Addressing alcohol and drug-related issues: Reducing harm and supporting positive change.


Addressing alcohol and drug-related issues: Reducing harm and supporting positive change.

Categories of Drugs

Drugs and Physical Health

  Drugs and Mental Health

Mixing Drugs

Prescription Medications

Drink & Drug Driving


Drugs & Physical Health


Each drug has risks for a person’s health and when used over time the consequences can be more severe. The effects may be short term or long term and can be physical or psychological. The effects of drug use differs for each drug depending on the substance and may differ for each person.  Factors such as other existing health conditions can be exacerbated when some drugs are used. The information below explains the effects some drugs can have on your body. 




Mephedrone is a powerful stimulant that is often compared to drugs like cocaine and ecstasy, a former legal high it is now banned in the EU. It is a manufactured rather than natural substance.

As more reports emerge, the risks are becoming clearer –there are several deaths a year in the UK from people taking mephedrone. It risks overstimulating your nervous system, which may cause hallucinations, feelings of agitation and even fits, as well as overstimulating/ damaging the heart and circulation.

Some users have had severe nosebleeds after snorting mephedrone. Injecting mephedrone is particularly dangerous for several reasons, including the fact that it is easier to overdose from injecting.



Cocaine is one of the drugs that regularly causes death. It causes thousands of emergency hospital admissions, often with chest pain. Most people who die from cocaine are long-term users who take large quantities and whose bodies, particularly the heart, may have been damaged.

If you have a heart condition or high blood pressure then Cocaine is very risky, but it does not just affect those with pre-existing conditions- even healthy young people can have a fit or a heart attack after taking too much. As with all drugs, the risk of overdose increases if you mix Cocaine with other drugs including alcohol.

It can begin to affect physical appearance as over time the cartilage in your nose that separates the nostrils becomes damaged. This can leave heavy users with no cartilage and a misshapen nose.

Other risks with cocaine are associated with the route of administration- if you inject cocaine this can damage veins, which could lead to ulcers and gangrene. There is also an increased risk of HIV and hepatitis infections if sharing needles. Administering cocaine in this way also increases the risk of overdose.

As with all drugs the risk to your baby in pregnancy is heightened and can damage your baby, cause miscarriage, premature labour and low birth weight.



As a stimulant, amphetamine can suppress your appetite and sleep. It puts a strain on your heart and those with high blood pressure or a heart condition would be at very high risk– users have died from taking too much (although uncommon).

If you take a lot of amphetamine, it will begin to impact on your immune system leaving you more susceptible to colds, flus and sore throats.

Injecting amphetamine is particularly dangerous, and it is much easier to overdose when injecting. There is also an increased risk of HIV and hepatitis infections if sharing needles. Speed is usually very impure, so it is not just the amphetamine that goes into your bloodstream, but everything else that it has been cut with.



MDMA is a drug that produces feelings of euphoria and empathy along with energising effects similar to amphetamine. It is commonly sold either in pill form (known as ecstasy) or as MDMA crystals.

Use of ecstasy has been linked to liver, kidney and heart problems. Anyone with a heart condition, blood pressure problems, epilepsy or asthma can have a very dangerous reaction to the drug. Some users report getting colds and sore throats more often when they take ecstasy.

Ecstasy affects the body’s temperature control. Therefore, when taken in particular environments it can be even more risky. For example, if taken when out clubbing and dancing for long periods chances of overheating and dehydration are increased. On the other side to this drinking too much (including water) can also be dangerous. This is because ecstasy can cause the body to release a hormone, which stops it making urine. If you drink too quickly, you might affect your body’s salt balance, which can be as deadly as not drinking enough water.

If using Ecstasy-sip no more than a pint of water or non-alcoholic drink every hour. If you are taking MDMA, start by dabbing a small amount of powder only, then wait for the effects to kick in.



Smoking cannabis can make you wheeze and out of breath, make you cough uncomfortably or painfully and worsen your asthma if you have it. It is likely to have many of the long-term physical health risks as smoking tobacco (especially if you mix the cannabis with tobacco). So smoking cannabis can also increase the risk of lung cancer.

If you are trying to conceive Cannabis may affect your ability to have children as in females, it suppresses ovulation and in males, it can reduce sperm count. It can increase the risk of your baby being born smaller than expected if you smoke it while pregnant.

