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In the latest government figures for road deaths, 147 drivers who died were found to have taken legal or illegal drugs - excluding alcohol.

 This information explains the latest drug driving legislation, roadside testing procedures and what happens if you test positive for drugs.

Drugs change the way you feel. They will affect your perception of speed and distance and impair your judgment and reaction times, putting you and other road users at risk.

The effect of drugs on your driving will depend on which drugs you’ve used.

Cannabis

Drugs like cannabis can result in your reaction times becoming slower, so you’re less aware and less able to respond to hazards fast enough.  Research using driver simulators found that cannabis makes drivers less able to steer accurately and more likely to react slower to another vehicle pulling out.

Cocaine

Stimulant drugs such as cocaine or amphetamine give you a feeling of increased confidence. They can cause erratic behaviour, such as driving too fast and taking risks, and, at the same time, reduce your ability to judge the situation accurately.

Heroin

Heroin and other opiate-type drugs have a sedative effect, slowing reaction times. They can also cause inappropriate responses, reduce coordination and your ability to think clearly.

Medicine

Some prescription and over-the-counter medicines can have side effects, which include drowsiness, blurred vision, dizziness, slowed movement etc.

In March 2015, the government brought in a new offence of driving while over the limit specified for drugs in your system.

Section 5A is the new law and refers to ‘driving or being in charge of a vehicle with a concentration of a specified controlled drug above the permitted levels in your blood’. The law includes a number of illegal, and prescription drugs.

There are now two offences that relate to drug driving, as follows:

• Section 5A RTA 1988
• Section 4 RTA 1988

The previous Section 4 law (which still exists) concerns driving, attempting to drive, or being in charge of a motor vehicle while unfit - whether you’re over the limit or not.

Section 5A makes it easier to successfully prosecute drug driving offences because the court doesn’t have to prove impairment, as it has had to do under the Section 4 law. It will reduce the time and money spent on prosecutions, improve road safety and deter drug driving.

Permitted levels

Section 5A takes a zero-tolerance approach to the listed drugs. The limits are set so any claims of accidental exposure can be ruled out (no excuses that your mate was smoking cannabis close to you, and you just inhaled it).

Your driving doesn’t have to be impaired for you to be charged with this offence. You just have to be over the permitted levels.

Being in charge

It’s also an offence if you’re ‘in charge of a motor vehicle when under the influence of drugs’. This essentially means you could be parked up in your car and still be prosecuted if you are over the limit.

What drug driving charge will you face?

If your blood drug level is above the permitted levels, you will be charged with the Section 5A offence.

If you’re above the permitted levels and your driving is impaired, you’re likely to be charged with the Section 5A offence.

If it’s below the permitted level, but there is sufficient evidence of impairment, you’re likely to be charged with the Section 4 offence of being unfit to drive.

These are the drugs, and their permitted levels, which are currently covered by the new Section 5A law.

The levels are measured in microgrammes per litre of blood (µg), and are very small amounts.

Prescription drugs

You can drive after taking prescription drugs under the following circumstances:

• You’ve been prescribed them and followed the advice of a healthcare professional on how to take them.
• They are not causing you to be unfit to drive even if you’re above the specified limits.

How long can drugs be detected in your system?

It’s difficult to say with any degree of accuracy how long drugs are still detectable in your system*.

If you’re a regular cannabis user, it might take many days before it’s left your system and is no longer detectable.

A single line of cocaine could be detectable 12 hours later.  Benzoylecgonine, a by-product of cocaine use, is reportedly detectable for 30 hours, or even several days for some regular users. 

Many factors affect the speed at which your body processes and eliminates drugs, such as the following:

• sex
• age
• build
• dose
• how often you use drugs

The police can stop a vehicle for any reason. If they signal you to stop, you should always pull over when it’s safe to do so. You’re breaking the law if you don’t stop.

The police can conduct a roadside screening test or a field impairment test, both of which may result in your arrest under these circumstances:

• they think you’ve taken drugs
• you’ve committed a traffic offence
• you’ve been involved in a road traffic collision

Officers can test for cannabis and cocaine at the roadside, and screen for other drugs – including ecstasy, LSD, ketamine and heroin – at a police station.

Positive test

If the test is positive for drugs, you will be arrested and taken to a police station for a blood test.

A blood test can detect a broader range of drugs, provide an accurate reading of drug levels, and can be used as evidence in any future prosecution.

Even if you pass the roadside test, you may still be arrested and taken to a police station for further investigation if the police suspect that drugs have impaired your driving.

Giving a blood sample

When you arrive at the police station, a doctor or health care professional will take a blood sample.

They’ll send off one sample for testing and give you another so you can run your own independent test at an approved lab.

If you don’t provide the blood sample and have no reasonable medical excuse for failing to comply, you could be charged with ‘failure to provide’ and banned from driving and/or fined.

If you’re found guilty of drug driving, you’ll face several legal penalties, including the following:

• an automatic 12-month driving ban which could be extended depending on your circumstances and prior history of offending, and an unlimited fine
• a community sentence, which might include community service, a curfew requirement or mandatory rehabilitation treatment
• a prison sentence of up to six months, in the most serious cases

Aggravating circumstances, such as the following, will increase the penalties:

• you were driving for work, whether that’s driving a taxi, bus or making deliveries
• you had more than one drug in your system
• your standard of driving was poor
• you were driving near a school

The penalty for causing death by dangerous driving under the influence of drugs is a maximum prison sentence of 14 years.

Street Benzos or Street Valium, known as MSPs, blues, vallies, benzos and scoobies, has become a collective term used to describe real, fake, and novel/new benzodiazepines obtained and used without a legitimate prescription. 

Benzodiazepines are a group of pharmaceutical drugs. There are many Benzodiazepines. Some, such as diazepam and valium, are prescribed as medicines in the UK. They are generally used to treat anxiety, alcohol withdrawal, and seizures.

Benzodiazepines make you feel drowsy and sleepy. They depress your central nervous system depressants and slow down your heart rate and breathing. You may experience a 'floating' sensation and feel warm, calm, relaxed and tired.

Deaths following the use of benzodiazepines, both on their own and combined with other substances like alcohol and opiates, have been rising in recent years among all age groups. 

If you are using street benzos, this harm reduction information will highlight some of the risks and help you make informed decisions.

We use the term 'street benzos' to refer to illicit benzos obtained and used without a prescription. We have broken them down into three sections: Pharmaceutical, fake, and Novel and new benzodiazepines (NPS).

Pharmaceutical benzodiazepines 

Pharmaceutical benzodiazepines are manufactured under controlled conditions in regulated facilities, meaning the contents are safe, accurate, and consistent.

Obtained with a prescription and used under the supervision of a GP, or health professional, they will typically be supplied in blister packs or medicine bottles and contain information around dosage and side effects.

Fake benzodiazepines 

Fake benzodiazepines are made to look like legitimate medicines. Manufacturers will often produce pills and capsules which have the same shape, colour, size and markings as the real thing.  

They can contain no active ingredients or the wrong type or amount of active ingredient and cause serious harm, illness or overdose.

Fake drugs can sometimes come in poor quality packaging, lacking medical information, and poorly made pills or capsules.

Novel and new benzodiazepines (NPS) - designer drugs

Remember the days when we had so-called legal highs before they were made illegal in 2016 by the Psychoactive Substances Act? Well, guess what - they are still around. 

The supply has increased in line with demand; only now you have to obtain them illegally.

Many NPS benzos contain Etizolam, Phenazepam, Diclazepam, Flubromazolam, Flubromazepam, alprazolam (also known as 'Xanax') - none are licensed in the UK, and some are class C drugs.

They normally come as pills and are commonly referred to as MSJs, blues, vallies, benzos, scoobies - or are mis-sold as diazepam. 

They can often be referred to based on their markings, such as: 'Roche 10', 'MSJ', 'T20', 'WW' and 'D10'.

Public Health England has recently (July 2020) issued a warning about pills with similar markings - they warned:

"There is significant evidence from toxicology results of illicit tablets being sold as diazepam, temazepam and alprazolam linked to recent hospitalisations and deaths. This includes tablets known as and/or marked with 'DAN 5620' (on one side) and '10' (on the other), 'T-20', 'TEM 20', 'Bensedin' and 'MSJ'. These may contain dangerously potent benzodiazepines or their analogues [chemicals which have a similar effect to benzodiazepines] such as flualprazolam and etizolam. Most of the tablets causing concern are blue (but they come in various colours) and these may stain people's mouths".

How are benzodiazepines supplied?

The only legal way to obtain benzodiazepines is with a prescription and from a legitimate pharmacy. But they can be obtained in other ways.

Some benzodiazepines are supplied by people who sell on their legitimate supply; other supplies are 'diverted' from the factories that make them or from chemist burglaries.

Some drug dealers will supply benzodiazepines alongside more established illegal drugs.

An increasingly popular way to obtain illicit benzodiazepines is online, either in bulk through the so-called dark web, using social media and encrypted messaging apps, such as Instagram, Snapchat, WhatsApp and Wickr, or through bogus online pharmacies.

It can be difficult to distinguish between registered online pharmacies and other commercial websites. The General Pharmaceutical Council (GPhC) operates an internet pharmacy logo scheme to identify legitimate online pharmacies.

Harm reduction Advice

• Do not take large amounts. Start low and slow. You can't be sure if what you are taking this time is the same as last time. Take a small amount and give it time to work before you take more.
• Do not use it on your own. But if you do, let someone know and ask them to check on you.
• Do not use regularly/daily. Leave it for a week; give yourself a break to get over it. Otherwise, you will get addicted.
• Do not use during pregnancy or breastfeeding. But if you do, tell your doctor.
• Do not drive or operate machinery - if you do, you will have an accident.
• Do not take the day before your driving test/go to work/school – leave it for Saturday night.
• Do not mix with alcohol or other sedative drugs - JUST DON'T! But if you do, look after each other.
• Do not inject - JUST DON'T! But if you do - don't share, take care!
• Do not stop abruptly - but if you do, be prepared for withdrawals. Talk to your GP or a health professional. Tell them what you have been taking, so they can help reduce your use.

sophisticated online market : https://www.emcdda.europa.eu/publications/joint-publications/eu-drug-markets-report-2019_en

Buying apps:

https://theconversation.com/instadrugs-new-research-reveals-hidden-dangers-when-young-people-use-apps-to-buy-illicit-substances-110319

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The use of benzodiazepines  is increasing.More and more people are using benzodiazepines to help with anxiety, stress and sleep problems.

Most benzodiazepines are obtained legitimately, with a prescription, and their use monitored by a doctor or other health professional. 

But an increasing number of people are using illegally obtained so-called ‘street benzos’ or ‘street Valium’ - either diverted from legitimate prescriptions or purchased online.

WHAT ARE BENZODIAZEPINES?

Benzodiazepines are sedative and anti-anxiety drugs that are used to treat various conditions such as anxiety, insomnia, muscle spasms, epilepsy

Benzodiazepines work by increasing the effect of a brain chemical called GABA (gamma-aminobutyric acid). GABA reduces brain activity and has a calming effect.

They are also misused, and when used at the same time as alcohol and other drugs, the chances of a fatal overdose is increased.

TYPES OF BENZODIAZEPINES?

There are different types of  benzodiazepines, which include:

• Alprazolam (Xanax)
• Chlordiazepoxide (Librium)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Flubromazolam
• Flurazepam (Dalmane)
• Phenazepam
• Temazepam (Restoril)

Dosing

Different benzodiazepines will stay in your body for different lengths of time - depending on their half-life. Half-life is the time it takes for your body to break down and remove (metabolise) half the drug. 

Diazepam has a half-life of around 20 hours - so after 20 hours, you will still have half the dose in your body. Using again can lead to increased levels and an increased chance of overdose.

Remember, not all benzodiazepines are the same. 10mg of one benzodiazepine isn’t necessarily the same as 10mg of another. 

Their effects will feel different, as will the time they take to start working and how long the effects last.

SIDE EFFECTS

Not everyone who takes benzodiazepines will feel side effects. but those that do may experience:

Common side effects include:

• drowsiness
• light-headedness
• confusion
•  unsteadiness on your feet 
• dizziness
• slurred speech
• muscle weakness
• memory problems
• constipation
• nausea (feeling sick)
• dry mouth
• blurred vision

Less common side effects include:

• headaches
• low blood pressure
•  increased saliva production
• digestive disturbances
• rashes
• sight problems (such as double vision)
• tremors (shaking)
• changes in sexual desire
• incontinence (loss of bladder control)
• difficulty urinating

Disinhibition

Benzodiazepines are normally prescribed to help reduce anxiety and calm people down, but they can have the opposite effect on a small number of people. 

They can cause dis-inhibiting and risky behaviour, particularly when mixed with alcohol or other drugs.

Behaviour can include:

• acute excitement
• altered mental state
• increased anxiety 
• vivid dreams 
• hyperactivity
• sexual dis-inhibition
• aggression
    

MENTAL HEALTH

Links have been noted between benzodiazepine use and depression and, in some cases, the emergence of suicidal thoughts.

The evidence suggests that higher benzodiazepine dosages are associated with an increased risk of depression in certain groups of people and that reducing or discontinuing use can help deal with the feelings.

If you experience any of these feelings or are thinking about changing the way you use a benzodiazepine, you must consult your GP, keyworker, or other health professional.

STREET BENZOS/DIAZEPAM

Illicit or fake benzodiazepines, often called ‘street benzos’ or ‘street Diazepam’, are benzodiazepines bought online or obtained without a prescription.

They come in various sizes and colours and are packaged in blister packs or pill containers designed to make them look safe and legitimate. Markings can include ‘DAN 5620’ (on one side) and ‘10’ (on the other), ‘T-20’, ‘TEM 20’, ‘Bensedin’ and ‘MSJ’.

Street benzodiazepines are unpredictable in content and potency and often contain unknown substances or substances that are dangerously stronger than that displayed on the packaging.

The unpredictable content and potency make street benzodiazepines particularly dangerous and are causing an increase in overdose, hospitalisation and deaths.

COMBINING BENZOS WITH DOWNER DRUGS IS DANGEROUS.

Using benzodiazepines with other downer drugs, such as alcohol, GHB and opioids, is very dangerous. 

Both types of drugs suppress breathing, and when used together, smaller amounts of each kind of drug is needed to increase the risk of a fatal overdose.

Alcohol

Smaller amounts of alcohol and benzodiazepines are needed to cause an overdose when used together. 

Combining alcohol and benzodiazepines can also result in poor decision-making, blackouts, and an inability to control one’s emotions, resulting in hostile or aggressive behaviour.

GHB/GBL

Benzodiazepines will stay in your body for some time after the effects have worn off. Combining benzodiazepines and GHB/GBL is very dangerous and can be fatal - even when taken several hours apart.

Opioids

Combining opioid-type drugs like heroin, methadone and buprenorphine with benzodiazepines is causing an increasing number of overdose deaths.

Both drugs sedate users and suppress breathing, in addition to impairing cognitive functions.

When combined, smaller amounts of each drug are needed to cause an overdose.

ADDICTION & WITHDRAWAL

Addiction

Benzodiazepines are normally only prescribed for a short length of time. (Lower doses may be prescribed for extended periods - depending on individual circumstances). 

Tolerance can build up quickly, and users can end up increasing the amount they use to maintain the initial effects. 

Using benzodiazepines for too long can cause psychological and physical addiction. 

Cutting down or stopping suddenly can cause unpleasant and dangerous withdrawal symptoms.

Reducing benzodiazepine use should only be done over a period of time, with the support of a health professional.

Withdrawal symptoms

Symptoms can start anything from eight hours to two days after you last took them. 

Symptoms can include:

• feeling sick or vomiting
• unpleasant sensations in your body, including muscle spasms, ‘crawling’ skin or goosebumps
• hallucinations (seeing or hearing things that aren’t there)
• feeling spaced out
• anxiety and panic attacks
• seizures (fits)

Call NHS 111 or go to NHS 111 online if you stop taking benzodiazepines and start to get any of these symptoms.

OVERDOSE ADVICE

If you are with someone when taking drugs, watch them carefully for the signs of an overdose.

Signs of overdose may include:

•  unconsciousness (won’t wake up with a shake or a shout)
• nausea and vomiting
• noisy, rasping, slow breathing
• difficulty breathing
• slow or erratic pulse (heartbeat)
• pale tinge to lips
• cold clammy skin
   

Benzodiazepines and opiates

If you have access to naloxone and you think someone has also used heroin, methadone or other opiates, give them a shot of naloxone.

It will not reverse a benzodiazepine-only overdose, but it will not harm them if you administer it when it’s not needed.

IF SOMEONE OVERDOSES, CALL 999 IMMEDIATELY FOR AN AMBULANCE.

Put the person in the recovery position and monitor the airway, breathing and pulse.

Do not assume that a person who seems to be coming around will not worsen later – stay with them until the ambulance arrives.

REDUCING THE RISKS FROM USING BENZODIAZEPINES

The only way to avoid the risks associated with benzodiazepines is not to use them. but if you intend to, this information will help reduce some of the risks.

Avoid buying benzodiazepines online. - usually advertised as diazepam (referred to as Valium), temazepam, and alprazolam (referred to as ‘Xanax’). 

Markings can include ‘DAN 5620’ (on one side) and ‘10’ (on the other), ‘T-20’, ‘TEM 20’, ‘Bensedin’ and ‘MSJ’, and can contain dangerously potent benzodiazepines or other dangerous substances not for medical use. 

If you use Benzodiazepines or other drugs, be extra cautious; test the strength by starting with a small test dose (1/2 a pill) and waiting at least an hour before taking more.

Don’t drive or operate machinery while using benzodiazepines or any other drugs.

Don’t mix benzodiazepines with alcohol.

Don’t mix benzodiazepines with any combination of alcohol, heroin, and gabapentinoids like gabapentin and pregabalin. Gabapentinoids work in a similar way to benzodiazepines and reduce tolerance to heroin and other opiates, increasing the chances of overdose.

If you’re going to use any drugs, make sure someone is around when you take them - if you overdose alone, nobody can help you.

If your drug use is causing you problems, you should seek help from your GP or local drug and alcohol service.

THE LAW

If you have a prescription for benzodiazepines and have obtained them from a pharmacist, you have nothing to worry about.

If you have bought them from the internet, been given them, or sold them by another person, they become a Class C drug and they are unlawful to use or possess.

Possession

Unlawful possession of Class C drugs is an offence which carries a maximum sentence of 2 years’ imprisonment or a fine, or both. 

Supplying

It is also an offence to supply or produce Class C drugs. Supply carries a maximum sentence of 14 years’ imprisonment or a fine, or both.

HELP AND SUPPORT

Here are some websites and organisations that can provide further information about benzodiazepines.

NHS

Advice, tips and tools to help you make the best choices about your health and wellbeing.

www.nhs.uk

Talk to Frank

National drugs awareness website. 24hrs a day, seven days a week.

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

www.talktofrank.com 

Release | Drugs, The Law

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

www.release.org.uk

Order the Benzodiazepines resource

Including information on 'street benzos' and MSJ (Diazepam)

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What is it?

• A colourless and, mainly, odourless gas.
• Also known as laughing gas, noz or noxy.
• Comes in small silver pressurised containers (bulbs).
• Usually transferred from a canister into a balloon for inhaling.
• It’s a class C drug. Supply or possession with the intention of using to get high is illegal.

How does it make you feel?

• Users feel light-headed, dizzy, giggly and euphoric.
• Can also cause confusion, headaches and nausea.

What are the risks?

• Using pressurised gas directly from a cannister is dangerous.
• Inhaling in an enclosed space or putting your head in a bag of gas can lead to unconsciousness.
• Using in hazardous locations, like high buildings, close to water etc, is risky.
• Prolonged and heavy use can result in vitamin B deficiency and nerve damage.
• Symptoms of nerve damage can include numbness or pins and needles in the arms and/or legs.
• Excessive use can cause breathing difficulties and heart problems.