps even paranoid. If you have been drinking alcohol as well, the come down can be worse, with an increased risk of dehydration.

If you are experiencing any of these symptoms, don't panic - it's how most people feel after taking speed; if the feeling of anxiety or depression continues for more than a day or two you should seek medical attention. Even after only a small amount, you may feel tired, anxious and hungry for a couple of days.

Using speed a lot +/-

Speed is a powerful drug and if you use it day after day - a speed 'run' - you may experience powerful sensations such as panic and persecution; you may hallucinate. These gradually disappear over a number of days when you stop taking speed. It doesn't take long to build up a tolerance to speed - even using once a week for a few weeks can mean that you need more to get the same effects. It becomes very tempting to use more and more speed, but if you use a lot, you run a number of health risks.

The main health risks are:

  • Generally feeling weak and unwell and getting a lot of colds and bugs - your body is missing good food and sleep.
  • High blood pressure and heart problems – if you have heart or blood pressure problems, you should avoid speed.
  • Mixing speed with other stimulant drugs – ecstasy, or cocaine - can put serious strain on your heart.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Avoid taking other stimulants.
  • Avoid taking speed if you're on anti-depressants; they can interact and worsen the negative effects of speed.
  • Avoid taking speed if you're pregnant, or trying to get pregnant - medical research suggests amphetamines can damage your baby.
  • Avoid taking more speed to put off coming down - you have to come down some time and the longer you leave it, the worse it will be.
  • Avoid injecting speed – it is often cut with stuff that can cause a lot of damage.
  • If you do inject, you may end up having to inject several times a day to maintain the high and prevent the come-down, make sure you get advice from your local drug project to avoid dirty hits, collapsed veins and infected sites.
  • Avoid increasing the amount of speed you take - if you need more to get the same effect, take a break from it. You'll get the same effect from using less again. Remember, if you take a break from using any drug, your tolerance will drop, so if you start again, use a much smaller amount – or you might overdose.
  • Make sure you get plenty of rest and food after a session on speed - arrange life so you're doing nothing the day after.

Vimeo link - need to know from Global Drug Survey +/-

Cannabis

  • Hash
  • Weed
  • Skunk
  • Hydro
  • Herb
  • Ganja
  • Blow
  • Puff
  • Spice

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Cannabis is a relaxant that changes the way you see the world - it can be hallucinogenic.

How people react when they smoke - or eat - cannabis varies. Its effects on you will depend on how you are feeling before you take it, the environment you’re in, and the strength of the cannabis you take. It’s hard to predict the strength of both herbal cannabis and the new man-made versions. However, in recent years, very strong varieties of cannabis usually known as ‘Skunk’ have become the most common form of cannabis sold in the UK.

Taking cannabis and going out +/-

There are an increasing number of “herbal” and man-made products – such as ‘Spice’, ‘Annihilation’ and ‘Black Mamba’ on the market sold as having cannabis-like effects. These are smoking mixtures that contain chemicals which are similar to those found in cannabis and can make you hallucinate. Although they do have similar effects to cannabis, they are often stronger, have longer lasting effect than cannabis and may have different harms associated with their use. Most are illegal with the same penalties for use or dealing as cannabis. Because there are so many different varieties on sale, it is not possible to be clear about the risks associated with them, but research suggest that the negative effects are likely to be similar to cannabis, although there are also reports of more serious problems including seizures, severe agitation/aggression, kidney problems, high blood pressure and other heart related problems.

When smoking cannabis, the effects are usually felt fairly quickly. Although effects vary, most people feel relaxed and happy, possibly losing inhibitions and becoming very giggly. They often feel more aware of music and colour. But another common effect is to feel anxious and paranoid. Vomiting is relatively common and can be very prolonged in some people, particularly if they are using cannabis for a long time. Physical effects are bloodshot eyes, a dry mouth and slow reflexes. Eating cannabis makes it hard to know when the effects will be felt - it may take 90 minutes. It is hard to predict how strong the experience will be or how long it will last, but it can be more than 12 hours.

Using a lot of cannabis +/-

Some of the worst health risks of using a lot of cannabis are linked to the tobacco it is normally smoked with. However, smoking cannabis by itself does cause damage to your chest and may contribute to getting bronchitis or lung cancer. Many long term users talk about feeling very lethargic generally and leading a much less active life. About 10% of cannabis users become dependent – when they stop smoking they become restless, can’t sleep, lose their appetite and crave the drug.

Withdrawal lasts for about 3-7 days. Using cannabis, especially when you start before the age of 15 years, can be associated with an increased risk of mental health problems, especially schizophrenia. The long-term problems of using the new “herbal” and man-made products aren’t yet known.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Make sure you use it in small amounts to test the strength.
  • If you are eating cannabis, make sure you allow at least four hours for the effects to come on before eating any more, otherwise you may accidentally eat too much and have a bad trip.
  • Some people avoid drinking alcohol as it lessens the effect of the cannabis and makes it more likely you will feel sick, dizzy, anxious or claustrophobic. It makes some people throw up.
  • Make sure you tell a friend if you are feeling anxious or paranoid in a club and get them to take you to the chill out room or outside.
  • If you use skunk, you will get a more powerful effect and of course the potential unpleasant reactions will also be more powerful.

Vimeo link - need to know from Global Drug Survey +/-

Cocaine

  • Coke
  • C
  • Charlie/Charles
  • Snow
  • Crack
  • Rocks
  • Stones

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Crack is cocaine powder converted to its free base form – a rock which is normally smoked. Everything in this section applies equally to cocaine powder and crack.

Cocaine is a powerful stimulant drug with very strong effects on both body and mind.