Taking too much too fast can cause someone to ‘whitey’, feeling shaky, ill and becoming pale, that can lead to vomit or collapse. This is due to the rapid drop in blood pressure.



Chemicals designed to act like the main psychoactive chemical in cannabis. These can often be misunderstood as being like Cannabis, but the only similarity is that the chemical links to the same receptors in the brain as THC, found in Cannabis, does. Under New Psychoactive Substances Act 2016, those who use Synthetic Cannabinoids are able to avoid possession charges and drug tests due to them being difficult to detect. Popularity has decreased amongst the public but they are still used amongst the prison and homeless population. This is partly due to their dissociative effect, which can support the user in their unpleasant environment.

Effects can be increased appetite, feeling energised and stimulated as well as producing a dream like state. However, it can also incur hallucinations, vomiting, seizures, confusion and aggression with a very intense comedown.  There can be a sudden increase in body temperature, heart rate with risk to internal organs and coma.


Ketamine is a very powerful anaesthetic that can cause serious harm. It can make you feel sick, and it can cause damage to your short and long-term memory.

Ketamine increases your heart rate and blood pressure and can make you confused, agitated, delirious and disconnected from reality. Because you do not feel pain properly when you have recently taken ketamine, you can injure yourself and not know you have done it. This can leave you very vulnerable to hurting yourself or being hurt by others as it causes loss of feelings, paralysis of the muscles and the mind’s loss of touch with reality.

Longer-term impacts on physical health can be serious bladder problems, with the urgent and frequent need to pee or even incontinence. Although stopping using ketamine can help, sometimes the damage can be so serious that the bladder needs surgical repair or even removal.

‘K cramps’- this is abdominal pain, have also been reported by people who have taken ketamine for a long time and there is evidence of liver damage due to regular, heavy ketamine use emerging.

As with all drugs, mixing ketamine with other drugs can be particularly dangerous and even fatal.



Nitrous Oxide is a gas, used recreationally and medicinally for over 200 years, with pain-relieving properties. It is commonly known for making whipped cream, and therefore can be widely available. However, under Psychoactive Substances Act 2016, it is illegal to sell or give away, but has no penalty for possession unless in prison.

Effects are different for people but can cause dizziness and euphoria as well as laughter. Distortions of sound and voices can occur as well as hallucinations. The effects only last seconds and often the user will return to normal within 2 minutes. Continued use of the gas can affect the Vitamin B reserves, which in turn can lead to nerve or brain damage.

The least risky method of use is inhalation from a balloon; however, risks associated with other methods include unconsciousness, brain damage and death.




Solvents are glues, gases and aerosols and are usually readily available as household products, because of this, some people think they are safe to use, but they are not. They can kill the first time they are used. Solvent use can cause people to pass out and choke on their own vomit, as well as risks of suffocation if inhaling with plastic bags.

Inhaling solvents can cause mood swings, aggressive behaviour, hallucinations, vomiting and blackouts. There are a number of physical health risks with solvents such as unsteadiness, disorientation/confusion and fainting, which can all contribute to the risk of accidents and a number of deaths.

Squirting gas products down the throat is particularly dangerous as it can make your throat swell up so you cannot breathe and it can slow down your heart and can cause a heart attack.

Long-term abuse can damage the muscles, liver and kidneys. While very long-term use, such as 10 years or more, can cause a lasting impairment of brain function (especially affecting how the brain controls body movement).



Poppers cause muscle relaxation and head rush. Their effect is short- lasting, usually up to about 5 minutes. Poppers come in liquid form in small bottles and are inhaled. It is reported that Poppers enhance the intensity of sexual experiences, increase sex drive and can make orgasms last longer. It can also be used as a way to relax the vaginal and anal muscles for sex.

Effects after use of Poppers may be headaches, nausea, dizziness or sickness and possibly fainting. They can be poisonous and should never be swallowed, as this on occasion has been fatal. Inhaling in large quantities can also cause overdose.



GHB is naturally found in tiny quantities in the body of humans and other animals. The GHB that is available as a recreational drug or medication is manufactured but is still the same compound. GBL is converted into GHB in the body, so it has very similar effects and harms.

GHB has a medical use in the treatment of narcolepsy, and GBL is used in stain remover, rust remover, and superglue remover, as an alloy cleaner and as a paint stripper.

