Amphetamine is a manufactured chemical, also known as speed and whizz.
Appears as a white/yellowish powder.
It’s a stimulant which can make you feel confident, talkative and energetic.Can cause strain on your heart and make you feel anxious and depressed. Tolerance to amphetamine can build up, so you need to take more to feel the same effect.
It’s a Class B drug. Illegal to have, sell or give away.
Mephedrone
Mephedrone, also known as M-cat, bubble, meow-meow, is a manufactured chemical similar to amphetamine.
It’s usually a white or off-white powder found in tablets, capsules or powder form.
It’s a stimulant which can make you feel alert, confident and talkative.
Can cause anxiety, panic attacks, and irregular heartbeat. It raises blood pressure, which can put additional strain on the heart and can become habit-forming.
It’s a Class B drug. Illegal to have, sell or give away.
Cannabis
Cannabis comes from a plant called Cannabis Sativa.
It’s typically smoked, rolled with tobacco in cigarette papers, or using a pipe or bong. It comes in a brown block called hash (the resin scraped from the plant) or its dried flowers, known as grass or weed.
Cannabis makes you feel relaxed, trippy, tired and sleepy. But it can also make you feel edgy, anxious and frightened.
Smoking cannabis mixed with tobacco can cause lung damage and cancer.
It’s a Class B drug. Illegal to have, sell, grow or give away.
Alcohol
Alcohol is a chemical produced by brewing grains or fruits with water, sugar and yeast.
It comes in various forms, such as lager, wine, cider or vodka. The amount of alcohol in a drink is measured in units found on alcohol packaging. Different drinks have different numbers of units.
It slows down your brain, which, in small amounts, can make you feel relaxed and friendly.
Too much alcohol can damage your health and lead to addiction. Drinking large amounts too quickly can result in unconsciousness and sometimes death.
It’s illegal to buy, attempt to buy, or sell alcohol to anyone under 18.
Tobacco
Tobacco is the chopped up leaves of the Nicotiana plant, which are usually rolled into cigarettes.
It’s a stimulant which makes your heart pump faster, increasing your blood pressure.
Tobacco contains nicotine, which is addictive
It contains thousands of chemicals, some of which will increase your chances of developing cancer and heart disease or having a stroke.
Tobacco is legal but illegal to sell or give to anyone under 18.
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Cannabis, also known as marijuana, generally refers to the dried flowers (Grass) or resin (Hash) of the female Marijuana plant (Cannabis Sativa/Indica). It comes in the form of resin, normally extracted from the flowers of the plant, the dried flowers themselves, or very rarely as cannabis oil.
Cannabis contains many chemicals, some of which are known as cannabinoids.
The cannabinoid which give you the feeling of being high or stoned is called THC (tetrahydrocannabinol).
HOW IS IT USED?
Smoked as a joint
Cannabis is usually smoked in a cigarette called a ‘joint’, normally rolled with tobacco.
Smoked using a bong or pipe
Smoked in a pipe or a water ‘bong’ (a pipe which passes the smoke through water to cool and filter it). When smoked, cannabis usually affects you quite quickly.
Vaporisers
Vaporisers (about £50 to buy) are less risky - they get just hot enough to release the THC (Tetrahydrocannabinol, the bit that gets you stoned) but not the tar.
Eating
Sometime people will eat cannabis, mixed with other ingredients, eg. in biscuits (cookies) or cakes.
If it is eaten, the effects take much longer to be felt but can build up and get stronger over a longer time.
It is much harder for someone to control the dose of the drug when cannabis is eaten.
How will cannabis make you feel?
Cannabis affects people in different ways. It depends on how you feel, how much you smoke and where and who you are with, but generally, when smoked, the effects are felt quite quickly.
They can range from feeling relaxed, happy and laid back to feeling wired and paranoid.
Other effects can include eating large amounts of biscuits, pot burns in your favourite clothes and sitting on your bum all day.
PROBLEMS
Physical Health
Cannabis is usually smoked with tobacco which is known to cause serious health problems including cancer and heart disease. The nicotine in tobacco is very addictive and damaging to your health.
Your lungs were not meant to take in hot, noxious gases, so smoking cannabis, even on its own, is not good for your lungs.
Mental Health
If you feel down, cannabis will probably make you feel worse. You may feel sick, confused and worried – but these feeling will normally wear off as the cannabis does.