Taking cocaine and going out +/-

Cocaine increases the heart rate, raises the blood pressure and may produce a dry mouth. You may feel a strong urge to drink or smoke, but probably won’t want to eat or sleep. Some people feel sick, irritable or aggressive. The higher the dose, the more pleasurable the feelings but the greater the risk of negative effects.

The strength of cocaine powder can vary wildly from as little as 5% to 40%. Crack produces a rapid, intense high which lasts for about 2 minutes. This is followed by a less intense, but pleasurable feeling which lasts for about another 20 minutes. Taking crack may make you feel - for the brief period of time the effects last - that you’re having the best time of your life and that you are sexually very potent.

After effects +/-

What goes up must come down. Cocaine makes your body work faster and use up its resources quicker. When it wears off, you come down. A come down almost always involves feeling exhausted and hungry.

You will also probably feel anxious or panicky, depressed or even paranoid. Snorting cocaine damages the nasal passages and smoking crack can cause black phlegm, chest pain, lung damage and bronchitis.

Using cocaine a lot +/-

Cocaine is a drug which is difficult to control and long term use can have a powerful effect on mental health resulting in a range of conditions from mild depression and anxiety to the extremes of cocaine psychosis with symptoms similar to schizophrenia.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Avoid taking other stimulants.
  • Avoid mixing with alcohol – alcohol can potentially increase the adverse effects of cocaine on the heart.
  • Avoid taking cocaine if you’re on anti-depressants; they can interact and worsen the negative effects.
  • When substances are snorted, tiny capillaries in the nose burst, sharing straws or notes can pass blood-borne infections such as Hepatitis B or C or even HIV. Use your own snorting device.
  • Avoid injecting cocaine, it is generally a bad idea and brings lots of added risks.
  • Avoid taking more cocaine or crack to put off coming down. You have to come down some time and the longer you leave it, the worse it will be. Don’t be tempted to take heroin or benzos as a way of taking the edge off your come down, this is a very easy way to develop an addiction to another drug.
  • Make sure you get plenty of rest and food after taking cocaine – don’t plan anything strenuous for the day after.
  • Resist the temptation to have another hit the morning after as a pick-me-up, this can be a first step towards changing social, recreational use into problem use.

Vimeo link - need to know from Global Drug Survey +/-

Ecstasy

  • MDMA/PMA E
  • E
  • Pills

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Ecstasy (MDMA) is both a stimulant - it speeds up your body system - and a mood changing drug, which alters how you see the world.

Its effects can vary considerably, depending on how you feel when you take it, who you are with and where you are and how much you have taken previously. The effects of ecstasy also vary according to what you take.

Taking ecstasy and going out +/-

There’s a whole range of drugs sold as ecstasy, such as MDEA, MDA, PMA, PMMA and different cathinones (see the section on Legal highs - new drugs ). This means that it’s almost impossible to know what you are taking - both the effects and how strong those effects are will vary widely. Often MDMA comes as a powder or crystals. This is believed to be purer than traditional tablets. As it is dabbed or snorted, the hit comes on quickly and is more intense - it also makes it harder to work out how much you have taken.

PMA can be stronger than MDMA and can take up to 2 hours for the effects to be felt. It is therefore easy to overdose on PMA as you may end up taking extra doses as you don’t believe the “ecstasy” is working properly.

The effects can combine feeling both stimulated and relaxed as well as being totally in tune with other people.

Around 20 minutes to an hour after taking ecstasy, you are likely to feel hot and sweaty, have a dry mouth and grind your teeth. Your heart beats faster and you lose your appetite. People often feel things more intensely. In a club you are likely to really lock into the music and many people warm to others. But experiences vary and some people feel anxious and even paranoid. Effects tend to be at their strongest during the first two hours, but can last for several hours at a lesser intensity.

Complications of ecstasy use include feeling agitated, a high heart rate, high blood pressure, dehydration and a high body temperature. These complications can lead to severe liver and kidney problems.

After-effects +/-

In 2014 there were 50 reported deaths in the UK where ecstasy use was implicated, often alongside other drugs. In 2014, PMA was implicated in 24 deaths.

Despite the level of media coverage, the number of ecstasy-related deaths remains small in comparison to deaths from heroin and cocaine.

Ecstasy decreases the feeling of tiredness and thirst. Since you naturally get very hot dancing all night in a sweaty club, it is easy to become so dehydrated that you overheat and collapse. See Staying Safe below.

Because ecstasy is a stimulant, the come down is like speed (see the section on Amphetamine and Methamphetamine ).

Once your mood is no longer artificially elevated, you may sink into anxiety and depression. You will experience how tired and hungry you really are. Awkward situations can be hard to handle and make you panic or paranoid.

Using ecstasy on a regular basis +/-

Long term frequent users find that they need more ecstasy to get high, but even then the effect is not as good. Using it often, you may get run down from exhaustion resulting in colds, sore throats and flu. Women may find they get infections like cystitis and thrush.

The more ecstasy you use, the worse the come down effects. If you’re already depressed, taking MDMA will make this worse. If you are on anti-depressants, MDMA can interact with them in unpredictable and risky ways.

Long term effects +/-

Researchers have found evidence that high doses of ecstasy damages the brains of animals. Some studies have shown that this also applies to humans, and may lead to mental health problems later in life. Your short term memory may be affected.