GHB depresses the nervous system and can have similar effects on the body as alcohol. It can cause unpleasant effects such as vomiting or if too much is taken- coma and has a high risk of accidental overdose. GHB can be addictive and repeat doses can have greater effects than the first.



Heroin is a powerful opiate usually sold as a white or brown powder. It is semi- synthetic, i.e. made by chemically altering morphine. Heroin used illegally is usually less than 50% pure. This in itself leaves it very difficult to know the strength and therefore increases risk of overdose.

Heroin produces intense feelings of Euphoria and relaxation. It is very easy to overdose from heroin; if you overdose, you may begin to feel very sleepy. Your breathing will slow and you can fall into a coma. If your breathing slows too much you could die.

Regular heroin use may have built up some tolerance. However, if you then stop taking heroin for just for a few days, your tolerance rapidly drops and you risk an overdose if you simply take the same dose as before. As it is a sedative, it prevents you from coughing properly and so choking on your own vomit and death can become likely outcomes.

Injecting heroin is particularly dangerous, and it is much easier to overdose when injecting. There is also an increased risk of HIV and hepatitis infections if sharing needles as well as the risk of damaging veins and developing infections (gangrene) and blood clots.



Methadone is a prescribed alternative to illicit opioid addiction. It is usually a green liquid but can come in tablet or injectable form. It lasts longer in the body than heroin therefore is useful in stabilising people currently using opioid drugs. It mimics the body’s pain- killing chemicals and so can cause drowsiness, euphoria, slow breathing and constipation. If receiving as a prescription then the amount will be controlled by the doctor, however, if this is then mixed with other drugs there can be an increased risk of overdose, respiratory failure and death.

If used as prescribed long-term risks are low.



LSD is usually sold as small squares of paper with pictures on them, known as tabs or blotters. LSD can also be sold as a liquid or as tiny pellets, known as microdots.

LSD use causes the pupils to dilate, and blood pressure, heart rate, and temperature to rise. Other short-term effects include dizziness and sleeplessness, reduced appetite, dry mouth, and sweating, numbness, weakness, and tremors.

There is no evidence to suggest that LSD does any long-term physical damage. Severe or life-threatening physical effects are only likely to occur at high doses, but the psychological effects can lead to unusual and risky behavior, potentially resulting in significant injury and death.

If people are in a bad mood, feeling depressed or worried they should avoid taking the drug.



There are more than 180 psilocybin-containing mushrooms species found all around the world. The key ingredient found in these mushrooms is psilocybin. Psilocybin mushrooms are often called ‘magic’ mushrooms. The small and potent Liberty Cap mushroom (Psilocybe semilanceata) is probably the most common and widespread species found in Europe. Other species occur in the wild, and Psilocybe cubensis is cultivated indoors.

Fly Agaric mushrooms (the fairy-tale toadstools with white spots on red) belong to a different family and should not be confused with psilocybin-containing mushrooms. The key chemicals in Fly Agaric that are associated with the psychoactive effects include ibotenic acid and muscimol. Effects can include twitching, drooling, sweating, dizziness, vomiting and delirium, very unlike the mild physical effects of psilocybin mushrooms. 

  • Liberty Caps look like small tan-coloured mushrooms
  • Fly Agarics look like red and white spotted toadstools 

Psilocybin Mushrooms can induce hallucinogenic/psychedelic effects. This can cause changes in consciousness, mood, thought and perception that people call a ‘trip’, or a ‘psychedelic experience’. In higher doses, the effects can be extremely intense.

Other effects include: Euphoric feeling, visual and auditory hallucinations, altered perception, nausea and stomach discomfort, diluted Pupils and may feel heavy and clumsy and delayed headaches can also occur for up to 2 days.

The psychedelic experience can be overwhelming, frightening or unpleasantly disorientating. This risk increases with increasing dosages. It can take between 10 to 60 minutes after eating psilocybin mushrooms before the effects kick in. A moderate dose will wear off after about 4 hours. It is important to note that the strength of psilocybin mushrooms is hugely variable, and as with all drugs, different people can respond very differently to the same dose.

Setting is important. A loud, busy party with strangers may increase the risk of unpleasant effects. People do not seem to become addicted to psilocybin mushrooms. Although some people take them quite regularly, they should be able to stop easily if causing problems. Tolerance level may cause people to stop, as a dose that produced strong effects may have no effects if repeated the next day.

Harms such as HPPD seem more likely in people who use drugs regularly and heavily.