Some research suggests that if you have an underlying mental health problem or one that you may not know about, using cannabis may bring it on.
Be aware of how you feel when you smoke cannabis. If you start to feel anxious, paranoid or stressed out you should think about cutting down or stopping altogether.
Dependency
Using cannabis can become a habit. Regular users may find it hard to stop. If you smoke cannabis with tobacco you may find it even more difficult to give up cigarettes.
Motivation
When you use cannabis, you may keep forgetting what you’re doing and find it hard to concentrate. You might find you can’t work or study properly. You may still feel spaced out the next day.
Accidents
Cannabis can make you clumsy and slow to react. Don’t smoke cannabis if you are going to drive or operate machinery.
REDUCE THE RISKS
The only risk-free drug use is no drug use, but if you are using, or considering using cannabis, the advice below will help minimise the risks to your health.
Don’t mix it with tobacco.
Tobacco is addictive and has been proven to cause cancer and heart disease.
Don’t hold the cannabis smoke in your lungs
You won’t get more stoned. It just means more tar and other nasty chemicals will stick to your lungs.
Don’t use a cigarette filter for a roach
You will inhale more tar. Use plain card, loosely rolled up, for a roach – this lets the smoke flow easily.
Don’t use too many papers
Three skinners will do – or you’ll breathe in too much burnt paper.
Don’t use plastic bottles, rubber hoses, PVC, foil and aluminium
These give off toxic fumes when hot. Glass, steel or brass pipes are safer.
Maybe you like to get high, but not everyone does. Show some respect. Don’t smoke near people who don’t use cannabis – especially children and people with breathing problems.
IN CONTROL
If you or someone you are with is having a bad time while using cannabis, the information below will help you stay in control:
If one of your friends is having a bad time sit them somewhere quiet and comfortable, away from others. Stay calm and keep them calm, take their mind off things by talking to them. Tell them the bad feelings will wear off soon.
Cannabis lowers blood-sugar levels. You will feel better if you have something sweet to eat or drink.
If you feel bad when stoned you should think about stopping, if only for a short time. Give your mind and your body a break.
If you use it every day, have a couple of days off each week. Smoke fewer spliffs a day, or put a bit less in them.
If you are trying to cut down, avoid places, people or events that remind you of cannabis.
Don’t buy extra, thinking you will save some for tomorrow – you probably won’t.
CANNABIS AND THE LAW
Cannabis is illegal. It is a class B drug. It’s against the law to possess cannabis, sell it or give it away, grow it or let your place be used for smoking it.
The maximum penalty for possession of a Class B drug can be up to five years in prison and an unlimited fine.
The maximum penalty for supplying a Class B drug can be 14 years’ imprisonment and an unlimited fine.
In reality, if you are caught in possession of cannabis an ‘escalation’ penalty system may be used.
First offence:
Verbal ‘cannabis warning’ from the police.
Second offence:
Penalty Notice for Disorder (PND), resulting in an on-the-spot £80 fine.
Third offence:
Arrest, conditional caution or prosecution.
If you are under 18
Anyone under 18 years of age found in possession of cannabis will be taken to a police station where they may receive a reprimand, final warning or charge, depending on the seriousness of the offence. This must be administered in the presence of an appropriate adult.
If you are caught with cannabis in Scotland you’ll be arrested and reported to the Procurater Fiscal, who will decide if criminal proceedings should be taken or not.
A criminal record can be a real problem at home, college or work, and in later life.
You can buy printed versions of this information in the Substance shop
Article Introduction: Health-related information and advice for people who use alcohol and drugs in a nightclub environment.
Clubbing & Drugs: your guide to a safer night out
This information will help guide you through some of thepotential risks of a night or weekend clubbing and provide tips on reducing the risks and staying as safe as possible.
The UK has a vibrant nightlife scene attracting a diverse range of clubbers using an ever-changing range of drugs, legal and illegal.
Taking drugs is risky and taking them in a nighttime environment brings its own set of risks. It's essential to know as much as possible about what drugs you're taking. This guide will help you understand those risks and help you stay safer.
Before we get into the drug information, let's take a look at a couple of important harm reduction strategies, pill testing and how you consume your drugs.