Staying Safe +/-

As well as the general guidelines in the section Keeping Safe

  • Make sure you feel fit and rested in the first place. Ecstasy puts a lot of strain on the heart, liver and kidneys.
  • Even if you’re a regular E user, take small amounts at first to test the strength, you can always take more later. Even what looks like the same pill bought from the same person can be twice as strong this week as it was last week.
  • PMA and other compounds sometimes found in tablets sold as ecstasy pills may take an hour or longer to kick in, make sure you don’t assume you’ve been sold a weak pill and double dose.
  • Be wary of buying MDMA powder from a stranger (though there’s no guarantee a dealer you know won’t rip you off) as some users have been sold something completely different with very different effects, or even tablets made from Plaster of Paris.
  • Make sure when you’re dancing non-stop that you drink around a pint of fluid (not alcohol) an hour to replace fluid lost by sweating. Isotonic sports drinks replace lost body salts very effectively.
  • Make sure you rest often and use the chill out area. Avoid taking other drugs, including alcohol and energy drinks like Red Bull because they can dehydrate you and make it more likely you will over heat.
  • Avoid taking more ecstasy once the initial effects have worn off – this strains your system and makes coming down worse.
  • Avoid taking ecstasy if you’re on anti-depressants.
  • Avoid taking ecstasy if you suffer from epilepsy, have a heart disease or sickle cell disease.
  • Avoid increasing the amount of ecstasy you take – if you need to take more to get the same effect as the last time, take a break from it. Remember, if you take a break from using any drug, your tolerance will drop, so if you start again, use a much smaller amount – or you might overdose.
  • Avoid taking ecstasy if you are on medication for HIV-related conditions (anti-retro-viral medicines), they react very badly together and can be life-threatening.

Sorting out a problem +/-

If someone gets anxious or panicky in a club, calm them by talking in a quiet and reassuring way, move them away from the music and lights and seek medical help. For more information see the section on First Aid

Vimeo link - need to know from Global Drug Survey +/-

GHB

  • G
  • Gina

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Essentially a ‘downer’, a small dose - a small capful - of GHB or GBL will make you feel relaxed and uninhibited if you’re feeling good to start with; or more down and miserable if you’re feeling low when you take it.

With larger doses, you risk unpleasant effects such as feeling and being sick, and disorientation.

NB GHB and GBL are different but similar drugs, to avoid confusion we use the term GHB to refer to both in this section.

Taking GHB/GBL and going out +/-

People have had fits and collapsed. As well as causing collapse, GHB can cause coma and even cause you to stop breathing. Coma and vomiting is a dangerous combination as you can choke on your vomit and die. GHB is normally found in liquid form, which makes it difficult to control the amount taken, be very careful not to take too much.

The effects of GHB kick in after 10 minutes and last for 1-2 hours. The strength of GHB varies a lot.

If you use it, take a small amount (0.5ml test dose – because a dose of more than 1-2 mls can easily overdose you especially with alcohol) and wait at least an hour before taking more – it might be stronger than you or your friends have taken before. Be careful as badly made GHB can really burn your mouth.

Avoid taking GHB with alcohol or any other 'downer', you greatly increase the risk of overdose and the effect you get is very unpredictable.

Staying Safe +/-

As well as the general guidelines in the section Keeping Safe

The biggest problem with taking GHB is the ‘steep dose/response curve’, people keep sipping a little bit more and go straight from having mild effects to being unconscious. There is no guaranteed way of avoiding this. However, you should take very small amounts and wait at least an hour without any effects before taking any more. Drinking alcohol definitely makes passing out much more likely. So don’t drink if you are planning to take G.

GHB can cause severe breathing problems, so don’t take it if you have asthma or any other respiratory condition.

Vomiting can also occur if you take too much GHB, and this can be more dangerous if you are drowsy and then start vomiting.

Most users recover fully and quickly if they go into a GHB-induced coma, but a GHB-induced coma can be dangerous and individuals who are unconscious after taking GHB need urgent hospital assessment. There have been an increasing number of deaths in the last few years. Just because you survive a coma once, doesn’t mean you will do so next time.

GHB is a drug that people can get addicted to. This can happen when people start taking it regularly (often several times a day every day) and then they need to keep taking it to avoid withdrawal symptoms (which can be very unpleasant and dangerous). If you or a friend find yourself in this situation or your are worried about your GHB use, please seek help. (see the contact information in the Links section).

If someone collapses after taking G, you MUST call an ambulance immediately, you don’t want to be responsible for someone’s death. It is vital to put them in the recovery position (see the section on First Aid ) while you are waiting for the ambulance.

Heroin

  • Smack
  • Brown
  • Gear
  • Skag
  • H

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Heroin is a strong painkiller, well known for its addictive properties, so be cautious.

Street heroin usually comes as a brown powder, and is snorted, smoked in a joint, smoked on foil (chasing), or injected. The first use may make you vomit, this is followed by a feeling of well-being and distance from worries. Users may become so sedated that they appear to be asleep.

Taking heroin and going out +/-

Heroin is not a drug generally associated with going out, although some people use it as a chill out drug. Using heroin to help you come down is very risky, it is much more addictive than many recreational drugs. Many people have ended up dependent in this way.

Remember – you can get addicted even if you only ever smoke it.

The negative effects of heroin can be very serious, drowsiness and coma and stopping breathing.

Staying safe +/-

As well as the general guidelines in Keeping Safe

  • Heroin addiction does not happen instantly, watch for your use increasing, and needing to use more to feel the same effect or to stave off feeling sick - dependency can creep up on you. It is best not used to come down after a hectic night.
  • If you inject heroin, it is vital that you do not share any equipment, as blood borne viruses like Hepatitis and HIV are passed on easily. Seek advice from a local drug agency. It is not just sharing needles and syringes that can be dangerous.
  • Many of the health risks with heroin come from injecting, but smoking can lead to chest problems.
  • Be aware that heroin may contain impurities, strength can vary and injecting heroin carries a risk of overdose.
  • Avoid drinking alcohol with heroin, it greatly increases the risk of overdose.

