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Shisha and hookah

Shisha and hookah

Health awareness information for people who use shisha.

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What is shisha?

Shisha is also known as hookah, hubble-bubble and narghile.

It’s usually flavoured tobacco mixed with molasses, making it taste sweeter and burn longer.

You can also get tobacco and nicotine-free versions in paste and gel form.

Shisha is heated with charcoal and smoked through a water pipe. When you draw on the pipe, the smoke passes through a water bowl, cooling it.

Effects of shisha

Shisha gets into your system faster and is more intense than a cigarette because the cooler smoke allows you to inhale more.

Your heart rate and blood pressure increase.

Regular users say it helps them concentrate, relax and makes them less anxious.

Shisha risks

The first time, you might feel sick and light-headed because you’re inhaling large amounts of nicotine, carbon monoxide and other chemicals.

During a shisha session, you inhale more of these harmful substances than you would smoking a cigarette.

Regular shisha smokers risk cancers, and heart, lung and circulatory diseases. Children are particularly vulnerable to second-hand smoke.

Sharing a hookah pipe can spread infectious diseases such as herpes, TB and hepatitis.

Shisha and the law

As with UK law on cigarettes, it’s illegal to smoke shisha in enclosed public spaces and to sell tobacco or vaping products to anyone
under 18.


Smoking health awareness resources

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Ketamine and Your Bladder: What You Need to Know

KETAMINE AND YOUR BLADDER: What You Need to Know

If you're a regular ketamine user, you might experience bladder problems, sometimes called "K cramps." Ketamine can cause serious damage to your bladder, where urine is stored, especially with long-term or heavy use. The information on this page will help you reduce the risks

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Why does ketamine harm the bladder?

Ketamine and the chemicals it breaks down into irritate the bladder lining, causing inflammation and scarring. Over time, this can lead to permanent damage. What are the signs of bladder problems.


Early signs of bladder problems:

  • Pain when urinating
  • Needing to urinate more frequently
  • Difficulty holding urine
  •  Passing only small amounts of urine each time

More severe symptoms:

  • Blood in urine
  • Lower abdominal pain
  • Loss of bladder control

Long-term effects:

Prolonged ketamine use can cause your bladder to scar and shrink, leading to chronic pain and discomfort. In some cases, the damage may require surgical intervention.

If you notice any symptoms, the best thing to do is stop using ketamine. For most people, stopping when problems first appear allows the bladder to heal. Continued use will worsen the condition and make it less likely your bladder will heal on its own.


If you can't or don't want to stop using ketamine completely, here's how to reduce risks:

Watch for signs of bladder problems

Watch for signs of bladder problems and seek medical advice if you experience any symptoms.

Stop or reduce your use of ketamine

Stop using ketamine, or use smaller amounts less often to lower the risk of bladder damage. Remember that even moderate use can cause problems in some people.

Stay hydrated

Drink water before, during, and after using ketamine. Proper hydration helps flush out your bladder and reduce irritation. Avoid excessive caffeine and alcohol, as they can dehydrate you and irritate your bladder.

Take regular breaks

Give your bladder time to recover by taking breaks from ketamine use. This can reduce strain and allow for healing.

Limit other substances

Avoid combining ketamine with other drugs, especially alcohol or stimulants, as this can increase strain on your bladder and kidneys.

Consider alternatives

Consider using a different substance that is less harmful to your body but still provides the desired effects.


Important: If you experience any bladder-related symptoms, seek medical advice promptly. Early intervention can prevent more serious damage. Even if symptoms improve after stopping ketamine use, it's crucial to get a medical assessment to check for lasting damage.

Remember, healthcare professionals and drug services are there to help, not judge. Don't hesitate to reach out if you're concerned about your ketamine use or its effects on your health.

New, and updated resources

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Ketamine Aware

Ketamine Aware

Ketamine harm reduction information

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WHAT IS KETAMINE? 


Ketamine is an anaesthetic licensed for use in human and animal medicine. 

The non-medical use of ketamine became popular in the UK in the early 1990s rave scene, often sold in tablet form as ecstasy. 

The illicit form of ketamine normally comes as white crystals or powder. 

HOW IS KETAMINE USED?


Snorted

A common method in a club environment would be to dip the end of a key into the bag of powder and sniff a small amount from the tip, known as ‘keying’.  Alternatively it is chopped up into lines and snorted.

Swallowed Although less common, as it takes too long to work and acts as a laxative, ketamine is sometimes wrapped in paper or tissue and swallowed, known as ‘bombing or ‘parachuting’.

Smoked 

This is a rare way to use ketamine as it tastes awful and wears off quickly.

Injecting

Usually injected into a muscle. Injecting ketamine increases the risk of overdose and the infection problems related to injecting.