Pill testing kits can provide some information about the chemicals that might be present, but they don’t indicate the strength of a pill or what else it may contain. A positive result doesn’t guarantee safety – a pill can still contain other harmful substances. Testing is better than nothing, but it should always be combined with caution and other harm reduction steps.
The way you take drugs affects how soon the effects start and how long they last.
Snorting drugs will cause the effects to start within a very short time and with a higher intensity, but they will wear off relatively quickly. Eating your drugs, pills, or powder means the effects will come on much slower and steadier, but last for a longer period with much less of a crash at the end.
Passing around notes or straws for snorting drugs can pass around germs like hepatitis and other blood-borne viruses. Keep your nostrils healthy by flushing out your nose with clean water at the end of each session.
Now let’s get into the drugs themselves. In the uppers section, you’ll find drugs such as cocaine, speed, ecstasy and MDMA. The spacing-out section covers substances like cannabis, mushrooms and ketamine. The downers section features alcohol, benzos and GHB. Finally, the new psychoactive substances section looks at drugs such as mephedrone and nitrous oxide.
UPPERS
Stimulants that speed up the body and mind, giving energy and confidence but carrying risks like anxiety, insomnia, and dependence.
Relaxation, talkative, increased confidence and sociability
Problems:
Dizziness, loss of coordination, confusion, aggression and violence, poisoning, addiction, accidents, anti-social behaviour, increased risk of STIs or unplanned pregnancies
Form:
Liquid
Law:
Illegal to drive while under the influence
Benzodiazepines (Valium, Mogadon, Librium, etc.)
Type:
Depressant
Effects:
Relaxation, reduced stress and anxiety, drowsiness and sleep
Problems:
Drowsiness, forgetfulness and confusion. Strong risk of dependence with regular use
Users feel light-headed, dizzy, giggly and euphoric
Problems:
Confusion, headaches and nausea. Direct inhalation from a canister is risky. Inhaling in enclosed spaces or from a bag may cause unconsciousness. Heavy, prolonged use can cause numbness or tingling in limbs, and breathing and heart issues
Form:
Colourless gas in small metal canisters (whippits) or larger tanks
Law:
Class C drug. Supply or possession to get high is illegal
Each part of a night out has it's own set of unique risk so we split this part of the guide into sections to make it easier to follow.
Before the Club looks at pre-drinks, the law and getting through the door safely. In the Club covers looking out for your mates, what happens if you’re caught with drugs, and health risks like heatstroke, water intoxication and mixing. After the Club gives advice on getting home, sex and ED drugs, handling the come-down and looking after yourself. Finally, the Overdose section explains the signs and what to do in an emergency.
BEFORE THE CLUB
Pre-club drinks
Mixing alcohol with drugs is dangerous. If you must drink, try and stick to drinks with a low percentage of alcohol. Avoid the high-strength lagers, shots and spirits. Alternate your drinks with soft drinks, fruit juice or lemonade.
Drugs and the law
Under a new law, all psychoactive substances (i.e. drugs) are illegal - apart from alcohol, tobacco, and caffeine. So if it doesn’t look like booze, fags, or coffee, the police can pull you. So is picking up drugs for yourself and your mates to share. If you are stopped by the police and tell them the drugs are for you and your mates, that would be considered possession with intent to supply, a very serious offence.
If you are in a car in which the police find drugs and no one claims ownership, everyone in the car could be charged with possession or supply.
On the door
Many clubs insist on a search. You can refuse, but the club also has the right to refuse you entry.
Only the outside of clothes, pockets and bags can be searched. The search must be conducted by a member of staff of the same sex. They cannot search inside clothes without your permission and can never conduct intimate searches, such as inside underwear or strip-searches.
Necking all your drugs at once to get around the search is dangerous, you could also still be standing in the queue when your drugs start to come up. Make sure you bring some warm clothes for waiting in the queue and for going home.
Don’t buy drugs in the club. You can’t be sure what you are buying in a dark club if you are off your face.
Know what drugs your mates have taken so you can tell the medical staff if they are taken ill. If anyone starts to have a bad trip, take them somewhere quiet and reassure them it’s just the effects of the drugs and the feelings will wear off.
Don’t let a friend leave with strangers. Try to find out who they are and where they are going first.
Getting caught with drugs in the club
Any club that allows its premises to be used for the consumption of drugs can be closed down. So it’s unsurprising they keep a close eye on what’s happening inside. Openly snorting powders and necking tablets aren’t good looks.