Ketamine

  • K
  • Special K
  • Mexxy

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Ketamine is an animal and human anaesthetic. It is usually supplied as a powder or as crystals, but occasionally as a liquid.

It detaches people from their environment, and some users report being unable to move or speak while being fully conscious and able to see what is going on. For these reasons, it is important to be cautious the first time you use it.

Taking ketamine and going out +/-

Ketamine’s hallucinogenic and painkilling effects come on within about 30 seconds if it is snorted, and a few seconds if injected. Sometimes ketamine is combined with MDMA type drugs and sold in pills as ecstasy. It is also found in liquid form, when it is difficult to predict its strength. Some say that the first effects are of physical numbness, and a rush combined with hallucinations and out of body sensations.

People have described weird trips believing the hallucinations to be real. Ketamine taken in higher doses may produce difficulty in co-ordination and speech. It’s very easy to injure yourself because you won’t feel the pain straight away.

Other people report a feeling of temporary paralysis, slurring their words and feeling sick especially if they have eaten a few hours before using

Regular ketamine use damages the lining of the bladder resulting in considerable pain, an increased need to urinate and/or passing blood in the urine. The damage can be permanent and require surgery. If you need to urinate frequently, it hurts to wee or you have blood in your urine, stop using ketamine and seek medical advice – whatever you do, don’t continue to use ketamine to ease the pain.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Be careful how much ketamine you take - it is a very different drug from speed or ecstasy.
  • Avoid taking ketamine anywhere where it could be dangerous if you fall - because it’s an anaesthetic, you won’t know you’re hurt. People often burn themselves when smoking after taking ketamine.
  • Avoid taking speed if you're pregnant, or trying to get pregnant - medical research suggests amphetamines can damage your baby.
  • Make sure you understand you may have a very strong trip and your body will feel numb in what may be a frightening and unpleasant way.
  • Make sure you have friends who know you’ve taken it and will look out for you. It is very easy to rob or take sexual advantage of someone who has taken ketamine.
  • Make sure you are feeling fit and well physically and emotionally before you take ketamine; your body and mind need to be strong to cope with it.
  • Avoid mixing ketamine with other drugs, especially alcohol. If you drink, it is very difficult to judge how much ketamine to take without falling into a ‘K-hole’ – a semi-comatose state.
  • There have been “new drugs” sold as “safe alternatives to Ketamine”. Methoxetamine (Mexxy, MXE) was one of these which turned out to be potentially more dangerous than Ketamine with the same negative effects on the bladder.

Vimeo link - need to know from drug global survey +/-

Legal highs
and new drugs

  • Herbal Highs
  • Novel Psychoactive Drugs
  • NPS

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In recent years, there has been a great increase in products sold as “legal highs”. Sometimes these are herbal and sometimes man made.

In the last four years, approximately 1-2 new substance per week has been identified in Europe. Many of these substances have been made illegal in the UK under the Misuse of Drugs Act. On 26 May 2016 a new law created a blanket ban on the production, distribution, sale and supply of all psychoactive substances (basically any form of drug not a medicine) in the UK.
See the section on drugs and the law for more details.

There are too many products to discuss here and even products which have a similar name or description may be completely different in terms of their contents, strength, effects and how long they last for. It should be borne in mind that many of these products, although marketed as natural, contain substances never designed to be consumed by humans. Since many of these products are sold on the Internet as a white powder in small ziplock bags, it’s hard to know what they actually contain.

Two of the most common families of these new drugs are covered here:

Cathinones: MeOW, M-Cat,Bubbles, Bath Salts, Mephedrone +/-

Cathinones are synthetic chemicals related to the natural compounds found in the Khat plant.

Mephedrone is a white or off-white powder which is either snorted or swallowed. Its unwanted effects and risks are similar to cocaine and/or amphetamine.

When mephedrone is snorted, it only takes a few minutes for its effects to appear, and the effects generally peak in half an hour or less. When swallowed (usually wrapped in a cigarette paper - known as bombing) its effects can take more than 45 minutes to appear, depending on factors like how much food is in the stomach.

Synthetic/man-made Cannabinoids: Spice, Clockwork Orange, Pandora's Box, Annihilation +/-

These are smoking herbal mixtures with chemicals added to them that have a similar effect to cannabis. They may be stronger, have much longer lasting effects than cannabis and may have more serious unwanted effects.

Many people find the experience of smoking legal highs less enjoyable than smoking cannabis. They are often illegal with the same penalties for use or dealing as cannabis.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Different packets may vary considerably in strength.
  • Try to find out as much as you can about any new drug you are trying (but remember it may not be what you’re told it is).
  • Don’t try a new drug when you are not feeling well or if you are coming down from taking other drugs.
  • Take a new drug in a safe place with friends who are not going to take it.
  • Don’t be the first person to experiment with a new drug – why be your friends’ guinea pig?
  • Take only small amounts – about a quarter of what you would consider to be a tiny dose – and wait at least 90 minutes to two hours before taking more if you don’t seem to have any effect.
  • Don’t mix them with alcohol or other drugs.
  • Avoid driving after use.

LSD and
hallucinogens

  • Acid
  • Tabs
  • Trips
  • Microdots
  • Liberty Cap
  • Fly Agaric
  • Shrooms
  • AMT
  • Hallucinogens

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LSD, Magic Mushrooms and some of the 'new drugs' which make you hallucinate – such as DMT, AMT, NBOM-e and 2-CB – are all dealt with in this section because their effects are similar.