WHAT ARE THE PROBLEMS WITH KETAMINE


The ketamine experience can vary depending on your environment, but generally, in small doses ketamine acts as a stimulant, boosting your energy levels, and making you feel high and trippy. At larger doses it can provide a mystical out-of-body-experience where you can experience hallucinations (sometimes shared), a sense of calm and serenity, distortions of time, panic, unpleasant feelings and nightmare-like experiences. 

The out-of-body experience is known as being in a ‘K hole’.

These feelings can last up to 90 minutes.

Physical effects can include loss of control over the body, loss of coordination, difficulty speaking, moving, hearing and seeing (delirium), numbness, and nausea. 

When snorted, the effects begin within a few minutes and last around 30-45 minutes, depending on how much is taken.

If swallowed, the effects begin around 15-30 minutes and last for 1-3 hours.

Personal safety

The main problem associated with ketamine is physical helplessness experienced at high doses. Disconnection from the body can be dangerous, especially in the disorienting environment of a club or rave. This can leave the user vulnerable to accidents and assault (both physical and sexual) and having unprotected sex, increasing the risk of unplanned pregnancy and sexually transmitted infections.

Physical health

Bladder problems

Prolonged and regular ketamine use can damage your bladder and kidneys, sometimes permanently. If you experience an increased need to urinate, passing blood, leakage of urine and pain on urination, consult your GP and let them know you use ketamine. 

K-Cramps

A commonly reported symptom of ketamine use is K-pains or K-cramps. The cause of these abdominal pains are, as yet, unclear, but seem to be linked to high dose use of more than a gram a day.

Mental health

Occasional use of ketamine (once or twice a month) is not thought to cause any long-term or irreversible damage. Persistent use, however, has been linked with a wide range of distressing psychological effects, including anxiety, panic attacks, flashbacks, persistent perceptual changes, mania, depression, insomnia, nightmares, an unpleasant feeling of being unreal or that the world is unreal, paranoia and delusions.

Dependency

Although not considered physically addictive, tolerance to ketamine builds up very quickly and higher doses are needed to achieve the desired effects.

This can lead to problems with memory, word/name recall, reduced attention span, damage to relationships, loss of productivity, isolation, and neglecting other interests.

Mixing drugs

Nowadays, very few people use one drug on its own, and ketamine is no exception. Ketamine is often used, on a night out, in combination with a range of substances including alcohol (avoid!), cocaine (CK1), and the plethora of new and emerging compounds (“legal highs”) that are becoming more readily available. Obviously, mixing drugs increases the risks and should be avoided as the outcome is difficult to predict.

REDUCE THE RISKS FROM USING KETAMINE


The best way to avoid the risk associated with drugs is not to use drugs. But if you are considering using ketamine, the following advice will help minimise the risks to your health:

  • Don’t take ketamine on your own. Only do it somewhere you feel safe and where you can keep an eye on each other. 
  • Chopping the crystals/powder as fine as possible before snorting will help reduce the damage to your nose
  • Start low and slow, take a small amount and wait. Don’t take more because you can’t feel anything when you expect it to. It could be a different substance or a different strength than last time. Be patient, give it time to work. Don’t overload yourself with different substances, learn to recognise and handle the effects. 
  • Don’t mix ketamine with other drugs, especially depressant like alcohol, GHB/GBL, these will slow your breathing down to dangerous levels. This can lead to dependence on several drugs, and increase your risk of overdose.
  • Don’t spark up or slip into a nice relaxing warm bath just before you are about to lose the use of your limbs. It can only end in tears

IN CONTROL


If you are using ketamine follow these tips to stay in control:

  • Only buy what you are going to use during a session. Don’t buy ‘some for later’, ‘later’ will only become ‘now’.
  • Using any drugs can put a strain on your body and affect your physical and mental health, so try to eat a healthy diet and get enough sleep, it will make you feel better.
  • If you start to feel agitated, confused or anxious, stop using, go and chill out somewhere quiet and take a friend to keep an eye on you
  • Repeated ketamine use reduces the effects you feel when you first use it. You may use more to ‘chase the high’, leading to a damaging habit. Don’t use every day and space out the sessions.
  • All drug users need to know how to react if someone overdoses. Because of the ‘sledging’ effects of ketamine, this may prove very important to know how to react.
    It can be difficult to be sure, with someone who has used ketamine, if they are in difficulty. But if someone’s breathing is slow and shallow and they do not respond when you try to talk to them, it is probably better to be cautious and put them in the recovery position, which is lying them on their side, so they don’t choke if they vomit, before you get help and call an ambulance. Tell the medical staff everything they have taken. It may save a life.

KETAMINE & THE LAW


Ketamine is controlled as a Class B Drug under the Misuse of Drugs Act 1971.  (It was reclassified from Class C in June 2014).

Penalties for possession are up to five years in prison and/or an unlimited fine. Supply holds penalties of up to 14 years in prison and/or an unlimited fine.

New, and updated resources

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GETTING HELP

If you feel your ketamine use is getting out of hand, the organisations below may be able to help.

  • TALK TO FRANK

    National drugs awareness site for young people and parents/carers.