If you are lucky, you will only have your drugs confiscated and have a very long wait outside the club for your mates to come out, rather than being reported to the police and ending up with a criminal record.
Uppers and heatstroke (Hyperthermia)
Uppers can raise your body temperature and decrease the release of heat by constricting blood vessels near the skin, combined with physical exertion it can cause your body to overheat. If it reaches extreme levels it can permanently damage your organs or prove fatal.
Signs of heatstroke are:
Headaches
Dizziness
Hot dry skin
Nausea (this can also be caused by your drugs starting to kick in)
If you start to feel ill stop what you are doing, get some fluids and take some time out. Go to the chillout area and try and get some fresh air. If the symptoms don’t improve, get medical help straight away.
Water intoxication (hyponatraemia)
While it is important not to become dehydrated when out clubbing, taking on too much fluid can also cause its own problems. It can upset the balance of sodium in your body and cause your brain to swell, which is extremely dangerous.
You should try to sip about a pint of fluid an hour. Try to include some fruit juice or Isotonic sports drinks.
Mixing drugs
Mixing drugs is dangerous as the effects of the two drugs together are unpredictable. Your body can only process so much at once. Putting extra pressure on it by asking it to do too much can lead to a dangerous build-up of drug levels in your body which could have serious consequences. If you drink alcohol and take cocaine, your body produces a third substance called Cocaethylene. This is highly toxic and can cause heart problems.
Mixing alcohol or prescription drugs with illegal drugs is asking for trouble.
Those on HIV or hepatitis meds should seek specialist advice before using GHB/GBL or Ketamine. They can cause serious interactions with prescribed medication.
It’s simple – DON’T DRIVE IF YOU HAVE BEEN TAKING DRUGS! They affect your vision, coordination, concentration, perception and spatial awareness, and reaction times. You will be affected for a long time after you have taken drugs.
It’s illegal to drive if either:
you’re unfit to do so because you’re on legal or illegal drugs
you have certain levels of illegal drugs in your blood (even if they haven’t affected your driving)
The police can stop you and use a roadside drug kit if they think you’ve been using drugs. If convicted, the penalties are:
a minimum 1-year driving ban
an unlimited fine
up to 6 months in prison
a criminal record
Your driving licence will also show you’ve been convicted of drug driving. This will last for 11 years
Sex and ED (erectile dysfunction) drugs
Some drugs give you a loved-up feeling and increase sexual desire, but they can also make it difficult to get an erection. Some of you may consider using ED drugs to try and overcome this. But combining uppers (ecstasy, speed or cocaine) with ED drugs can have an increased effect on body temperature, blood pressure and heart rate. Using Poppers with ED drugs can also compromise your immune system, increasing the risk of sexually transmitted infections. Poppers are dangerous for anyone with chest or heart problems, anaemia or glaucoma.
ED drug’s ability to prolong sex increases the risk of breaks in the skin, increasing the risk of passing on sexually transmitted infections. Always carry condoms and use them.
Handling the come-down
The best way to ensure a bad come-down is to take more drugs or drink alcohol. You won’t get any higher, but you will regret it later on. Taking downers to ease the landing will only put off the inevitable for a few hours.
When you get back from the club, try to resist the temptation to keep the party going by taking more drugs. Treat it as a different part of the experience. This is the best time of the night. Relax. Change into fresh, loose-fitting clothes. Turn the lights down low. Put on some chilled tunes. Get a cup of tea - the best come-down drug there is! Crash on the sofa and chat with your friends. Chill out.
Look after yourself
If you enjoy clubbing and want to continue doing it, be good to yourself. Don’t drink or do drugs throughout the week. Get plenty of rest and sleep. Eat well. A healthy, balanced diet throughout the week is like putting money in the bank to spend at the weekend. Stay fit. Working out, walking, swimming, or any sport will strengthen your heart and lungs and improve your mental wellbeing.
Keep clubbing as a special weekend treat; don’t let it take over your life. The more varied social life you have outside the club nights will make those sessions all the more enjoyable. Clubbing can be fun, but it’s not the top and bottom of everything. Enjoy life. The more you have going on in your life, the more special your night’s clubbing will become.
Using any drug carries risk. These risks increase if you are mixing drugs or combining them with alcohol, and can result in an overdose. This can still happen even sometime after you have taken the drugs.