There are a number of new hallucinogens such as the tryptamines. See the section on Legal highs - new drugs for more information about new drugs.

What is LSD? +/-

LSD is a powerful hallucinogenic drug often known as ‘acid’ or ‘trips’ and usually comes on a ‘tab’ (a small square of paper impregnated with the drug). It affects the way you see things and feel about the world.

LSD may be found as a liquid in containers like those used for breath freshener and as tiny tablets called microdots.

What are Magic Mushrooms? +/-

Magic Mushrooms are mushrooms which grow in the wild that produce similar effects to LSD when you eat them.

The most common form is Liberty Cap (Psilocybe semilanceata).

Some species of Magic Mushrooms look almost the same as deadly poisonous ones – if you don’t know what you’re picking, don’t eat them. After picking, they’re either eaten raw or dried out and stored.

Taking hallucinogens and going out +/-

As with all drugs, people’s experience of hallucinogens tends to be very individual. However the added problem is that with both LSD and mushrooms, it’s impossible to tell how strong they are until after you’ve taken it. Indeed some people can experience much stronger effects than others, even when they take the same substance. The effects of acid are normally felt about 20 minutes to two hours after taking it. If you are not used to it, you may not realise you are affected for some time. The effects are known as a ‘trip’ and can last anywhere from five to 24 hours, though 8-12 hours is most common.

As the trip starts to come on, you may feel exhilarated or agitated; you may want to dance or laugh a lot. The drug affects perception. Familiar objects and even people may appear unfamiliar and strange. The trip tends to get more intense after two to four hours; sight, hearing and touch often become very sensitive and distorted. The experiences may be pleasurable or upsetting.

If you are tripping in a club, you may experience a great place full of happy, dancing people; or you may find the music and lights and crowds very frightening.

The effects of mushrooms are very similar to the effects of LSD except that they may make you vomit. The effects for both types of mushrooms can take between 30 minutes to two hours to happen. The strongest part of the trip takes 4-10 hours and the after-effects usually last a further 2-6 hours. The more you take, the longer your trip could last.

The main risk is eating poisonous mushrooms which could prove fatal - if you are worried that you may have eaten a poisonous mushroom it is important that you are seen by a doctor / in hospital as soon as possible (and preferably take some of the uncooked mushroom with you). If you have a mental health problem such as paranoia or schizophrenia, mushrooms can give you a very bad time and complicate the problems you already have. As with all hallucinogens, make sure you are in a safe place with friends. It is quite common to vomit and have stomach pains after taking mushrooms.

If you keep vomiting and have severe stomach pains, seek medical attention and take a sample of the mushrooms you have taken with you IMMEDIATELY.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • There are no known physical dangers associated with the use of LSD, (though it’s easy to have an accident) nor any proof of brain damage, although you may injure yourself as part of the trip you are having. However, users may experience flashbacks days or even weeks after taking acid, when elements of their trip are experienced again as if they are happening in the present.
  • There are psychological risks. Depressed or anxious people will probably find that taking acid makes life feel even more chaotic and confused. Anyone with a history of mental illness may find that hallucinogens aggravate existing problems.

Vimeo link - need to know from Global Drug Survey +/-

Nitrous Oxide

  • Balloons
  • Hippy Crack
  • Laughing Gas

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The last few years have seen a growth in the use of nitrous oxide to get high, especially at festivals and often in combination with other drugs.

People generally used a whipped cream charger (known as a cracker) which is dispensed into a balloon and then breathed in.

Taking nitrous oxide and going out +/-

Most people experience a rush immediately, tend to burst out laughing and feel dizzy. They may also feel quite relaxed and may have some hallucinations, ranging from moving bright dots to more detailed dreamscapes.

Because nitrous oxide is an anaesthetic, it slows people down and affects co-ordination. Using reduces the amount of oxygen in the bloodstream, so your heart rate will increase and your limbs can feel heavy and tingle, you may get a headache.

These effects peak very quickly and then die away almost as fast, the whole experience lasting a couple of minutes.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Avoid using with other depressant drugs (alcohol/GHB/ketamine) as you could lose consciousness; this can be very dangerous.
  • Avoid using with other hallucinogens (strong cannabis, ecstasy, ketamine, LSD, mushrooms) as the effects can be very intense and disturbing.
  • Never put a bag with nitrous oxide over your head – you could die from suffocation.
  • Always use a balloon – inhaling straight from a cracker can result in frostbite of the lips and mouth and could freeze your airways, leading to suffocation.
  • People who use nitrous oxide regularly over a long period can get numbness and spasms in their arms and legs and tinnitus (a ringing sensation) in their ears. If these happen stop using nitrous oxide and see your GP.

Vimeo link - need to know from Global Drug Survey +/-

Poppers

  • Amyl
  • Rush
  • TNT
  • Rock
  • Hard
  • Kix
  • LiquidGold

Top

Volatile nitrites – generally known as "poppers" – dilate veins and arteries, making blood flow faster through the heart and brain.

Taking poppers and going out +/-

Most people experience a rush immediately after sniffing poppers. After the initial rush, you may feel light-headed for a few minutes. Some people report less pleasant feelings – pounding headaches, dizziness and a flushed face.

It is possible that using poppers may damage your sight – see an optician if you experience blurred vision after using poppers.