    0800 77 66 00. www.talktofrank.com

  • ADDACTION

    UK - wide treatment agency, helping individuals, families and communities to manage the effects of drug and alcohol misuse.

    Go to website...

  • RELEASE

    Release is the national centre of expertise on drugs and drugs law – providing free and confidential specialist advice to the public and professionals.

    Helpline 0845 4500 215

    Go to website...

  • THESITE.ORG

    Factsheets & articles on all the key issues facing young people including: sex and relationships; drinking and drugs; health and wellbeing.

    Go to website...



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Festival Highs: Reducing the risks of using drugs at festivals

Article Introduction: Learn essential information about drug-testing, mixing drugs & alcohol, taking too many drugs, overdose, synthetic opiods and looking after each other.

FESTIVAL HIGHS

Reducing the risks of using drugs at festivals


Essential information about drug testing, mixing drugs & alcohol, taking too many drugs, overdosing, synthetic opioids and looking after each other.

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WHO DOESN’T LOVE A GOOD FESTIVAL? SOME OF THE BEST BANDS AND DJs IN THE WORLD, TIME WITH YOUR MATES AND, FOR SOME OF YOU, DRUGS: LEGAL AND ILLEGAL.

People take all kinds of drugs at festivals. Some, such as alcohol, are legal. Others, like cannabis, ecstasy, cocaine, ketamine, mephedrone, mushrooms and LSD, are illegal. New drugs (formerly known as legal highs) are now automatically illegal under the Psychoactive Substances Act 2016.

Some drugs speed you up, others slow you down, while some turn your head upside down and inside out. The trick to surviving a festival is making sure they don’t speed you up or slow you down too much.

The only way to avoid the risks associated with using drugs is not to use them. If you choose to take them at a festival, here are some ways to look after yourself and your mates.


HOW DO YOU KNOW WHAT YOU’RE TAKING?

The answer is you can’t be sure. One powder or pill looks much like any other, so you won’t know how long it takes to come up, how powerful it is, or how it will make you feel.

TEST YOUR DRUGS

Some festivals now offer a drug-testing service on the festival site. When you arrive, find out where they are. The service is confidential and non-judgemental and can help you identify what is - or isn’t - in your drugs.

This doesn’t mean they’re safe to use, but it can tell you if drugs are more potent than usual or have been mixed with unexpected substances.

LOW AND SLOW

Even if you do have your drugs tested, always exercise caution.

Using a small amount and giving it time to take effect before using more will keep you safer.

FENTANYL AND NITAZENES

More and more powerful synthetic opioids like fentanyl and nitazenes are being mixed with other drugs, increasing the number of overdose deaths. Be careful: test your drugs and go low and slow.


TAKING TOO MANY DRUGS

Using drugs can have long-term effects on your health, but the most immediate risk at festivals is overdose - basically, taking too many drugs.

Overdose signs will vary depending on what type of drugs you have taken
Overdose signs for stimulant drugs such as ecstasy and mephedrone:

  • shallow breathing
  • fast or racing pulse
  • rigid muscles
  • hyper-aggression/mania
  • seizure
  • unconsciousness

Overdose signs for depressant drugs such as GBL and heroin, alcohol and Xanax:

  • slowed breathing
  • pale or clammy face
  • fingernails and lips turn blue or purplish black (greyish or ashen on dark skin)
  • pulse (heartbeat) is slow, erratic
  • unresponsive

What to do if you think someone is overdosing or becomes ill

Most festivals have a medical tent with staff to help a person through emergencies, so find out where it is when you arrive on-site.

If someone is showing signs of overdose, get them to medical help as soon as you can.

If you have to leave them alone to get help, put them in the recovery position before you leave them.

Please don’t be worried about letting medical staff know what they’ve taken. Show them the substance so it can be identified, and the proper treatment can be given.


MIXING DRUGS

Using several drugs at the same time - and this includes alcohol - is dangerous.

Overdose is frequently caused by taking  more than one drug or adulterated drugs.

Taking drugs throughout a two or three-day festival can put you under a lot of strain and increase the risks to your mind and body.

OVERHEATING

Stimulant drugs cause your body temperature to rise. So, if you’ve taken drugs and been dancing all day and well into the night, you can get dehydrated and suffer heatstroke, which can lead to organ failure and death.

Heatstroke symptoms include
nausea, vomiting, fatigue, weakness, headache, muscle cramps, aches and dizziness.

Stay hydrated. Always carry a bottle of water or a sports drink with you and sip it regularly. Take frequent breaks and find somewhere cool and quiet to chill out for a while.

Also, it can be a long way back to your tent or trailer, especially if you get lost. Make sure you have warm, dry clothes to wear as you head back. Cooling down too quickly can make you ill.


OVERDOING IT

Going to a festival can be like going on holiday: you can get overexcited, feel invincible, and do too much too soon, which can lead to dangerous situations.