The symptoms for people who are overdosing on uppers or downers are different but some people can display symptoms of both.
Overdose symptoms can include
Uppers - Chest pain or tightness, shortness of breath, hot to the touch and red in the face, sudden collapse.
Downers - Looks pale, blue lips, shortness of breath, sudden collapse, not waking in response to stimuli, snoring deeply (this is a sign of difficulty breathing, not deep sleep).
If this happens in a club, take them to a cool quiet place and get help straight away, most clubs will have a designated first aider who will help them until an ambulance arrives.
If it happens away from the club, put them in the recovery position and call an ambulance, you do not have to give your name, and the police have a policy of not attending overdose calls, unless there is any danger to the medical staff, a death, or child safety issues.
Always tell the medical staff who attend what drugs they have taken, and if possible give samples to the medical staff this could save someone's life.
These organisations and websites can provide further drug information and advice.
Talk to Frank
National drugs awareness site for young people and parents/carers. www.talktofrank.com
Helpline 0800 77 66 00
talktofrank.com
RELEASE
Release is the national centre of expertise on drugs and drugs law - providing free and confidential specialist advice to the public and professionals.
Article Introduction: Cocaethylene awareness and harm reduction advice for anyone who uses alcohol and cocaine together.
COCAETHYLENE
Effects & toxicity explained
Learn about cocaethylene: what it is, how it forms when alcohol & cocaine are used together, the risks to your heart and liver, and simple steps to reduce harm.
What is Cocaethylene?
Cocaine and alcohol are increasingly being used together as a 'straightener' to keep the night going, allowing people to drink more alcohol and lessen the 'comedown' from cocaine. When you use these substances together, your liver automatically creates a third drug called cocaethylene. This new compound affects your body differently than cocaine or alcohol alone, creating both stronger effects and greater risks. The information in this guide will help you understand and minimise these risks.
Cocaethylene Effects
Cocaethylene increases both the duration and intensity of cocaine's effects. It stays active in your body 3–5 times longer than cocaine alone, creating a more powerful high. But the downside (yes, there always is one!) is that cocaethylene is also more toxic than cocaine by itself, causing both short-term and long-term physical and mental health problems.
Cocaethylene Risks
Health
Cocaethylene causes more severe increases in heart rate and blood pressure than cocaine alone. Even for perfectly healthy people, this increases the chance of seizures, heart attacks and strokes. For anyone with an underlying heart condition, this is extremely risky. Cocaethylene is more toxic than cocaine and stays in your system much longer, putting greater strain on your liver and other organs. Over time, this can cause serious damage.
Violence
Alcohol reduces your inhibitions, cocaine increases confidence, and cocaethylene amplifies both effects. This combination significantly increases the risk of impulsive or reckless behaviour, including violence.
Sex
The combined effect of cocaine and alcohol can significantly impact sexual performance. It increases sexual desire but makes it harder to achieve an erection and lubrication, and more difficult to reach orgasm. Prolonged attempts to climax can cause physical damage and increase the risk of sexually transmitted infections (STIs).
Important: Using sexual stimulants like Viagra with cocaine and alcohol puts massive strain on your heart and is not recommended.
Warning Signs
Cocaethylene itself doesn't increase addiction risk beyond what cocaine and alcohol carry individually. However, you can become accustomed to using both substances together, so that using one triggers cravings for the other. This can lead to dependency on both substances.
Some warning signs include:
Using larger amounts of alcohol and cocaine to get the same effect, or to cancel out the negative effects of either substance
Spending time thinking about when you are going to use next
Having problems at home, work or university because of your behaviour or neglecting responsibilities
Getting involved in violence or injuring yourself or others after a session
Taking Control
If you want to cut down or stop using alcohol and cocaine, the following advice may help:
Use smaller amounts at each session and give yourself more time to recover between sessions
Think about the negatives – financial problems, feeling rough all the time, relationship issues. Remind yourself of these when you feel the urge to use
Avoid triggers like places or people you use with
Take a break from certain friends, avoid specific pubs and clubs, and find alternative activities
Tell someone what you're doing or ask a friend to support you. Having someone to talk to during difficult moments can make all the difference
Don't give up. Breaking the habit is possible. If you don't succeed the first time, don't be hard on yourself – you've taken the first step. Try again!