Poppers and sex +/-

Poppers are often used during sex, as a stimulant and muscle relaxant. Poppers used in conjunction with Viagra can massively decrease your blood pressure and can even be fatal. See the section on Sex and Drugs for more advice on taking drugs and having sex.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • Make sure you take a break from poppers if you experience unpleasant sensations – headaches, swelling of the nasal passages, skin problems (crusty sores around nose, mouth and lips) – or if they lose their effect.
  • Wash liquid off immediately if it gets on the skin as it causes skin rashes.
  • Avoid holding poppers in your mouth - if someone accidentally swallows poppers, get medical help immediately - this can cause severe problems and one bottle may even kill you.
  • Avoid taking other drugs – especially stimulants (speed, ecstasy, cocaine) which will put too much strain on your heart.
  • Avoid using poppers if you have heart trouble or breathing problems, anaemia or glaucoma.
  • Never smoke when using poppers – they can go up in flames.
  • Never have naked flames around poppers – they are flammable and can cause a fire.
  • Stop using immediately if you experience blurred vision.

Vimeo link - need to know from Global Drug Survey +/-

Steroids

  • Anabolics
  • Juice
  • Roids

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Most steroids used in the UK are manufactured abroad and imported in the UK. Some are purchased on-line but many from people at the gym.

Steroids come in different forms: as a liquid for injecting (into the muscle, NEVER into a vein) or as tablets. Sometimes the tablets look like regular medicines in foil packs, but sometimes they are just unmarked tablets in a plastic bag. They are often counterfeit and do not contain the correct drug.

Taking steroids and going out +/-

Unlike most drugs in this guide, steroids don’t change how you feel in a short time. Most work by providing extra testosterone which helps people grow bigger muscles quicker. They do also give you a lift, increasing sexual desire and making you feel more confident.

Steroids are generally taken in cycles – with specific dosages for a number of weeks followed by a rest from steroid use for a further few weeks.

There are a number of health risks including:

  • The body stops producing its own testosterone leading to reduced sex drive, impotence and depression.
  • Men can develop breast tissue.
  • Women can develop facial hair, experience a reduction in breast tissue and have irregular or no periods.
  • There are particular risks for young people where steroid use can affect bone development and general health.

Staying Safe +/-

As well as the general guidelines in Keeping Safe

  • It’s very important to know what steroids you’re taking.
  • Use low doses.
  • Don’t repeat cycles, make sure you have rest periods of several weeks
  • If you inject, make sure your needle and all other equipment is new every time.
  • Don’t use diuretics (tablets to suppress your appetite by making you urinate more).
  • Avoid using other drugs to treat side effects.

Mixing Drugs

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There’s no way to predict accurately how a combination of drugs will affect any individual. Drug interactions are complex.

Taking two different stimulants may be much more powerful and have a different effect from taking twice the amount of one drug. The best advice is not to mix any drugs – and that also includes alcohol and medicines/drugs you have on prescription or from a pharmacy/chemist.

However, if you do take more than one drug a night, the most important thing is to remember what you take when and to allow time for the effects to kick in and wear off. Not only is this much safer, but it also means you’re more likely to get the effect you intended. Remember all the times you have a smoke of cannabis or a dab of speed - the effects are cumulative and they’ll mount up.

  • Give the first drug plenty of time to kick in or wear off before taking another one.
  • If you don’t feel comfortable don’t take more to make yourself better.
  • Look out for your mates – you’ll probably spot the signs they are in trouble quicker than they will.
  • If you weigh less than your friends, bear in mind that any drugs or alcohol will have more effect on you than on heavier people – adjust your intake accordingly.
  • Recreational drugs can react badly with ordinary medicines that you have bought in a pharmacy or been prescribed by a doctor. There can be two types of reactions: the negative effects of the recreational drugs are greater and/or the drugs that you are taking for a medical condition become less effective.
  • Don’t just take the same amount of drugs as your friends - some will have potentially used different amounts in the past and therefore will be able to tolerate taking more than you can.
  • Be particularly cautious with drugs you haven’t tried before.

People often try different substances to try to make the come down earlier (see the Coming Down section in Keeping Safe for more information on coming down safely).

Smoking strong cannabis such as skunk to take the edge off ecstasy is unlikely to work; you’ll probably get stronger feelings of anxiety and paranoia and may experience upsetting sensations. If you use alcohol to come down from taking drugs, remember that alcohol dehydrates you. It really is important to drink non-alcoholic fluids as well - you’ll feel much better the next day. Try not to put off coming down. The longer you put it off, the worse it will be. In particular, avoid using heroin or benzodiazepines like diazepam (Valium) or temazepam to take the edge off your come down from your main drug. You are just using more drugs which are much more physically addictive than ecstasy, speed or acid. There’s a real danger that you can easily extend your drug taking to become a daily need rather than a party experience. The best way to come down is naturally, with rest and relaxation, replenishing your body with food and fluids.

Sex and Drugs

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Drugs, including alcohol, can make many people feel more sexually confident or sexier in general. Some can improve sexual performance and give people added stamina for longer sex sessions. Others can make people feel more sexy or simply more in the mood for sex.

Some drugs such as Viagra and its equivalents are taken by men solely to enhance their sex life - mainly to get and keep an erection.

Using drugs and having sex +/-

Lots of people use drugs before, during or after sex but gay men are more likely to use drugs during sex.

Some drugs are used because they help with certain sex acts. Poppers relax the anal sphincter when having sex or fisting. Ketamine relaxes anal muscles too, and is used for fisting. Some drugs such as ketamine,, speed, and methamphetamine act as pain killers, especially when put directly on the anus. This lets people have rougher sex – and for longer.