Some drugs, such as ketamine or GBL/GHB, can be very dose-dependent. A small increase in the amount used can leave you physically helpless and vulnerable to accidents and assaults (both physical and sexual).

TAKE A BREAK

Being off your face in the middle of a huge festival site with thousands of people can be daunting. It can also make you anxious and paranoid. If you or any of your friends start to feel this way, chill out in a quiet place. Take someone with you or tell your mates where you’re going so they can keep an eye on you.


SEX

Some drugs can increase sexual desire even though they decrease the ability to perform. This could increase the chances of risky sexual behaviour. Always carry condoms, and make sure you use them.

Consent

People who have taken lots of drugs or alcohol may be in no fit state to consent to sex. Remember, sex without consent is rape.


HOME TIME

REMEMBER, if you’ve been drinking alcohol and taking drugs during a festival, you may be unfit to drive.

You’re likely to be tired from the festival anyway, so it could be dangerous for you, your passengers and other road users.

DRUG DRIVING

Like drink driving, driving with above the permitted drug level in your system is illegal - even if they don’t affect your driving and will lead to a ban, fine or even prison. The permitted levels are tiny. If you’ve recently taken drugs, there’s a good chance you’ll be over the limit.

Finally...

It’s your body, so look after it. Many websites and forums can provide you with more information than we can fit into this leaflet. So, before you decide to use any drug, find out as much as you can about it from as many different sources as possible. Below, we have listed some places that may be of help.

erowid.org
Drug information library

release.org.uk
Drugs and the law

wearetheloop.org
Drug-checking at festivals

wedinos.org
Anonymous online drug-checking service


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New, and updated resources

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

The resources are really good. Very user-friendly and packed with relevant information. They’re great.

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Drink Spiking: protecting you and your friends

Article Introduction: Prevent drink spiking. Recognise the spiking signs, and learn effective response strategies to protect yourself and your friends.

DRINK SPIKING

Protecting you and your friends

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A night out with friends should be safe and fun. But an increasing number of people are reporting drink spiking going on at clubs, festivals and house parties. 

That means it’s becoming more common for somebody to add a drug – including alcohol – to your drink without your knowledge. It’s usually done to make you vulnerable so they can steal from you, or assault you physically or sexually.

This leaflet contains tips and advice to help prevent you and your friends from being spiked and what to do if you think you have been spiked.

WHAT ARE THE MOST COMMON SPIKING DRUGS

Alcohol

Alcohol is the most common drug used to spike drinks. It can happen in several ways, such as getting somebody a double when they asked for a single, adding alcohol to someone’s drink when they’re not looking, or buying drinks for someone who’s already drunk.

Drugs

Some common substances used for spiking include the following: 

  • GHB/GBL
  • Benzodiazepines 
  •  (Valium and Rohypnol)
  • Ketamine

These drugs can sedate or confuse someone. They can dangerously reduce someone’s awareness of what’s going on and make them unresponsive physically, particularly when mixed with alcohol.

They risk slowing your heart and breathing and can lead to unconsciousness. They often go unnoticed in drinks because they’re colourless and don’t taste or smell of much. 

SIGNS OF SPIKING

  • A sudden increase in how drunk or affected someone seems
  • Feeling dizzy or sick
  • Confusion
  • Trouble with balance or coordination
  • Slurred speech or difficulty talking
  • Throwing up
  • Passing out

AVOIDING DRINK SPIKING

The best way to avoid getting spiked is to look out for each other while you’re out drinking. These tips will help you create a safe environment and reduce risks.

Keep an eye on your drink

Keep an eye on your drink, and never leave it unattended. Take your drink with you when you go to the toilet or to dance. Or if you’re buying a round, take a friend so you can carry all the glasses in one go. If you notice any changes to the appearance or taste of your drink, pour it away.

Be cautious

Only accept drinks from people you trust. 

Spikeys and bottle stops

‘Spikeys’ or bottle-stops help protect your drink and make it harder for someone to add something. Some bars will supply these, or you can buy them online and take them out with you.

Buy drinks in screw bottle tops

You can buy drinks that come in bottles with screw-top lids and are more difficult to spike.

IF YOU THINK SOMEONE HAS SPIKED YOU OR A FRIEND

Tell somebody

If you suspect someone has spiked you or a friend, tell a member of staff or a friend straightaway and find a safe space. Don’t wander off alone or leave your friends behind.

Feeling unsafe

Be careful when accepting help from strangers or anyone who makes you feel unsafe. Think very carefully about whether you should leave a pub, club or party with someone you’ve just met. If you feel in danger, dial 999. 

Feeling unwell

If you feel unwell, head directly to the nearest A&E. If you’re not feeling that unwell but think you’ve been spiked, ask a friend to go home with you until the effects wear off.

REPORTING SPIKING

If you feel up to it, report the spiking to the police immediately. It’s important because many spiking drugs become undetectable in your system as quickly as 12 hours later. Early reporting can assist the police in understanding what happened.

Don’t let the fact you might have taken drugs yourself stop you, as it’s not a crime to have illegal drugs in your system unless you’re driving.

When you report a suspected spiking incident, the police may ask you for blood and urine samples. Take someone you trust along for support. 

IF YOU THINK YOU’VE BEEN ASSAULTED

If you’ve been spiked, you may have no memory of being assaulted because certain substances induce amnesia. But, if you suspect something has happened, here’s what to do:  

  • Confide in someone you trust
  • Seek medical care for any injuries
  • Report it to the police immediately

Reporting an incident allows police to review CCTV, quickly identify suspects, and educate venue staff on preventing future spiking.

DON’T LOOK THE OTHER WAY

Adding extra alcohol or drugs to a drink makes people vulnerable and puts them at risk.

If you know someone who’s thinking of spiking someone, challenge them and consider reporting it.

INJECTION SPIKING

Injection spiking is rare, but if it happens, tell someone immediately. You might feel a scratch or pain from the needle.

It often takes 15-20 seconds to inject drugs that can incapacitate someone.

The chances of getting HIV from a needlestick are extremely low. However, if there’s a risk of exposure to HIV or hepatitis, Post-Exposure Prophylaxis (PEP) is available through the NHS or sexual health clinics, ideally within 72 hours after exposure.

You can take an HIV test any time, though it’ll take at least eight weeks after exposure for a definitive result.

SPIKING AND THE LAW

Spiking is already illegal under existing laws.

However, the government is currently updating parts of the Offences Against the Person Act 1861, which already makes it an offence to maliciously administer poison to endanger the life of someone or inflict grievous bodily harm. This will recognise spiking as an offence with a potential 10 years in prison for offenders.

HELP AND SUPPORT

Rape Crisis: for 24/7 confidential support

0808 500 2222

CrimeStoppers: give information anonymously

0800 555 111

crimestoppers-uk.org

FRANK: honest information about drugs

talktofrank.com


New, and updated resources

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Heads Up! Some street drugs have been contaminated with the synthetic opioids Fentanyl and nitazenes

HEADS-UP!

Some street drugs have been contaminated with the synthetic opioids Fentanyl and nitazenes

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Some street drugs have been contaminated with the synthetic opioids Fentanyl and nitazenes. These include heroin, illicit Oxycodone pills, Xanax powders, and synthetic cannabis (spice).

Fentanyl and nitazenes are much stronger than heroin and have led to an increase in deaths caaused by overdose.

If you’re a heroin user or use other opiate-type drugs, the advice in this leaflet will help you to reduce the chances of overdosing.

HOW TO SPOT IF SOMEONE IS SUFFERING FROM AN OPIATE OVERDOSE


The usual effects of heroin use, like drowsiness and slower breathing, can look similar to overdose, so it’s important to know the difference.

SOME SIGNS OF AN OPIATE OVERDOSE:

Shallow breathing
Breaths that are shorter and not as deep as normal.

Unresponsive
Not responding to someone’s voice or physical attempts to wake them up, such as shaking, pinching the back of their arms, or rubbing their chest bone with your knuckles.

Pinned pupils
The pupils of the eye become tiny.

Change in skin colour
Blue/purple lips and fingertips in light-skinned people.

In darker-skinned people, skin can appear greyish or duller than usual. In this instance, a colour change might be easier to detect on the inside of the lips, on the gums and under fingernails.

Limp body
Muscles become slack and the person may appear floppy.

Seizures
Synthetic opioids (such as fentanyl) can cause symptoms similar to seizures - such as muscle spasms, rigidity, and chest tightness - that complicate breathing.

Gurgling or snoring sounds
Snoring doesn’t always mean someone is asleep. Snoring and gurgling can mean someone is struggling to breathe.

Severe nausea and vomiting
Opioids can trigger the vomiting reflex, causing nausea and puking.

WHAT TO DO IF SOMEONE HAS OVERDOSED


Give them naloxone

If you use heroin - or any opiate-type drugs - or know someone who does, you should carry naloxone. This is a drug that can reverse the symptoms of an overdose. If you can, carry multiple doses as they may be needed if the overdose has been caused by drugs containing nitazene.

Even if you don’t use opioids, carry it, as nitazenes have been found in other drugs like illicit Xanax.

If you’re unsure if the cause of the overdose is heroin or another opioid, give them naloxone anyway. It won’t cause any harm.

A single dose of naloxone will begin to work in 2-5 minutes, and its effects will last between 20-40 minutes. If fentanyl or nitazenes are involved, you may need to give them more than one dose.

It’s more likely that overdose symptoms will return with nitazenes, so keep an eye on the person longer than you would if they had overdosed on heroin alone.

You only need to recover their breathing. They don’t necessarily need to regain consciousness.

Put them in the recovery position.

When they are breathing normally again, put them in the recovery position. This will help with their breathing and guard against inhaling their sick if they vomit.

Call 999

Remember that naloxone is not a substitute for emergency medical care. It’s a temporary measure that buys time until proper medical treatment can be given.

Call an ambulance as soon as you can. The police will not usually attend an overdose emergency. When the emergency services arrive, tell them what the person overdosing has taken – better still, give them a sample of what has been used.

Stay with them

Keep an eye on them. The effects of naloxone will wear off. You may need to give them more doses.

TIPS ON STAYING SAFER


Keep an eye on each other

Try not to use drugs alone. It’s always better to be with someone you trust so you can keep an eye on each other.

If you are with other people, make sure multiple naloxone kits are available. Don’t all use at the same time. Space out hits so somebody is alert and sober and can get medical help if anything goes wrong.

If you have to use drugs alone, tell someone and ask them to check up on you.

If you can’t do the above, consider using the BuddyUp phone app. It’s a confidential service that allows you to prepare an overdose rescue plan. BuddyUp is available via Android and iPhone.

Low and slow

Start with a small amount and wait to feel the peak effects before taking more.

If you’re using pills that haven’t been prescribed, try cutting them into smaller pieces.

If you can’t do that, crush the pill, dab a bit, and wait. This method works well for powdered or crystal drugs and can make pill use safer, too.
Don’t mix your drugs

Mixing drugs is more likely to cause an overdose. Try to use one drug at a time. If you are going to mix drugs, use less of each.

Check your drugs

There is no way to see if your drugs contain fentanyl or nitazene. Consider sending an anonymous substance sample to the WEDINOS Project for analysis. You don’t need to provide personal details other than your age, sex and the first part of your postcode.

Getting the results takes a few days, so take it easy. Use the low and slow method if you are going to take drugs in the meantime.

Fentanyl test strips, which are used to check for the presence of fentanyl in drugs, don’t detect nitazenes.

ADDITIONAL SUPPORT


HOW TO GET NALOXONE

England

Naloxone is available from all drug and alcohol services. Make sure you find out where you can get it locally.

Scotland

Scottish Families Affected by Alcohol and Drugs offers a ‘click & deliver’ naloxone service

W. sfad.org.uk/support-services/take-home-naloxone-application

Wales

If you live in Wales, Barod offers a naloxone ‘click & deliver’ service.

W. barod.cymru/naloxone-click-deliver-service

DRUG TESTING

WEDINOS

WEDINOS tests substances to give individual users and others rapid and accurate information to reduce harms.

W. wedinos.org


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Spice: synthetic\fake cannabis harm reduction information

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SPICE

Synthetic cannabis harm reduction advice

What is spice?

Spice is a mixture of chemicals created in a lab to mimic the effects of cannabis. It’s the most common synthetic cannabis and is known by various names including fake cannabis, K2, black mamba and lots more, depending on where you live.What does it look like?

The chemicals in spice, known as synthetic cannabinoid receptor agonists (SCRAs), start off as a powder, are turned into liquid and then usually sprayed onto chopped-up leaves and herbs to look like herbal cannabis (unlike cannabis, spice isn‘t sticky, doesn’t contain buds and has no distinctive smell). These chemicals can also be sprayed onto paper, making spice much harder to detect, and it’s in this form that it often finds its way into prisons.

How is it used?

Spice is usually mixed with tobacco and smoked like cannabis to make the most of its similar effects. More and more, it’s turning up in vapes and e-liquids, often sold online as CBD or THC liquids.

How strong is spice?

There are hundreds of different SCRAs, and they vary in strength and toxicity. There’s no consistency. It all depends on the type and amount of SCRAs used in each batch. So, there’s no way of knowing how strong your spice is going to be, or how it’ll affect you. Spice is potent even at very low doses: a pinch the size of a match head is an active dose.

Is spice illegal?

Spice is an illegal class B drug, the same as cannabis. It‘s illegal to make, sell, or possess. It used to be a legal high, until the law changed in 2013. Some synthetic cannabinoids are altered to avoid the class B classification and come under the new Psychoactive Substances Act 2016. Under this Act, possession for personal use is not an offence but production and dealing are illegal.

But, it’s an offence to possess, supply, or produce psychoactive substances in prison. Some synthetic cannabis can already be detected in urine tests, and more tests are being developed.

How does spice make you feel?

Spice can make you feel euphoric, relaxed, happy, talkative and drowsy. The effects are felt in seconds and typically peak in half an hour or so and tail off over the next two to three hours.

Can you overdose on spice?

Using too much spice is easy because an active dose is so small, and you can‘t be sure which chemicals have been used and what effect they’ll have on you.

Symptoms of overdose can range from the mild to the severe.

Mild

  • Anxiety
  • Paranoia
  • Nausea
  • Vomiting

Severe

  • Inability to move
  • Seizures
  • Convulsions
  • Psychotic episodes
  • Abnormally fast heartbeat
  • Hallucinations

Is spice addictive?

Regular use of spice can lead to dependence (addiction) and withdrawal.

Withdrawal symptoms include the following:

  • Disturbed sleep
  • Profuse sweating
  • Irritability Cravings
  • Tremors Seizures

Tolerance

Tolerance to spice can build up quickly, sometimes within just a few days of regular use. Tolerance means your body gets used to the effects of spice and you need to use more to get the same effects. Because the chemicals in spice change so often, even experienced users who’ve built up a tolerance to its most extreme effects, can get those extreme effects again with any new batch.


Reducing the risks

There‘s no safe way to use spice. If you use it, there’s a risk of harm. But, if what you’ve read so far hasn’t put you off, there are certain things you can do which may help reduce the risks.

Low and slow

Use a small amount, about the size of a match head, or less, and wait to see how it affects you before considering using more.

Avoid other drugs, alcohol or medicines

There are so many types of spice that you can never be sure how it‘ll react with other substances.

Don’t use it on your own

There‘s safety in numbers. You can look after each other.

Look after your mental health

Spice will make existing mental health problems worse. Even small amounts can cause severe mental health side effects in people without a history of mental health problems.

Take a break

You can become dependent. Don‘t use everyday. Get support If you think you‘re dependent, don‘t stop immediately. Use less, and get help and support from your local drug and alcohol service or GP.

Don’t share

Avoid sharing joints, bongs and vapes. Sharing spreads germs.

Sit down

Sit down to prevent falls, tripping, or collapsing.


In an emergency

Someone who’s used spice, might be behaving in a disturbing or worrying way. This can include appearing ‘zombie-like‘, talking gibberisah, hallucinating, and being unable to control movements.

Most of the time this behaviour will pass after a few minutes, but if you’re concerned, roll them on their side, put them in the recovery position and call an ambulance immediately.

Let the emergency workers know what they‘ve taken - it could save their life.

Symptoms include the following:

Heavy, rapid, or shallow breathing

If this goes on for five minutes or longer, call an ambulance.

Overheating

If someone has a high temperature loosen their clothing and put a damp cloth on their forehead. If it doesn‘t drop within five minutes, call an ambulance.

Chest pain or seizures

Try to calm them down, but don‘t delay, call an ambulance.

Bad trip

Reassure them, take them somewhere quiet. No need for an ambulance. It should pass.


Help & support

FRANK
Information about drugs Find out everything you need to know about drugs, their effects and the law. Talk to Frank for facts, support and advice on drugs and alcohol today.

www.talktofrank.com
Call: 0300 123 66 00

ADFAM
Help for the families of drug users Adfam has local groups for families affected by drugs and alcohol. It also has a range of information for the families of drug users.
www.adfam.org.uk

RELEASE
Drugs & the law Release provides free, non-judgmental, specialist advice and information to the public and professionals on issues related to drug use and to drug laws.
www.release.org.uk
Call: 020 7324 2989

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Smart drugs harm reduction information

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SMART DRUGS
HARM REDUCTION INFORMATION

Smart drugs, also known as nootropics, are a group of substances that claim to boost your brainpower, focus, and memory. I have added this copy - They’ve become increasingly popular in recent years as people seek ways to improve their cognitive performance.

Whether it’s an essay you want to do really well in, exams you need to revise for, or a looming project deadline, the idea of popping a pill for that much-needed brain boost can seem appealing. 

Hundreds of drugs both manufactured pharmaceuticals and natural organic substances claim to boost your brain power, and increase intelligence.

This page contains information about the two most commonly used assmart drugs in the UK: the manufactured pharmaceuticals modafinil and Ritalin. It will explain what they are, the risks of using them and how to reduce those risks.

RITALIN & MODAFINIL

Ritalin is a brand-name prescription medication with the active ingredientmethylphenidate, generally used for treating ADHD (attention deficit hyperactivity disorder) and sometimes narcolepsy (falling asleep without warning).

Modafinil, a prescription-only stimulant, is sold under the names Provigil, Modalert, Alertec and Modavigil.

Modafinil is used to treat sleep disorders like narcolepsy.

> How they work

Both drugs are stimulants, which affect the level of certain chemicals in your brain (neurotransmitters).

> Appearance

Ritalin comes in yellow, grey and white tablets and various-coloured capsules. Modafinil comes as a white tablet.

> How they make you feel

The effects are similar to stimulants: they will make you feel more awake, alert, and energised.

The downsides of smart drugs:

  • raised blood pressure and increased heart rate
  • insomnia
  • headaches
  • loss of appetite
  • dizziness
  • skin rash
  • in extreme cases, large doses can cause a psychotic episode

> Onset and duration

They take between 30 and 90 minutes to take effect, peak between two to four hours after taking them and can last between 12 to 15 hours or even longer, depending on dose, tolerance to the drug, liver function, and age.

> How long they stay in your system

Both can be detected via a drug or urine test; up to four days later for modafinil and up to three for Ritalin.

> The law

Ritalin (methylphenidate) is a controlled ‘Class B’ substance and is illegal to possess or supply without a prescription. Modafinil is legal to possess but is illegal to supply without a prescription.

THE RISKS

> Irregular sleep patterns

Stimulants can cause insomnia and irregular sleep patterns, increase stress, weaken the immune system, and raise the risk of cardiovascular disease and depression.

> Focus Shift

Some people who use smart drugs find their focus has shifted from the task they set out to do to something else that’s distracted them.

> Pregnancy and contraception

If you use modafinil during pregnancy, it may cause birth defects. It can also reduce the effectiveness of some hormonal contraceptives, including oral contraceptives. 

Ritalin may increase the risk of having a miscarriage. Some studies have suggested an increased chance for foetal heart defects when Ritalin is used during pregnancy.

If you’re breast-feeding, avoid using any drug not prescribed by a health professional.

> Addiction and withdrawal

Some people experience withdrawal symptoms such as poor concentration, sleepiness, low energy, depression, anxiety and shortness of breath. They’re usually infrequent and, in most cases, relatively mild.

Addiction to modafinil is unlikely, but it may be possible as it affects neurotransmitters like dopamine.

> Buying medicines online

Buying prescription-only medicines from unauthorised sources can increase the risk of getting poor quality or fake medication, or even not what you thought you were buying, putting yourself at serious risk of harm.

> Driving

Both can cause blurred vision and might affect your reactions and ability to drive. It’s an offence to drive while your reactions are impaired.

HARM REDUCTION TIPS

Modafinil and Ritalin are intended for people who need medication for specific conditions. You increase the risks if you take drugs you don’t medically need. Do your best to avoid using study drugs.

But, if you’re still considering taking them, here are some tips on reducing the potential for harm:

> Know the risks

Research the drugs you want to take. Don’t take what your friends or websites say at face value. 

> Know when to stop

If you get any adverse side effects, such as anxiety, insomnia, or headaches, stop taking them.

> Low and slow

Start with a low dose and see how you react. You can always increase the amount later, if needed.

> Avoid mixing with drugs or alcohol

Mixing smart drugs with other drugs or alcohol, makes their effects unpredictable. 

Drugs and alcohol can cancel each. You could take more to get the same effects - leading to dangerous levels of both.

Even at low doses, some combinations can increase how long the effects last, make sleep more difficult and increase the risk of high blood pressure, racing heartbeat, panic attacks and serotonin toxicity.

> Take a break

Don’t take them every day. They can have a cumulative effect. Even if you don’t have side effects, taking breaks from them can help to reduce the risk of dependency.

> Don’t mix with antidepressants

Avoid taking MAO inhibitors (anti-depressants). Be cautious: both substances affect chemicals in the brain and, when combined, can cause dangerous interactions.

DO SMART DRUGS WORK?

For people who have no medical need for Ritalin or modafinil, they are risky, and unlikely to make any difference to their cognitive performance. 

If there is any benefit, research suggests it’s quite modest and rather than making you smarter, they make you feel more awake and alert, so you get more done.

Most people would be better off focusing on getting enough sleep, following a healthy diet, and managing deadline stress.

BEFORE YOU REACH FOR THE PILLS, CONSIDER THESE STUDY TECHNIQUES:

Find a good place to study

Make sure the space is free from distractions and that you’ve got everything you need, such as your textbooks, notes, and a computer.

Set realistic goals

Don’t try to cram everything into one study session. Break what you’re doing down into smaller, more manageable chunks.

Use active learning techniques

Try to summarise the material in your own words, create concept maps, or practice answering questions.

Take breaks

Studying for long periods can be counterproductive. Get up and move around every 20-30 minutes to avoid burnout.

Reward yourself

When you reach a study goal, give yourself a small reward to help with motivation.

Get enough sleep

Studying when you’re tired is counterproductive. Aim for 7-8 hours of sleep each night.

> Manage your stress

Stress can make it difficult to focus and learn. Find healthy ways to manage stress, such as exercise, yoga, or meditation. Exercise has been linked to enhanced memory, improved focus, and increased cognitive flexibility. Meditation can help improve attention and focus.

WHAT TO DO IN AN EMERGENCY

If you, or someone you know, are experiencing any of the following symptoms, call 999 immediately:

  • chest pains
  • extreme confusion or severe agitation
  • uncontrollable shivering or shaking
  • overheating and an inability to control body temperature
  • stomach pains and/or continuous vomiting

Stay with the person in an emergency and reassure them until help arrives. Be honest about what they’ve taken, how much, and when.

ADDITIONAL HELP AND SUPPORT

Talk to Frank

National drugs awareness site for young people.

Call 0800 77 66 00 (calls are free and confidential)

talktofrank.com 

Mind

Student mental health information.

mind.org.uk/information-support/tips-for-everyday-living/student-life/

Release | Drugs, The Law

Free non-judgmental, specialist advice and information on issues related to drug use and to drug laws.

release.org.uk

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