Additional Cocaethylene Information
The information above is from our cocaethylene harm-reduction leaflet. It includes everything people need to reduce the risks of using cocaine and alcohol together.
The additional information below comes from questions we receive from clients and searches made on our website and takes a deeper dive into the science of cocaethylene.
How much stronger is cocaethylene than cocaine?
Cocaethylene isn't exactly "stronger" than cocaine, but it does affect you more intensely and lasts longer. When you use cocaine and alcohol together, your liver creates cocaethylene – and this new compound behaves very differently in your body.
Why it feels more intense:
Lasts 3–5 times longer: While cocaine leaves your system quickly, cocaethylene sticks around longer
Affects the brain more powerfully: It blocks dopamine more effectively than cocaine alone, creating a more intense high
Builds up over time: Because it breaks down slowly, it accumulates if you keep using both substances
Key takeaway: While people might find the cocaine-alcohol combination more appealing because of these enhanced effects, the longer duration and increased potency make it a very different experience than cocaine alone.
How toxic is cocaethylene compared to cocaine?
Cocaethylene is more toxic than cocaine alone and carries a higher risk of overdose. Research studies consistently show that combining cocaine and alcohol increases the risk of fatal complications compared to using cocaine by itself.
What "more toxic" means:
Affects the heart more severely: It causes more dangerous changes to blood pressure and heart rhythm than cocaine alone
Impacts multiple organ systems: It's more damaging to the liver, lungs, and immune system compared to cocaine by itself
Higher overdose risk: The combination creates unpredictable effects that increase the likelihood of medical emergencies
Fatal cardiac events: Heart arrhythmias or cardiac arrest can occur without warning and can be fatal, even on first use
Research findings: Multiple studies have found that people who use cocaine and alcohol together face substantially higher risks of serious medical complications and fatal outcomes compared to those who use cocaine alone, though the exact level of increased risk varies between studies.
How is cocaethylene made in the body?
Cocaethylene forms automatically in your liver when you use cocaine and alcohol together through a chemical process that creates an entirely new drug.
How cocaethylene forms:
Normal cocaine breakdown: When you use cocaine by itself, your liver breaks it down into two inactive waste products: benzoylecgonine and ecgonine methyl ester. These don't produce drug effects and get filtered out by your kidneys and eliminated from your body through urine.
What changes when alcohol is present: When someone drinks alcohol and uses cocaine at the same time, something different happens in the liver. Instead of just breaking down the cocaine normally, some of the cocaine combines with the alcohol inside the liver to create a completely new active drug called cocaethylene. This process happens automatically – you don't control it.
Article Introduction: Street benzos like MSJs and other non-prescribed pills are behind a rise in overdose deaths. This guide shares practical, non-judgemental advice to help people stay safer and understand the risks.
Benzodiazepines: MSJ/Diazepam guide
Street benzos like MSJs and other non-prescribed pills are behind a rise in overdose deaths. This guide shares practical, non-judgemental advice to help people stay safer and understand the risks.
Street benzos—also called MSJs, blues, vallies, scoobies, and street Valium—refer to benzodiazepines bought online or obtained without a prescription. They can be real, fake, or novel drugs that imitate legitimate medicines.
They’re usually cheap, easy to get, and may be sold in blister packs or pill containers designed to look safe and official. Common markings include ‘DAN 5620’, ‘10’, ‘T-20’, ‘TEM 20’, ‘Bensedin’, and ‘MSJ’.
Street benzos are unpredictable in both content and strength. Some contain novel psychoactive substances (NPS) like etizolam, flualprazolam, or phenazepam, which are not licensed in the UK and can be much stronger than diazepam.
In 2024, the UK classified 15 more novel benzodiazepines as Class C drugs. Some of these, like bromazolam, have been found in tablets marked ‘MSJ’ or sold as diazepam. These substances may be stronger than expected and increase the risk of overdose—especially when mixed with alcohol, opioids or GHB. Read more on GOV.UK.
What are MSJs?
MSJs are blue diazepam tablets stamped with 'MSJ' on one side and a break line on the other. They're produced by MSJ Industries, a subsidiary of Sri Lankan manufacturer J.L. Morison Son & Jones (Ceylon) PLC. Though legitimate, they're being diverted into the illicit market.