But rougher and longer sex means there is more chance your skin will get sore or cut either inside the body or on the skin of your penis or anus. This makes it easier for infections including HIV to get out of one body and into another. Rougher, longer sex also puts added stress on condoms. Rubbers are more likely to break after around 30 minutes, so a fresh one will be needed or at least check regularly that it’s still in one piece.

The risks of Viagra +/-

  • Viagra used in conjunction with poppers can massively decrease your blood pressure and can even be fatal.
  • Don’t use Viagra if you have low blood pressure or have any heart or liver problems.
  • If you take HIV medication (protease inhibitors), you are likely to experience stronger side effects from Viagra (headache, stomach upset and blurred vision).

Drugs and risky sex +/-

Being less self-conscious or in control through using drugs has a downside. You may decide to do things you wouldn’t do if sober, including high risk acts like unprotected sex.

Drugfucked is a great online resource for gay men taking drugs before, during or after sex: www.drugfucked.tht.org.uk

Drugs and HIV +/-

If you think you have been exposed to HIV through risky sex, you should go to your doctor, an A&E department or a sexual health clinic (GUM clinic) immediately (as soon as possible or the next day) and ask about PEP (post-exposure prophylaxis). PEP involves taking anti-HIV medications within 3 days (the earlier the better) after you may have been exposed to HIV to try to reduce the chance of becoming HIV positive. PEP is a month-long course of emergency medication taken to try to keep HIV from making copies of itself and spreading through your body. You will need to be followed up in a sexual health clinic once you start PEP to make sure that you don’t get side effects from the medication and also to see if it has worked.

Friday/Monday is a great online resource from the Terrence Higgins Trust for gay and bi men taking drugs before, during or after sex: www.tht.org.uk/friday-monday

SAFER CHEMS from the Gay Men’s Health Charity is also an excellent source of advice and information: www.gmfa.org.uk/Pages/Category/safer-chems

Law

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Caution

This is a complex area where we can only provide general guidelines. Anyone in difficulties with the law should get legal advice at the earliest opportunity by contacting their solicitor or Release (Helpline 020 7324 2989 [email protected] )

The Misuse of Drugs Act +/-

There are a number of laws and regulations affecting the possession, supply and trafficking of illegal drugs. The most important is the Misuse of Drugs Act 1971 which has been updated regularly over the last 40 years. This law sets out which drugs are ‘controlled’ and outlines the range of offences and penalties the courts can apply for each. The Act places controlled drugs into three classes; A, B and C. These classes dictate how serious the penalty can be for a crime involving a drug in that category.

Class A: includes heroin, LSD, ecstasy, cocaine, methamphetamine, magic mushrooms and any Class B drug prepared for injection.

Class B: includes speed, cannabis, ketamine, cathinones such as mephedrone and forms of synthetic cannabis such as ‘Spice’.

Class C: Many prescribed drugs such as tranquillisers, GHB, GBL and anabolic steroids are Class C drugs.

New drugs can now quickly be made illegal under a Temporary Class Drug Order – TCDOs can come into effect immediately and can last up to 12 months. This gives time for the government to decide whether a new substance is dangerous and should be added to the Misuse of Drugs Act. It is not illegal to possess or use a drug subject to a TCDO but it is illegal to sell it.

The main offences +/-

The most common offence is possession of a controlled drug. This includes shared possession of a common pool of drugs and past possession, when past drug use is admitted.

More serious offences are supply and intention to supply. Remember, supply includes giving or selling drugs to a friend, or even looking after them for someone else. People who say, “the drugs were not all for me, some were for a friend” usually make things worse for themselves by admitting supply.

The heaviest penalties concern the import and export of large amounts of controlled drugs. Cultivation of cannabis is also an offence. Penalties are more severe if the court believes cultivation was intended to supply others.

Prosecution and punishment +/-

There are many factors to take into account in deciding the punishment for any particular offence and this booklet cannot cover all of them.

However, you should know that for possession of a Class C drug the maximum penalty is 2 years imprisonment or a fine or both. The maximum penalty for supplying Class C drugs is 14 years imprisonment or a fine or both.

Although maximum sentences are rare, prison sentences are common for offences which involve supplying drugs. Many aggravating and mitigating factors can operate, such as the amount of the drug involved, whether it was a first offence or not and the defendant’s character. Sentences are generally more severe for offences relating to Class A and B drugs.

Possession of cannabis is treated differently +/-

If an adult (aged 18 or older) is caught in possession of cannabis, they should be issued with a cannabis warning which is a spoken warning. If they are caught a second time, they should be issued with a Penalty Notice for Disorder (PND) for cannabis possession. PNDs are tickets that police officers can issue at the scene of an incident or in custody – they carry an on-the-spot fine of £80. A third offence could result in someone facing criminal charges.

If a young person (aged under 18) is caught in possession of cannabis, they will be arrested and taken to a police station where they can receive a reprimand, final warning or charge depending on the seriousness of the offence. This must be administered in the presence of an appropriate adult.

Finally, the local police and prosecution policies where offences are committed are very important. Some police forces automatically caution first time offenders with small amounts of drugs. Others tend to always prosecute. There’s a wide variation across the UK and it’s impossible to generalise. Even if a first time offender with a small quantity of drugs for personal use is simply cautioned or fined, it shouldn’t be taken lightly since it can affect that person’s future career. Lots of job applications ask about any criminal convictions. Also several countries, including the USA, may refuse you entry.

The Psychoactive Substances Act +/-

As discussed in the “legal highs” section, many new artificial and herbal substances have been made illegal over recent years. As soon as a drug was made illegal, the people manufacturing it changed its chemical composition to make it legal again. So, the government decided to change tack.

On 26 May 2016, The Psychoactive Substances Act became law and made it a crime to produce, supply or offer to supply any psychoactive substance if the substance is likely to be used for its psychoactive effects and regardless of its potential for harm.

The term 'psychoactive' is still to be defined by the courts but is generally considered to be “a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behaviour” .

The only exemption from the Act are those substances already controlled by the Misuse of Drugs Act (see above), nicotine, alcohol, caffeine and medicines.

The law is aimed at shops and websites supplying legal highs. It is NOT illegal to buy or use these substances (unless they are controlled by the Misuse of Drugs Act as most artificial forms of cannabis such as Spice and cathinones such as mephedrone are).

It is illegal to supply them to your friends or buy them off the Internet if the site is based in another country (you are then considered to be 'importing' psychoactive substances).

Drugs and driving +/-

It’s illegal to drive if either:

  • you’re unfit to do so because you’re on legal or illegal drugs
  • you have certain levels of illegal drugs in your blood (even if they haven’t affected your driving)

Legal drugs are prescription or over-the-counter medicines. If you’re taking them and not sure if you should drive, talk to your doctor, pharmacist or healthcare professional.

The police can stop you and make you do a ‘field impairment assessment’ if they think you’re on drugs. This is a series of tests, e.g. asking you to walk in a straight line. They can also use a roadside drug kit to screen for cannabis and cocaine.

If they think you’re unfit to drive because of taking drugs, you’ll be arrested and will have to take a blood or urine test at a police station. You could be charged with a crime if the test shows you’ve taken drugs.

If guilty of driving when unfit, there's a compulsory 12 months' disqualification and a fine. In cases involving accidents or other aggravating circumstances, then longer disqualifications, stiffer fines and imprisonment can apply. The consequences are the same whether you are driving under the influence of drink or drugs.

Know your rights +/-

Remember: you can be stopped and searched if the police have reasonable suspicion that you are in possession of a controlled drug. If you are arrested, don’t panic, you cannot be locked up indefinitely. Always consult a solicitor – it’s your legal right.

First Aid

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Getting help in the club

Good clubs have at least one First Aider or paramedic who knows about drugs. Ask a staff member for the First Aider and if you have trouble, demand to see the manager.

If in doubt, always ask for an ambulance to be called – do it yourself if necessary.

If you know, tell the First Aider or paramedic what drugs have been taken. They are not interested in legalities, but want to help your friend, so the drug information is vital. If someone collapses on the dance floor. Put the person in the recovery position, then send for help immediately.

Recovery Position +/-

If the person is breathing, turn them on to their front, with their head sideways. Bend their upper arm and leg. Straighten the other arm parallel to their back. Either stay with them, asking stewards to clear a space or, if possible, move them, still in the recovery position, to a quieter place.

If they are not breathing, and you know how to do mouth to mouth resuscitation or chest compression- only, do so. If not, wait until someone arrives who does. In the meantime, put them in the recovery position. Call 999 if necessary. Monitor until help arrives.

1

  • Place arm nearest to you at a right angle, with palm facing up.
2

  • Move other arm as shown, keeping the back of their hand against their cheek.
  • Get hold of knee furthest from you and pull up until foot is flat on the floor.
3

  • Pull the knee towards you keeping the casualty's hand pressed against their cheek.
  • Position the leg at a right angle.
4

  • Make sure that the airway remains open by tilting the head back, then checking breathing by feeling and listening for breath.

Recognising Heat Exhaustion, Heat Stroke and Overheating +/-

It is not just being hot. Symptoms could include any or many of the following:– dizziness, feeling sick, sudden tiredness, sudden headache or cramps, particularly in the arms and legs. Peeing is difficult and it’s dark in colour. Sweating may stop, which is a strong signal of dangerously increasing body heat. Blackouts, collapsing, fits or fainting can follow. A very high body temperature can lead to life-threatening problems.

Anyone suffering from any of these symptoms should immediately take a break, cool down in the quieter area or chill out room and sip about a pint of water slowly. Gulping down a great deal of water should be avoided. (As a general rule, when dancing, sip about a pint of water per hour.) If your body gets back to normal temperature, try to find dry or warmer clothes or a blanket – don’t over chill.

If you are concerned that someone has heat exhaustion, get them assessed in the club first aid room and have their body temperature checked. If the body temperature is very high, an ambulance should be called as this is a medical emergency .

Cool or tepid water splashed on the head and neck help with cooling down, as will wrapping them in cool damp towels. Loosen tight clothes and remove hats or other headgear. If the symptoms persist, get help and call an ambulance.

Anxiety/bad trips +/-

If someone gets very anxious after taking drugs, then:

  • Take them to a quiet place away from music, bright lights and crowds.
  • Talk to them calmly and reassure them that their feelings will pass.

If they are hyper-ventilating (breathing fast and shallow), get them to relax and take long, slow breaths. If hyper-ventilation persists, get help and call an ambulance.

Other serious problems +/-

  • Any chest pain is potentially serious in people who have used drugs. If it persists for more than a few minutes get them assessed in the club first aid room or call an ambulance.
  • Drugs can cause people to have a stroke. This can result in difficulty with movement of the face / arms / legs, difficulty speaking or understanding you when you speak to them. If any of these occur call an ambulance without delay.
  • Drugs can cause people to have epileptic-like convulsions, even if they don’t have a history of epilepsy. Anyone who has a convulsion should be assessed in the club first aid room or seen in hospital.
  • Drugs can cause lots of other problems – if you or one of your friends is unwell after taking drugs it is best to seek medical attention. Be honest about what you have taken – doctors have a duty of confidentiality and will not report you to the police for taking illegal substances.