Drugs affect the neurological process of the brain. They alter perception and mood. They affect the brain’s function and change the individual’s state of mind. Their thoughts and feelings are altered so that moods and reality become distorted. Different substances affect the brain’s function in different ways. To be able to fully understand the way each substance affects the brain, drugs have been placed into four main catagories.The effects of the drugs in each of these categories work on the brain in a similar way.
Opiates (Opiod analgesic substances)
(Heroin, Pethadine, Codeine,Dihydrocodeine-DF118, Methadone, Subutex)
Opiates are painkillers. They are sedative drugs thatdepress the nervous system. Body functioning is slowed down and an overall sense of wellbeing is promoted. They reduce sensitivity to both physical and emotional pain and give the user a feeling of detachment. Feelings such as anxiety are reduced greatly. They are analgesics and have depressant effects.
Opiates can result in strong physical dependence. There are various ‘substitutes’ which have been developed to treat heroin addiction suchas Methadone, Subutex and Naltraxone. High doses of opiates can result in unconsciousness or overdose, which can lead to death. The risks increase when the tolerance is decreased, after a period of abstinence, when too much is taken for the body to cope with. Excessive doses can also lead to coma. Combining opiates with other similar drugs that depress the nervous system such as alcohol or benzodiazepines can also increase the risk of overdose. Injecting heroin causes damage to veins and I.V. users are more at risk of contracting blood borne viruses such as hepatitis C and H.I.V. through sharing equipment.
Stimulants (Stimulate the nervous system)
(Cocaine,Amphetamines, Ecstasy, Anabolic Steroids, ‘Poppers’-Nitrates, Methamphetamine,Caffeine)
Stimulants release chemicals which are related to reward and arousal. They promote the release of serotonin and dopamine (reward) andnor-adrenaline (arousal). This stimulates the nervous system and mental ability is increased. Social confidence and physical response is also enhanced. Amphetamine users may become more alert with elevated moods and increased stamina. Sociability is increased as inhibitions are lowered. Body temperature and heart rate become raised. It can also cause effects which mimic psychosis when taken in high doses or very often. This ‘speed’ psychosis is a temporary condition but is similar to paranoid schizophrenia. Regular use can also result in bouts of depression.
Anabolic steroids fall into this category. Steroids are synthetically produced substances that replace the natural hormones of the body. They can be taken orally or injected.Steroids increase muscle mass and aid the repair of damaged tissue. They can increase confidence and libido. Steroids also cause mood swings and bouts of depression.
Cocaine is also a stimulant which produces feelings of alertness, confidence and wellbeing. High doses however can cause severe anxiety and panic attacks. The high level of reward can cause psychological dependence and heart attack may occur from high usage. Cocaine produces serotonin, dopamine and nor-adrenaline. Paranoia and aggressive outbursts can also occur.
Ecstasy gives a euphoric burst and inhibitions are reduced. Confidence is boosted. Feelings of increased empathy can also be experienced.It works with the serotonin already present in the brain.
Poppers produce feelings of light headedness and dizziness and perception of time becomes distorted. Loss of consciousness is a risk associated with nitrates and there have also been cases of heart failure.
Hallucinogenics (Alter perceptual functions)
(L.S.D. Magic mushrooms, Cannabis-skunk,Peyote/Mescaline, 2-CB)
The effects of hallucinogenics are similar to stimulants andshake up the perceptual functions of the brain. They can enhance or change sensory perceptions and confuse emotions.
Cannabis is a hallucinogenic with depressant effects,causing relaxation and euphoria. It tends to enhance episodes of sociability,colour and sound. The adverse effects can be feelings of anxiety and paranoia.Cannabis can cause psychological dependency and reactions can be affected. The tobacco used with it can cause respiratory conditions. People who have existing mental health conditions are at serious risks as it can bring on mental illness or psychosis.
L.S.D. creates enhanced auditory and visual awareness. Short term memory loss can occur and concepts of time can become distorted. L.S.D.can also bring back old memories, recollections and also suppress responses.Flashbacks can occur long periods of time after use.
Magic mushrooms have the same effects as L.S.D. and growwild. User’s experiences are usually connected with what is going on currentlyin their lives and also the environment in which they are. Changes in mood can be erratic, moving rapidly between intense euphoria and confusion, paranoia andanxiety. Some experiences can be bad and vomiting is quite common. Mushrooms can be toxic, especially if the wrong one is picked. There is a possibility of psychological dependence should the user find the use rewarding.
Depressants (Slowdown the central nervous system)
(Alcohol,Tranquilisers, Ketamine, Aerosol, Solvents, GHB)
Depressants slow down the response of the central nervous system, reducing the ability of the brain to function properly and effectively and affecting the user’s ability to reason and make judgments. High doses may decrease the individual’s reflex responses and eventually their vital functions.
Alcohol slows down body functions and produces feelings of relaxation. Users may feel less inhibited. It can also cause visual distortion,‘double vision’ and, as it is an anaesthetic, it can lead to unconsciousness.Regular use can result in both physical and psychological dependence. Too much can be fatal and result in overdose. If someone becomes tolerant to alcohol and physical symptoms result, stopping suddenly can result in fits and in some cases death.
G.H.B. (Gamma-hydroxybutrate) is a synthetic substance which promotes sleep, slowing down the function of the nervous system and affecting co-ordination. It can give increased confidence but if used excessively it can lead to convulsions, respiratory failure and coma.
Ketamine is adepressant with analgesic and hallucinogenic properties. It produces a stimulatory effect along with increased energy and euphoria which is followed by sedation. If taken in larger doses, auditory and visual hallucinations can occur. Ketamine can also result in temporary paralysis or immobility due to the body being partially anaesthetised.
THE PSYCHOLOGICAL EFFECTS OF THESE GROUPS OF SUBSTANCES.
Opiates(Opiod analgesic substances)
Opiates are derived from the opium poppy. Opium is the dried milk of the opium poppy which contains morphine and codeine. Both are painkillers.
Opiates are sedatives which depress the central nervous system. They slow down the messages passed between the brain and the body.These substances affect the receptors in the brain which deal with sensations of pain and therefore combat both physical and emotional pain.
Physical dependence can occur with regular use. Effects can include relaxation, warmth, despondency and lessened anxiety. These effects can start quickly and may last several hours depending on how much is taken and howit is administered. Opiates can be smoked, snorted, taken orally or injected. Excessive use can result in coma and death from respiratory failure.
Stimulants (Stimulate the central nervous system)
Stimulant drugs latch on to the axon terminals in the brain and encourage the neuron to release more serotonin or dopamine than usual. These promote feelings of reward. They also encourage increased release of nor-adrenaline which promotes feelings of arousal. Both stimulate the nervous system to increase mental ability, sociability and physical response. Stimulants speed up the messages between the brain and the body making people feel more awake, excitable and less inhibited.
Heart rate increases and body temperature rises. They can also produce feelings of heightened aggressive tendencies and psychosis. Seizures can occur with stimulants and damage to nasal passages. Stimulant users are also at risk to blood borne viruses. Psychological dependence can occur.
Hallucinogenics (Alter perceptual functions)
Hallucinogenics have similar effects to stimulants and alsoaffect the perceptual functions of the brain. Sight, touch and smell can be affected. They can enhance or change sensory perception and distort emotions. Individuals have been known to experience ‘seeing sounds’ and ‘hearing colours’ (Synaethesia). Users can experience enhanced awareness but paranoia and memory loss are also common. Flashbacks can occur long periods of time after the immediate effect of the drugs have worn off.
Depressants (Slowdown the central nervous system)
Depressants slow down the messages between the brain and thebody. They reduce the ability of the brain to function effectively. They can impair the user’s ability to reason and also their judgment. In excessive dosesthe individual’s reflex responses and vital functions of the body and brain can be greatly affected. Depressants slow down the neural activity causing tiredness. Large doses can also lead to fatal overdose.
SOME OF THE PARTICULAR DANGERS ASSOCIATED WITH THESE GROUPS OF SUBSTANCES
I.V. Drug Users
Injecting drug users have many dangers associated with them. Some of these are contracting blood borne viruses, abscesses, vein damage. The list is endless. I.V. users should always be made aware of safer injecting techniques, i.e. rotation of sites, where to avoid and the risks supporting this. If it is evident that the user is having issues surrounding I.V. use then advice should be given as to the ‘up the bum’ technique or smoking, rather than injecting. Awareness around blood borne viruses such as Hep C, HIV and the risks involved with sharing equipment or unsterile preparation surfaces should always be given. Lots of long term I.V. users may be injecting pills such as Diconal which contains silicon and can result in loss of limbs. No pills are advisable for injection and cause damage to veins. Using too much citric acid and using equipment more than once can also result in vein damage. Deep vein thrombosis is also a risk particularly for those injecting in the groin area. Dangers of overdose are more prominent in I.V. users as the drug may have different strengths and be cut with other drugs. Women also may have a lowertolerance to substances than men thus increasing the risk of overdose in them.
Lack of hygiene can also promote all of the risks involved with I.V. use for obvious reasons. If an I.V. user is homeless then it may be difficult for them to keep their preparation surfaces sterile, increasing the risks of blood borne viruses. Also, it has been known for homeless injectors touse water from unsterile sources such as toilets or puddles in order to prepare their drugs for injection. This carries a high risk of being infected with bacteria and can cause all sorts of problems in the user. Another risk that is more evident with homeless injectors, as a result of the chaotic lifestyle that a homeless status carries, is the risk of being arrested, due to the fact that they are more likely to use in public places. Another major risk of people in this category is that because of their lack of personal hygiene and the fact that they sleep rough in all sorts of weather conditions, their immune systems may not be as effective as they should be in fighting disease and infection. As are sult of the homeless often living quite solitary lives, they are also at a greater risk of death if they are to overdose.
Pregnant Women /Women with Children
There are particular dangers associated with this type of drug user. The main risks to be aware of, on top of the already evident risks involved are the element of fear that could result in them not accessing the relevant services. Fear of social services becoming involved and the potential result of their children being taken from them can result in increase disolation and a covering up or hiding of their drug use. This may result in them not receiving the correct or relevant advice needed to keep themselves or their unborn children or siblings safe. If they are accessing services and fall pregnant during treatment, a child protection issue may ensue. This can result in a conflicting divide between the client and the worker. The worker must always maintain a duty of care towards the child / unborn child. Opiates during pregnancy can, in the worst case scenario, result in death of the baby. It may also result in the baby being born with withdrawal symptoms. Some pregnant women are advised to engage in a reducing script on an opiate substitute which reduces these withdrawals. If a pregnant woman is on prescribed medication, it may be that they are advised to attempt to come off it. This can however lead to increased anxiety and bouts of depression which they may require extra support around. There can be a lot of fear around being judged by others if witnessed accessing services too. Also some services are not equipped to accommodate children
8 POSSIBLE REASONS FOR SUBSTANCE USE.
Some individuals use various substances on an infrequent basis for various reasons, for example, to unwind from a stressful week or situation, to lower inhibitions, and become more sociable at the weekends, to relax at home or just to escape reality for a short period of time. There are some people who can maintain a ‘functioning’ lifestyle, holding down jobs,parental duties and other normal responsibilities using various substances as a sort of ‘reward system’. The dangers involved with this are that dependency can develop and also, because the drug taking is seen as ‘recreational’, they may not associate the risks involved of taking the drugs themselves. For example,the health risks associated with heavy drug use. With alcohol, binge drinking can cause all sorts of damage, where there is a period of abstinence followed by a period of excessive drinking. The body’s response to this can throw the senses out of sync and cause varied degrees of damage to the system.
Various drugs can result in physical or psychological dependence, causing withdrawal symptoms which can make the user feel anxious or physically ill to the point where taking more and more of the substance seems like the only answer. Some of the physically dependent drugs include opiates,alcohol, benzodiazepines, tranquilisers and anti depressants. These can result in both physical and mental suffering. Psychological dependence can occur with some stimulant drugs such as cocaine and amphetamine where the ‘reward’ from the high becomes permanent. The‘come down’ can cause depression, anxiety and suicidal feelings in extreme cases.
3. Peer Pressure
Although mainly associated with young persons, this can also be evident with adults where an individual feels pressured by their peers, partners or loved ones etc, to feel a part of a certain group or situation. Fear of being seen as different or being / becoming isolated can be a major trigger in these situations. This can be extremely dangerous as the individual will possibly be misinformed, if informed at all as to the risks and dangers of taking a particular substance.
4. Grievance / Loss /Pain
Certain events that occur in a person’s life can result in the individual seeking ‘comfort’ by using a particular substance, i.e. the death of a significant other, loss of employment / income, breakdown of a relationship or medical or physical problems etc. As some substances can promote sleep or numb the senses temporarily, introduction to a drug at this time may seem like just what is needed by the individual to deal with, or escape from, the situation at hand. An immediate danger with this is that it is only temporary and dependence on the substance to take away the pain can result in taking more and more, again resulting in physical and psychological dependence. Also, lack of knowledge about drugs can be a danger in itself.
Being homeless can bring about all sorts of triggers for drug use. Low self esteem, low self worth, depression, alienation, not feeling a part of society. Not having steady accommodation can result in a person living in night shelters or ‘sofa surfing’ or often these can be luxurious to some. This can make someone feel exceptionally lonely. They may be homeless for various reasons; loss of employment, relationship breakdown, or not being able to deal with every day responsibilities and unaware of where they can access support. In such situations the ‘comfort’ that is seemingly found in taking substances can become appealing, temporarily relieving the pain of certain situations or feelings. Drug use is very apparent in many hostels and temporary accommodation set ups where the vulnerability felt by those accessing theseservices can be ‘reduced’ by using substances. People sleeping rough are often stereotyped and judged very negatively and drugs can be used in order to helpthem to ‘deal’ with this, to help them escape or simply forget.
Alcohol can produce a numbing of the senses and help someone to stay warm so is common among the homeless. Homelessness can also be problematic when attempting to get benefits or get a script from the doctor. The individual can become trapped in a cycle where they can’t envisage themselves stopping taking the substances that bring them a certain amount of comfort until they can secure housing and deal with some of the issues that come with homelessness. Drug use can also be a reason for homelessness for numerous reasons, such as not paying rent or bills.
6. Self medication
Some individuals may find the stress of everyday living too much, issues in the home, at work, not being able to find that balance between the two. Depression, sleep disorders and general anxiety can result in the individual turning to prescription drugs such as valium, temazepam or other benzodiazepines or tranquilizers as well as certain street drugs in order to relieve the tension, promote sleep and help them to function. Some people may misunderstand the addictive qualities of certain prescribed drugs as they are prescribed by the family doctor. Physical health, for example, sufferers of cancer and multiple sclerosis have been known to self medicate on cannabis, andfind relief in this on top of, or instead of, their prescribed medication.
The environment in which an individual lives, or is brought up in, can be a trigger to drug use. Young people may be living in an environment where drug culture is evident and quite open. Their parents may be substance users, who openly use in front of them as if this is the normal thing to do. The area in which someone lives may also influence how someone perceives the use of drugs. On some estates where poverty levels are high, drugs have become a major problem. They are openly sold and used and in many cases it has become seen by certain individuals as an acceptable means of making money. This can also influence a young person who is living in a poor environment, or poor living conditions.
Many people who have never experienced the effects of substances before may be drawn towards the positive aspects and feedback thatthey hear amongst the using community. Their peers may portray the effects and feelings of certain substances in such a way that it would seem quite a positive experience. Lack of knowledge around the long term effects of certain drugs could be dangerous or damaging in such a situation. An example might be clubbing or raving. The curious party when talking to a peer may be told that ecstasy enhances the whole experience but not told about the comedown or the dehydration during use or the other risks associated with ecstasy.
EXPLORING THE DIFFERENCE BETWEEN EXPERIMENTAL, RECREATIONAL AND DEPENDANCY.
Individuals who fall into this category do not use drugs on a regular basis. They may be young people ‘trying out’ various substances to experiment out of curiosity. This however is not restricted to youth. Some adults may be curious as to the effects as well. They may not have tried any substances in their youth, and their curiosity may start to get the better of them in adult life. Most experimental drug users may only use the drug once ortwice to satisfy the curiosity factor. Many people in this category are often sick, may have a negative experience, or generally do not enjoy the effects produced. Sometimes ‘the hype’ exceeds the actual experience hence the user will not see any reason to continue using the substance. Sometimes however the experimental user may enjoy the effects which could result in them moving on to one of the next categories discussed.
Recreational drug use is when the individual uses substances to enhance a particular episode, such as a night out or a social event along the same sort of lines. Lots of people function normally, holding down regular jobs through the week but use various substances at the weekends for fun or to escape the tension and stress of the week. Other people may only use once a month for the same reasons. Some individuals might use certain substances to help them relax at home. The dangers of recreational use are similar to those of the dependant user as far as their health is concerned. They are still at risk of contacting blood borne viruses and the risk of overdose is high. This sort of ‘reward’ approach to using substances can also lead to dependency for numerous reasons, such as not coping with the comedowns, and therefore taking more to take away those feelings, or simply ‘just the one’ turning into two, then three, then all weekend, then through the week etc.
This is when an individual has become dependent on one or more substances either psychologically or physically, or both. Without the substance they become agitated, anxious or may experience physical withdrawals such as cramps, diarrhoea and vomiting which will cause so much pain that the only way the individual can see to take these symptoms or feelings away is to use more of the substance. Both psychological and physical addiction can create cravings and a ‘desperation to use’ that would seem paramount to the individual, overriding any other thought or need that the individual may have. Once someone has reached this stage, their body can no longer function, ortheir mood and thoughts become obsessive around whatever the substance is that they find comfort in. The effects of coming off these drugs can be severe, ranging from vomiting, to anxiety attacks and fits, which in extreme cases may require hospitalisation. Recreational users can build up a tolerance to substances, therefore needing more of the drug to get the desired effect. They could then use it more often or in higher quantities until they become totally dependent upon it. It is important to note that although the propensity for this occurring is high, it does not occur in every case.
POSSIBLE ASSUMPTIONS AND HOW THESE MAY AFFECT A SUBSTANCE USERS LIFE.
1. Feeling alienated and alone.
Drug users can often have feelings of alienation and of being unloved. They can suffer from a multitude of negative thoughts and feelings which make them feel ‘less than’, low in esteem and all alone. In general, society has a negative attitude towards drug use, which can feed these thoughts and feelings and result in the drug user in fact becoming alienated and alone, turning to substances to help deal with these feelings.
2. “I can stop anytime”
Some recreational drug users can stop any time they please, however there are some who think they can until they try. A common belief around this is that because it’s only psychologically addictive and not physically addictive, it won’t become a problem drug, or because it is not addictive at all, it won’t become a problem. The feelings that are produced by a substance can at times become almost as addictive as some substances, causing the user to want more.
3. “It won’t happen to me”
Due to individuals not being in possession of the full facts about some substances, certain usersmay see the end result of an addictive cycle and think they’ll never get that bad. Alternatively, when someone overdoses it is misunderstood and put down to the amount taken. What isn’t recognised is the fact that over time the body deteriorates due to damage caused when taking drugs. For example, veins collapse with IV users and increased amounts of the drug are required to achieve the same effects but the body copes less physically, causing overdoses to become more frequent in the long term user.
4. “All junkies are criminals and thieves”
This is a typical stereotype and judgmental attitude that is commonly associated with drug users. The facts are that this is far from the truth. There are fully functioning addicts who have quite well paid jobs. This can also result in an individual again becoming alienated and alone.
5. “If I phone the police because my mate’s overdosed, I’ll get arrested”
This isn’t true. The police aren’t automatically called to every case. They are notified, but will carry out a risk assessment in eachsituation and only attend if there is cause for concern, for example the threat of violence or aggression, if the incident is in a particularly well known, rough area or there are suspicions that the overdose may not have been self induced. The police are actually there to support those involved as well as the ambulance crew. This belief has resulted in numerous drug deaths that could have potentially been avoided.
6. “My children will be taken into care”
Many drug users, especially single mothers have a fear that if they access support from a drug agency that they’re children will automatically be taken off them. This can cause many individuals to avoid seeking support. This is not true. Drug services are there to support the individual and would only notify social services of there was evidence that the child’s health was at risk. The individual would also be notified in advance that this was the planned course of action.
7. “I’m going to die an addict, I’ll never get clean”
Many drug users attempt to get off drugs in many different ways. Many do not manage despite numerous attempts and can resign themselves to believing that they will never manage to escape addiction. Many manage to give up their drug of choice only to replace it with another substance which eventually, in many cases, leads them back to their drug of choice. Their beliefs need to be addressed in a positive manner in order to keep giving them hope.
8. The drug user is lazy and should get a job.
Many people have the assumption that drug users are all lazy, unemployed, unemployable, homeless outcasts, who have got in to the situation that they are in of their own volition. It may also be assumed by many that they are all infected with diseases such as H.I.V. and hepatitis. These assumptions are not always the case. Many individuals who use substances are employed in good jobs, live in good homes, are respectable members of society, who, to the onlooker live a very normal life. This stereotypical way of looking at victims of addiction is very detrimental to the individual and is in fact a form of mental and emotional abuse. This can result in an individual feeling isolated and even suicidal.
9. That nothing can be done for an individual who has contracted certain diseases.
Many drug users are under the assumption that if they contract a disease such as H.I.V or hepatitis that there is nothing that can be done about it. Although there may not be a cure for certain diseases, there is medical help available to arrest or ease the symptoms. Many drug users are unaware of how easily Hepatitis C can be contracted and the simple steps that can be taken in order to keep themselves safe around such viruses.
PROVISIONS OF THE MISUSE OF DRUGS ACT 1971.
The Misuse of Drugs Act 1971 divides what are described as controlled drugs into three categories or ‘classes’ dependent upon the seriousness of the offence and penalty given in connection with such an offence relating to each drug.
Offences covered in this act include unlawful supply,possession with intent to supply, import or export, collectively known as trafficking offences, and also the production of illegal substances. This act controls both medicinal drugs and non medicinal drugs. With medicinal drugs the act prohibits unlawful possession. The police have the power to ‘stop and search’and detain an individual should they have ‘reasonable suspicion’ that the individual may be in possession of a ‘controlled substance’.
The classes which these drugs are split into are as follows;
Class A includes: Cocaine, Crack,Heroin, Ecstacy, L.S.D, Methadone, Crystal Meth, Magic Mushrooms, and any class B drug prepared for injection.
Class B includes: Amphetamines, Barbiturates, Codeine and Ritalin.
Class C includes: Ketamine, Steroids, Tranquilisers, Cannabis and G.H.B.
Class A drugs are widely considered to be the most dangerous of substances although recently this has been open to debate.
In addition to putting the drugs into ‘classes’ which dictate the penalties for crimes involving each class, the act also lists the following schedules of substances;
Schedule 1: Non prescribed drugs which have no therapeutic value.
Schedule 2& 3: Prescribed drugs which may be possessed legally, by anyone with a prescription.
Schedule 4: Prescribed drugs that are lawful only with a prescription. Any person with a prescription for thedrug may possess it legally but without a prescription they are unlawful.
Schedule 5: This covers preparations such as cough mixtures which contain tiny amounts of controlled drugs, sold over the counter without prescription.
The three classes of drug, as defined by the Misuse of Drugs Act 1971 are;
Class A: Cocaine, Crack, Heroin,Ecstacy, L.S.D., Methadone, Crystal Meth, Magic Mushrooms and any Class B drugprepared for injection.
Class B: Amphetamines, Barbituates,Codeine, Ritalin
Class C: Ketamine, Steroids,Tranquilisers and G.H.B.
The two main offences relating to these classes of drugs are possession and supply. It also covers possession with intent to supply depending on the amount you may be in possession of. Most cases of possession can be dealt with in the Magistrates Court whereas supply charges will almost certainly be referred to the Crown Court on indictment.
LEGISLATION PERTAINING TO THE THREE CLASSES.
These carry the heaviest penalties. Anyone caught inpossession of a class A substance can be imprisoned for up to 7 years and/or receive a fine in the Crown Court. The sentence from a Magistrates Court can beup to 6 months imprisonment and/or a fine. Intent to supply carries a heavier sentence and can result in life imprisonment and/or a fine.
Class B drugs penalties are not as severe as those for Class A but still carry a substantial sentence. Possession of a Class B substance can carry with it imprisonment of up to 5 years and/or a fine, whereas intent to supply can result in up to 14 years imprisonment and/or a fine.
Possession of drugs in this category can result in up to 2 years imprisonment and/or a fine. For intent to supply the sentence could be upto 14 years imprisonment and/or a fine.