Small, blue, professionally pressed pills (approx. 6mm x 1.5mm)
Often referred to as MSJs, vallies, blues
Available online through unauthorised sources
Illicitly sourced from manufacturers in Sri Lanka, India, China, Thailand, and elsewhere
Due to illicit production and lack of quality control, MSJ tablets sold on the street can contain anywhere from 8mg to 30mg of diazepam despite being marketed as 10mg, making dosing unpredictable and dangerous.
Types of benzodiazepines
Different benzodiazepines vary in strength, duration and effect. Common types include:
Diazepam (Valium)
Temazepam (Restoril)
Alprazolam (Xanax)
Lorazepam (Ativan)
Chlordiazepoxide (Librium)
Flubromazolam
Flurazepam (Dalmane)
Phenazepam
Not all benzos are equal—10mg of one type may not be equivalent to 10mg of another.
Effects of diazepam
Diazepam is a long-acting benzodiazepine used for anxiety, muscle spasms, and insomnia. Its effects can include:
Drowsiness and sedation
Muscle relaxation
Confusion and memory loss
Dizziness and impaired coordination
Effects may last into the next day, especially when combined with alcohol. Long-term use increases the risk of dependence and withdrawal.
Side effects
Common side effects:
Drowsiness, confusion, dizziness
Light-headedness, blurred vision
Muscle weakness, slurred speech
Less common side effects:
Skin rashes, tremors, headaches
Sexual dysfunction
Low blood pressure, digestive problems
Difficulty urinating or incontinence
Rarely, paradoxical effects like aggression or disinhibition may occur—especially when mixed with alcohol or other drugs.
Mixing benzodiazepines with other drugs
Combining benzos with other depressant drugs increases overdose risk:
Alcohol: Increases sedation and impairs judgement. Risk of blackout and poor decision-making.
Opioids (heroin, methadone): Strongly suppresses breathing—leading cause of overdose deaths.
GHB/GBL: Even hours apart, the combined sedative effects can be fatal.
⚠️ Warning: Some fake benzos contain fentanyl or nitazenes
There have been reports of fake benzodiazepines contaminated with strong synthetic opioids like fentanyl or nitazenes. These can cause sudden overdose, even in small amounts. There's no way to see or taste these substances, so the risk of taking them unknowingly is real.
If you’re using benzos—especially street pills—go slow, don't use alone, and carry naloxone if you can. It won't reverse a benzo-only overdose, but it can save a life if someone's taken drugs containing fentanyl or nitazenes.
Overdose and withdrawal
Overdose signs
Unconsciousness
Slow or irregular breathing
Pale lips or skin, vomiting
Cold, clammy skin
If someone has also taken opioids, use naloxone if available—but call 999 in all cases.
Withdrawal symptoms
Stopping suddenly can cause:
Severe anxiety and panic
Shaking, sweating, confusion
Seizures and hallucinations
Withdrawal should be medically supervised. Symptoms can start within hours and last several days.
How are illicit benzodiazepines supplied?
Most legal benzos are prescribed and dispensed by pharmacists. Street benzos may be:
Diverted from legal prescriptions
Bought online, including the dark web
Distributed via social media apps (Snapchat, WhatsApp, Telegram, etc.)
Some are made to look legitimate, but contain unknown or highly potent substances. Public Health England has warned about pills with markings like ‘DAN 5620’, ‘10’, ‘T-20’, ‘MSJ’, and ‘TEM 20’ due to hospitalisations and deaths.
Reducing risk: harm reduction advice
Start low, go slow – dosage varies.
Don’t mix with alcohol or other sedatives.
Don’t use alone – have someone nearby.
Avoid daily use to reduce dependence.
Don’t inject. If you do, don’t share or reuse.
Never stop abruptly—seek medical advice to taper safely.
Don’t drive or operate machinery while affected.
The law (UK)
In the UK, benzodiazepines without a prescription are Class C drugs.
Possession: Up to 2 years in prison, a fine, or both
Supply: Up to 14 years in prison, a fine, or both
If prescribed, you can legally possess and use them—but selling or sharing your supply is still illegal.
Share this information
Raising awareness and sharing accurate information is one of the best ways to reduce harm. Services can order our benzodiazepine information and awareness booklet here, or use this guide to support people who use benzos—or anyone who needs to understand the risks and effects more clearly.
Help and support
For more information, advice, or support with benzodiazepine use, visit:
