Sexual Effects of Drugs

Alcohol
Shakespeare once said of alcohol that “lechery…it provokes and unprovokes; it provokes the desire but it takes away the performance (Shakespeare).” The Bard’s immortal words still ring true today. Alcohol generally makes people more willing to have sex but less capable of the act.

In small amounts, alcohol can reduce inhibitions and increase sexual desire in both sexes. One man describes the increase in desire like this: “With alcohol there comes a rush, especially in the early stages. With that rush I want more rush to come. I’m looking for excitement.”

Although small amounts of alcohol may increase sexual excitement, it does not necessarily increase sexual arousal. Even in small doses alcohol causes men’s erections to be less firm.

In larger doses alcohol reduces sexual arousal in both sexes. In men, alcohol causes impotence through several means. Long-term use of alcohol reduces testosterone levels and increases estrogen levels, which can result in impotence. Short-term use can cause transient (temporary) impotence through alcohol’s sedative effect. Additionally, alcohol can affect the nerves of the penis, causing neurogenic impotence.

Alcohol reduces sexual arousal in women as well as men. Alcohol can reduce vaginal lubrication by causing the body to send less blood to the genital region. In moderate or large quantities, alcohol can make orgasm difficult to achieve for women, just as it can for men.

Hormonal changes caused by long-term alcohol use can cause a reduction in libido, in addition to causing impotence. Using alcohol in combination with other depressants can amplify this effect.

Alcohol can interfere with the production of sperm in men. Alcohol use by men can cause abnormalities in sperm, making them less motile. When alcohol-effected sperm causes a pregnancy, there is a greater likelihood of miscarriage or birth defects.

And men agree that sex is less enjoyable when under the influence of alcohol, because alcohol makes the penis less sensitive and because it makes men take longer to orgasm. Men are also often less interested in pleasing their partner when drunk.

Amyl Nitrate and Butyl Nitrate (Poppers)
Poppers are often used as sexual enhancers, because they cause a feeling of heat and excitement which some feel makes sex more enjoyable. Although they can be legally purchased, poppers can increase the risk of heart failure.

Amphetamines
Like alcohol, amphetamines, including methamphetamine and MDMA (ecstasy), “provoke the desire but take away the performance.” Amphetamines can increase one’s desire for sex. A male amphetamine user reports that, while amphetamines do not make him physically aroused, if he starts to think about sex while under the influence of amphetamines, he begins obsessing on sex and can’t sleep until he has had an orgasm.

In men, amphetamines often make achieving and maintaining an erection difficult. Conversely, in moderate doses, amphetamines occasionally cause priapism, a painful erection that will not go away on its own.

Male amphetamine users report that amphetamines cause shrinkage. Because of the erection difficulties and shrinkage amphetamines cause, men on amphetamines often find masturbation easier than sex.

In spite of the erection difficulties amphetamines cause, male amphetamine users find it possible, although difficult, to achieve orgasm while flaccid when they are on amphetamines. Some men report that they have never been able to do this, except when on amphetamines.

Men generally find it very difficult to ejaculate while on high doses of amphetamines. Some people see this as an advantage, because it allows men to last longer during sex. However, this side effect can also be very frustrating. Some men say that while masturbating on amphetamines it “feels like you’re gonna cum at any second, but you don’t.” They feel that the physical sensation of sexual stimulation is better while on amphetamines, but the overall experience is less enjoyable. “After a while, it’s like you just want it to be over with.”

Ejaculation can cause mild discomfort to men on amphetamines. Male amphetamine users report that ejaculation feels equally good and satisfying whether on or off amphetamines, but the testicles feel uncomfortable after ejaculating while on amphetamines.

In very high doses, amphetamines can cause spontaneous orgasm. However, doses this high are extremely dangerous, as they can cause convulsions, heart failure, stroke and death.

Cocaine
Both amphetamines and cocaine are stimulants, so the effects of cocaine are similar to the affects of amphetamines. Like amphetamines, cocaine can cause erectile dysfunction and, in moderate doses, priapism. As with amphetamines, men generally find it very difficult to ejaculate while on high doses of cocaine, which some see as an advantage, and some find frustrating. Finally, in very high doses, cocaine can cause spontaneous orgasm, but doses this high can be fatal.

In small doses, cocaine causes excitement and euphoria, which the user may interpret as sexual excitement. However, chronic heavy use of cocaine can lower the libido . Because cocaine is addictive, the desire for cocaine may eventually overpower any desire for sex.

Cocaine is a local anesthetic. When applied to the skin, it reduces sensitivity. Some men take advantage of this effect by rubbing the drug on their penises so as to last longer during sex. This reduces the pleasure that the man receives, causing him to take longer to reach orgasm. The same effect can be achieved legally and relatively inexpensively through anesthetizing creams available in many sex toy stores.

Heroin
Heroin can reduce sexual responses in both sexes. Men on heroin have difficulty achieving erections and ejaculating, while women on heroin produce less vaginal lubrication and have more difficulty reaching orgasm. Heavy use of heroin can lower the libido.

GHB
In small doses, the effects of GHB are similar to those of alcohol. At these doses, GHB lowers inhibitions and increases sexual desire. However, the potency of this drug is often unpredictable, and in doses only slightly larger than are taken recreationally, it can cause the user to vomit or pass out and can even result in death. GHB is particularly dangerous in combination with alcohol and other depressants.

GHB is clear, odorless, and almost tasteless. Because the drug is not easily detected, and because of its sedative affect, it is sometimes used as a tool for date rape. The assaulter can secretly put the drug into the victim’s drink, and rape the victim when s/he is unconscious. Victims of this sort of date rape often do not later remember that they have been assaulted.

Nicotine
Nicotine can affect erectile tissue and the muscles involved in producing an erection, thus causing impotence. Men who smoke tobacco are twice as likely to be impotent as non-smoking men of the same age. Using nicotine in combination with cardiac drugs, antihypertensive medications or vasodilators drastically increases a man’s probability of complete impotence.

Tobacco can cause men to produce fewer sperm, and can cause deformities in the remaining sperm. These deformities reduce the motility of the sperm, and in pregnancies caused by these deformed sperm there is a greater chance of miscarriage or health problems for the fetus. Children whose fathers have smoked tobacco at some point have a greater risk of cancer, even if the father stopped smoking before the child was conceived.

Marijuana
For the first half hour after consuming marijuana, the drug causes excitement and euphoria and increases the user’s heart rate. The user may interpret these effects as sexual excitement. However, after half an hour, marijuana has a sedative effect.

Long-term use of marijuana generally has a negative effect on sexuality. Chronic heavy use of marijuana can lower the libido. There is some evidence that it can cause erectile dysfunction as well. In women, marijuana can disrupt the menstrual cycle.

Long-term use of marijuana can lower sperm production or cause sperm to develop abnormally. Long-term use can also lower testosterone levels. Both of these effects go away after marijuana use ceases.

Many people find sex under the influence of marijuana to be especially enjoyable. According to Adverse Drug Effects by Jennifer Kelly, marijuana “enhances sensory experiences, and so is described by some as an aphrodisiac.” One marijuana user claims, “Marijuana makes everything feel more sensual. That includes touch, music and definitely taste; and definitely for not just the orgasm, but the entire sexual experience. When both partners are under the influence of marijuana and naked and horny and rubbing their bodies together, it feels like it’s the first time they’ve ever been naked and horny and rubbing their bodies together.”

Some feel that marijuana makes orgasms longer and more intense. This may be a result of the distorted sense of time that marijuana use causes. Studies have found no measurable differences in the length or intensity of the orgasms of people on marijuana, even when the subjects felt that their orgasms had been longer and more intense.

Marijuana does not always make sex more enjoyable. Marijuana sometimes causes nervousness and self-consciousness, especially in people who are unfamiliar with the drug or are in unfamiliar situations. These emotions can interfere with sexual desire. Marijuana also impairs one’s motor skills, making the user clumsy, which can damage one’s performance during sex.

Viagra
Viagra is intended to treat erectile dysfunction and other erection problems in men. It does so by increasing blood flow to the penis. Viagra will not have this effect unless the man is sexually excited. Therefore, it is only helpful to men with physical reasons for their erection problems, and is not effective in treating erection difficulties that have psychological roots. However, one user of Viagra reports that the drug can indirectly alleviate some such problems. When not on Viagra, if he noticed that his erection was starting to get a little less firm, he would become anxious, and the anxiety would cause him to lose his erection all together. When on Viagra, he would never even start to lose his erection, so the anxiety would never occur in the first place and could not cause him to lose his erection.

Ecstasy and the Brain: Club Drug Rants and Raves

To see someone over 30 at a rave is unusual. Nicholas Saunders was one of the few who fit in, although he could have been a grandfather to the pierced, candy-sucking kids who flock to the orgiastic besotment of the London rave.

“Before I got into this whole rave thing I would tell [rave kids] to just try taking MDMA [the chemical name for Ecstasy] quietly in the country with friends, or try taking it with a blindfold … and none of them would listen,” Saunders told me in 1996. Saunders -- with mismatched socks, slender fingers, and piercing eyes – exuded a quiet intensity. He was the laymen’s expert of Ecstasy. Before he died in a car accident two years ago at the age of 60, he had published several books that acted as “Let’s Go” guides to the Ecstasy scene.

When we met, he had traveled to Baltimore, MD from his home in London to participate in a Johns Hopkins University study on the effects of Ecstasy. As the research coordinator, I interviewed more than two dozen Ecstasy users, ranging in age from 18 to 65. (Footnote: The conversations with Saunders mentioned here were not part of the study. He consented to be interviewed for an article.)

I liked them all. The study participants were an introspective, intelligent lot, and they asked sophisticated questions about the research we were conducting. I came to think of them as Peter Pan like psychological cosmonauts: they showed a child-like curiosity for understanding the mind and for pharmacologically enhanced insight.

But I noticed a generational divide. The study participants fell into two broad camps: The more prevalent under-30 crowd tended to use Ecstasy much more frequently and in higher doses—as high as 10 tablets a night, once a week for the past ten years. The older generation of Ecstasy users took Ecstasy in more moderate doses in quiet environments that fostered reflection, away from the pulsing techno trance.

There’s more than a cultural divide between the different generations of Ecstasy users. The experiences of these two groups were different, and scientists say there’s a chemical reason. The chemical reactions that go on in your brain on Ecstasy at a rave is different than at the psychiatrist’s office.

Generation X
The older generation first started taking Ecstasy in the late 1970s and early 1980s before it became illegal. Back then, a growing circle of psychiatrists exploited the “empathic” affects of MDMA, using it as a tool to enhance communication in psychoanalysis. Psychiatrists say their patients felt less defensive and were more open to explore their fears.

Now, a small community of psychiatrists from around the world is trying to bring MDMA back to its roots in psychiatric treatment. Many drugs, like opiates and marijuana, have a potential for abuse but can also have legitimate medical purposes, Rick Doblin points out. Doblin, president of the Multidisciplinary Association for Psychedelic Studies, has been lobbying for 15 years to make MDMA legal for medical treatment. Last month, he scored a victory: A research team in Spain received approval to start administering MDMA to 29 rape victims as part of a treatment for trauma. “I should frame this letter,” Doblin says, referring to the approval letter from the government of Spain. Trials begin next month. Other groups may not be far behind. Charles Grob at the Harbor UCLA Medical Center in Los Angeles is looking to use MDMA in treatment for terminally ill cancer patients.

But many scientists think MDMA is just too dangerous a drug to have any legitimate use. “There is no safe way to use any of these drugs,” said National Institutes of Drug Abuse Director Alan Leshner recently, referring to Ecstasy and other club drugs used at raves. Many scientists believe MDMA can cause long-term brain damage. And every year, over 1000 Ecstasy users show up in the emergency room with Ecstasy-related problems, according to statistics from the Department of Human Health Services. A few die, although the death rate is a tiny fraction of the rate associated with other drugs such as methamphetamine, cocaine, or heroin. Most of the complications are related to heat stroke or dehydration after taking Ecstasy at a club, experts say.

Is Ecstasy a dangerous club drug abused by kids or a therapeutic medical aid? Bringing MDMA back into clinical practice is a scientific and political fight that will require its proponents to sell the idea that dangers associated with Ecstasy are specific to raves.

Rave on
Raves have morphed from underground, roaming, often illegal parties that last through dawn to regular held events in huge clubs. No longer just the province of metropolitan centers, raves are cropping up in college town, U.S.A. Customs officials have seized almost 3.5 million pills in January and February of this year alone, more than 10 times the amount sold in all of 1993. In a 1999 survey, 8.0 % of high school seniors reported they had tried Ecstasy, up from 5.8% the previous year. As raves become ubiquitous, so has Ecstasy.

Ecstasy provides “a heady cocktail of hedonism and altruism which deepens one’s sense of self-identity while liberating an extraordinary sense of love, compassion, and empathy..." says an Internet rave fan. On Ecstasy, music can feel like an extension of your self, and aggression melts away.

“After I experienced this dance rave situation – which was really extraordinary the first time – I went around telling my generation, ‘you’ve really got to experience this rave setting,’” Saunders said. “Each experience is so good, it’s hard to believe that it could be even better taken another way.”

But it turns out that a hot, crowded environment is the most dangerous environment to take the drug, says neuropharmacologist Lewis Seiden of the University of Chicago. Whether it's broiling or freezing outside, one's internal temperature usually stay put at around 98.7 degrees Fahrenheit - unless you've popped a tablet of Ecstasy.

Seiden has been conducting studies on Ecstasy's effects on the brain since the mid-1980s. While studying the effects of various doses of Ecstasy on rats, he noticed that on some days, regardless of the amount of MDMA given, all the rats died.

He suspected the cause was related to high room temperatures, and Seiden and his graduate student Jessica Malberg decided to investigate. They carefully regulated the temperature of the lab and measured the core temperature of the rats using implanted thermometers as the rats were given various doses of MDMA. Slight increases in the environmental temperature caused larger changes in the rats’ internal temperature. When the rats' body temperature topped 106 degrees F, the rodents started to die. With Ecstasy surging through our veins, our bodies become more susceptible to small fluctuations in the temperature of the environment, Seiden and Malberg concluded. [J Neurosci, 1998 Jul 1 18:13, 5086-94]

Amphetamines, Ecstasy included, already tend to give our bodies a temperature-boosting buzz. Add a weakened ability to regulate temperature, vigorous dancing, and the synergistic blast of hundreds of other warm bodies, and heat stroke can be the-lack-of-a-glass-of-water away.

Malberg points out that their findings make sense considering the historical patterns of Ecstasy-related deaths. "You only began to see Ecstasy users showing up in emergency rooms after Ecstasy became associated with raves," she says. The advice: Stay cool and drink water (but not too much water. At least one death has been attributed to over-ingestion of water). “We know that at the very least, drinking water or going outside if you feel sick can prevent hyperthermia,” Malberg says.

Serotonin side-effects
But Seiden's rats suffered more than just heat stroke. When the temperature was cranked up, the rats on Ecstasy were also more likely to have damage to the brain cells that release serotonin—a chemical molecule in the brain that sends signals between nerves. Research by neurologist George Ricaurte of Johns Hopkins University in Baltimore (my former boss) backs up this claim. He has concluded in several animal studies and two human studies that MDMA can cause long-term damage to the ends of the long branch-like projections of serotonin-releasing nerve cells.

MDMA causes nerve cells (neurons) to release serotonin while also preventing the serotonin from becoming reabsorbed back into the cell. This means there's more serotonin in the junction between cells activating neighboring cells. This increase in serotonin is probably related to the rush users feel for the 3 to 6 hours after taking the drug.

Individual affects vary, but it tends to start with a prickly, tingly feeling in the scalp. Ecstasy heightens tactile sensation, yet seems to decrease sexual aggression. Saunders suggested that one of the main social features about raves is this lack of aggressive sexuality. “Ecstasy has this open feeling without all the sizing up business,” he said. Saunders added that the rush seemed to come on stronger and faster at a rave, and the amphetamine-like qualities of Ecstasy are enhanced.

If Ecstasy can cause damage to the nerve terminals, how does this happen? "No one knows exactly how the mechanism works," says Seiden. A popular hypothesis going around, Seiden says, has to do with the reaction of MDMA with super oxide radicals and hydroxy radicals that naturally float around our brain. In the presence of MDMA, these molecules could combine with the excess serotonin. When this new molecule is taken back up into the cell, it's in a form that may be neurotoxic to the cell. And in the presence of heat, and chemical reactions tend to speed up, Seiden notes.

Previously, Seiden and Malberg had found that serotonin cells could be protected against neurotoxicity when the researchers kept the rats body temperatures down. [J Pharmacol Exp Ther 1996 Jul; 278(1):258-67]. Can keeping cool protect humans against neurotoxicity as well? "I wouldn't make any claims about humans," Seiden says. "We just don't know." Researchers first have to show that keeping body temperatures down in primates protects against neurotoxicity, he says. But the research has yet to be done. "I would advise anyone not to take the drug until we know more about it, unless they want to take risks. But there are risks," Seiden adds.

Researchers suspect that a low level of serotonin might affect a host of behaviors regulated by serotonin, including mood (Prozac also affects serotonin), sleep, and appetite. Neurotoxicity--damage to brain cells that release neurotransmitters like serotonin -- may not kill but may lead to memory loss, sleeping problems, or depression.

Ricaurte's wife and colleague, psychiatrist Una McCann, has been looking for signs of behavioral changes in Ecstasy users. While she and others have found some evidence of mild memory impairments, what others find so striking is the lack of obvious deficits in people who use Ecstasy regularly over extended periods of time. Last month, Ricaurte told Time magazine that his work has never shown that the damage has any visible effect on “the vast majority of people who have experimented with MDMA.” While we may not see obvious signs of impairment now, McCann worries problems may begin to surface with old age.

Scientists disagree as to whether the amount taken during recreational use is enough to cause problems. The animal evidence clearly suggests MDMA may cause long term damage to neurons, but many researchers question the relevance of the data to regular recreational use in humans. The amount of MDMA given to both Ricaurte's monkeys and Seiden's rats were up to 40 times (as scaled for body weight), the amount of Ecstasy in one pure tablet.

And some call the finding in humans into question because researchers have no way of knowing exactly what the users were taking. What’s sold as Ecstasy in clubs usually isn’t pure. A 1996 study done on Ecstasy tablets sold in various U.S. cities by the Multidisciplinary Association for Psychedelic Studies (www.maps.org) found that only 14% of the samples contained pure MDMA. MDMA powder is often combined into tablets of various colors and sizes with MDA and MDEA (two related substances that are a halfway point in manufacturing MDMA) and / or ephedrine, a stimulant often used in asthma treatments.

Psychiatrist Charles Grob at the Harbor UCLA Medical Center in Los Angeles suspects the media place too much emphasis on the neurotoxicity findings and not enough attention on the increased dangers associated with overheating. Indeed, Seiden and Malberg’s work “is the most important research to come out” in the field. Sighing heavily, he realizes the implications: “It looks as if these [rave] kids have found the most dangerous model” for Ecstasy use.

Will You Or Won't You Take Drugs

You may know exactly how you feel about drugs. You may have seen friends getting high and decided that next time you get the chance you're going to try drugs too. Or you may be someone who hates the idea of losing control, so much so, that you're determined never to take drugs - even if it makes you feel like an outsider at times. Or you may be in two minds: sitting on the fence and weighing up the good and bad points, and wondering which way to jump.


Be well informed

The best way to explore your feelings about drugs is to find out everything you can about them, and arm yourself with the facts. Talk to people you trust: your best friend, your parents or the adult you get on best with. Share your feelings with older brothers and sisters if you have any. Get advice from a teacher whose opinion you respect, or from a social worker attached to your school. Try talking to people who have tried drugs and are willing to give you an honest account of their experiences - that means the lows as well as the highs. Take your time weighing up all the information and remember it's okay to say "No" whatever your friends say or do. Remember you always have a choice.


Don't be misled

The size of a tablet is not an indication of what it contains or how dangerous it may be.


What to think about

There are some important facts to consider when you're thinking about drugs:

• you can go to prison if you're caught with illegal drugs
• drugs are extremely unpredictable - they can kill
• taking drugs is a leap in the dark - you can have as many bad trips as good ones
• drugs mess with your mind and body - one bad trip can leave permanent damage
• you always have to come down, and the higher you go, the harder you fall
• you can never be sure what's in a dose
• you can become dependent and/or addicted to many drugs
• if you're mentally unstable, drugs will make your condition worse; they can trigger mental illness.

Standing your ground

If you really don't want to do drugs:

• make some new friends who don't take drugs. If your drug-taking friends try to make you feel like a freak because you won't join in, remember that there are plenty of other people who feel like you do
• avoid places where drugs are available
• focus on something positive that makes you feel really good about yourself, such as your studies or your favourite sport
• look after your body - exercise boosts self-esteem and gives you a natural high.

Remember you always have a choice.

The higher you go, the harder you fall.


DON'T RUSH INTO ANY DECISIONS ABOUT DRUGS

Handling Drugs With Common Sense

You may have friends who have experimented with illegal drugs like cannabis or ecstasy, and you may be interested in trying them yourself. But there are serious dangers associated with taking any drug. If you're determined to try a drug, don't do it without knowing what to expect - the downside as well as the upside.

What drugs do:

• Loosely speaking drugs have four different kinds of effect on the body: stimulants (such as amphetamine) quite literally speed up the body
• depressants (such as alcohol) slow the body down
• hallucinogens/psychedelics (such as acid) alter the way people perceive the world around them
• narcotics (such as heroin) induce a feeling of passive drowsiness.

But not every drug fits neatly into one category. There's cannabis, which gives users a bit of everything: it relaxes, mellows and some of the modern blends can also trigger hallucinations. There are drugs such as MDMA (ecstasy) that are halfway between being pure stimulants and pure psychedelic/hallucinogens. In fact all the drugs in the ecstasy family fall somewhere on the psychedelic/stimulant axis; some are more psychedelic than stimulant and some are the other way around.


These drugs share actions on a spectrum from purely psychedelic (acid) to purely stimulant (amphetamine), with ecstasy in the middle having both.


BE INFORMED AND STREETWISE - KNOW THE FACTS ABOUT DRUGS

Know what to expect

• Most drugs with a stimulant effect produce a rush, and this is usually the first feeling. The most commonly experienced rush is from tobacco - that slight feeling of giddiness after the first puff of the first cigarette of the day. Or the "hit" from alcohol - 20 minutes after the first mouthful - the warmth behind the eyes, and in the legs. Not surprisingly, because of its name, a rush feels like a sudden burst of energy when everything inside your body and your head is whizzing, dizzying, fainting and swooning. Involuntarily you may start gasping for breath.
• With ecstasy and amphetamine the rush can make people want to dance and never stop. The rush from MDA (ecstasy's parent drug) can make people want to sit down in a cool place and take deep breaths - and they should do just that.
• Depressant drugs, including alcohol, dull the central nervous system so the heart beats more slowly and this can give people a feeling of well-being, relaxation and loss of inhibitions.
• Drugs with hallucinogenic effects take an hour or so to act and they change the way people see the world. The changes can be pleasant, such as colours seeming more intense; or they can be frightening, such as thinking you're being attacked by strange animals. These drugs can take hours to wear off.
• It's asking for big trouble to take any drug unless you're sure what it is and where it's come from. Drugs are often padded out (cut) or substituted with anything from caffeine, flour or glucose to dog-worming tablets, all of which can be very harmful. Sometimes a drug is cut with another drug; for example, ketamine is often added to ecstasy and has horrible, unexpected effects.

Know the downside

You may know the pleasant and glamorous effects of certain drugs but do you know the negatives? Stimulants can cause overheating and dehydration. A "trip" may not go as you'd hoped - it could be nightmarish. And, remember, every time you go up you have to come down and the comedown can be nasty.


You, your mood and your friends

How you'll react to a drug depends only partly on what's in it. But reactions to the same drug can also vary from time to time and in different situations. The "set", literally your mind-set (your mood) when you take the drug: whether you're happy, sad, up, down, nervous or relaxed may mean a good trip or a bad trip. Where you are and who you're with - the "setting" - can also affect you positively or negatively. If you're somewhere you don't like or with people who make you feel uncomfortable, you're more likely to have a bad experience.

"Coming down"

The feelings of exhaustion, depression and sickness (being wasted) that come on in varying degrees when a drug wears off are described as "coming down". And the higher you go, the harder you fall. With stimulants the high is achieved using up the body's own store of energy - the drug merely acts as the trigger - so a down is inevitable when exhaustion and depression hit and the down can last for several days. Persistent use of stimulants can cause prolonged and "deeper" downs as the body has less time to recover.

• The comedown after the frequent use of any drug can make you feel paranoid, jittery and panicky.
• After cocaine the comedown is a sudden, intense and deep blackness. The more cocaine you take to compensate the deeper you go.
• Ecstasy can leave you feeling low and apathetic for up to a week.
• Crack gives at best a ten-minute high, followed by a low that can last for days and has been described as "rolling down a hill of broken glass".
• Tranquillizers give people a terrible hangover.

What's a bad trip like?
A bad trip from ecstasy, speed, acid or strong cannabis can affect you physically and emotionally. The worst part is that you can get flashbacks for months, even longer, when you'll relive the horrors of the bad trip. Everyone's bad trip is different and hard to put into words but it's possible to build a mental picture afterwards.




IF YOU'RE GOING TO BUY DRUGS, DON'T BUY THEM FROM A COMPLETE STRANGER


Know how to look after yourself

The dance/drug combination can cause real problems. Dance drugs like ecstasy, amphetamine and acid are stimulants that go hand-in-hand with the all-night dance culture of clubs and raves. The greatest dangers of taking them are dehydration, heat exhaustion and heatstroke. Although dance drugs speed up your body, giving you the energy to dance for hours, dancing in a hot club makes you overheat and sweat to excess, depleting your body of water and salts. The problem with dance drugs is that you probably won't feel tired, thirsty or hungry until it's either too late or the drug wears off, even though your body is exhausted and dangerously low on minerals and water.


Know the don'ts

• DON'T take alcohol with drugs.
• DON'T take more drugs after the first dose.
• DON'T mix drugs - they can react with each other producing serious side effects.
• DON'T dance all night without having regular breaks, preferably outside or in the chill-out room.
• DON'T dance all night without drinking liquids.
• DON'T wear a hat.
• DON'T drive a car or use machinery.

Know what to do in an emergency
Read the "If something goes wrong" section for each drug. This tells you what to do if you or a friend suffer adverse side effects. Also read the last chapter "What to do in an emergency" and, if possible, go on a first-aid course. Quick-thinking friends have saved lives.

Warning signs to watch out for:

• disorientation (the person can't say where she is or what day it is)
• drowsiness (the person is unresponsive to commands such as "Open your eyes")
• having fits (convulsions)
• gasping for breath or difficulty breathing
• feeling abnormally hot to the touch, even though the person's been in a cool environment
• fainting or unconsciousness.

If you notice any of the above, get help from a member of the club staff or Call an ambulance. Always say what you think your friend has taken.

Know the club
A good safe club should have:

• free water
• water, high-energy drinks, fruit juice and salty snacks for sale
• chill-out areas
• lots of public telephones, with the local hospital phone number and a taxi number displayed
• a resident paramedic.

Safety

Follow these guidelines and you reduce the chance of meeting problems face to face: Drink half a pint of liquid (NOT alcohol) every half an hour


Stimulants naturally increase your body temperature. Taking them in a hot place, like a club, raises your body temperature even more. If you also dance for hours, your body temperature goes through the roof. You overheat and to try to counter this, your body sweats - buckets. You must replace these lost fluids with high-energy sports drinks, fruit juice or water. They help to restock lost minerals and vitamins as well as the water, so your body has a better chance of recovering from the pounding it takes during a night's clubbing.

• Don't gulp the drink all at once. Drink some about every 15 minutes.
• Never drink alcohol. It makes you even more dehydrated, and is a nasty additive to any other drug. It depends on how much you sweat, but drinking more than three pints of water in an hour is dangerous.
• Eat salted crisps or peanuts This helps your body to replace salt lost through sweating. If it's not replaced, the least you can expect is aching limbs the morning after.
• Spend regular periods in the chill-out room These rooms aren't provided for decoration, they're there to allow your body to recover and cool down.
• Don't wear a hat Hats keep heat in the body. You may think you look good wearing one, but you'll feel terrible as you're more likely to overheat.
• Cool off with water If you're hot, splash water over your face and head.
• Go with friends Your mood ("mind-set") will be better if you're with people you like, and you're more likely to look out for each other.

Methadone: Common Questions

What is Methadone?

Methadone, also known as Dolophine is a oral medication that comes in liquid, pill, and diskett form, and is primarily used to treat narcotic addiction to heroin, Dilaudid, vicoden, and other opiates.

Methadone is currently the most effective treatment for heroin and opiate addiction, but is also used for patients experiencing chronic pain.

How do I know if methadone is right for me?

Do you have an opiate addiction? Have you tried other recovery options? These are just some of the questions you will be asked by the clinic's doctor when you go in for the first time. After you answer all the questions, the doctor will go over everything with you, and it will be at that time you and your doctor together can deciede if methadone is an option for you.

Why would I want methadone, isnt methadone just a drug replacing another drug?

Methadone is a legal MEDICATION used to help eliminate withdrawl and cravings, and enable's the patient to focus on underlying issues they may have, and from there they will be shown how to deal with these problems and build a productive,safe,healthy,drug-free life.

How long will I have to be on methadone?

There is not SET time limit so it depends on the person. Some people take methadone for only a short period of time, while other's stay on the program. Again, how long a person stays on methadone is up to that individual themself.

If I join a methadone program, will I have to the clinic everyday?

Yes,at first. You have to remember, when you first join a methadone program, you need first to get stabilized on a correct dose that is suitable for you, and this sometimes takes awhile, so if you didnt go everyday, it would be hard to get the increases or decreases you may need, but once you are stable, and have had NO dirty urines, and have not missed any appointments, you will be given take-homes. Generally take-homes begin after 60 or 90 days, depending on the clinic itself, and there policy.

How much does it cost for methadone treatment?

This varies from clinic to clinic. Some clinic's accept insurence, and have grants for people that are low income and cant afford the normal rates. Also, there are clinic's that give discount's to there patient's if they've attended there theripy sessions and have given there urine tests. Be sure to ask the clinic your going to what type of insurence plans they accept, if they have grants for low income patient's, and if they offer discount rates.

Methamphetamine

In the U.S., methamphetamine is most commonly referred to as 'crank', 'meth', 'shit' (as in, Do you have any shit ?) or 'crystal'. It is smoked, sniffed ('snorted'), eaten, mixed into a liquid such as coffee and drank, or injected ('banged', 'shot', 'whapped'). The latter method is extremely addictive. Smoking it increases tolerance and addiction quicker, too. This method causes a 'rush' that results in people quickly increasing the amount and frequency needed to obtain the feeling.

The cost and strength varies, being cheapest and purest in California. Although it is manufactured everywhere, California crank is considered to be the best, and is manufactured on a larger scale, producing larger 'batches' from each location. Crank produced elsewhere is produced on a smaller scale, is not as uniform from batch to batch or lab to lab, and is commonly referred to as 'bathtub crank'. It sells for about $100-$120/gram in the mid-west, or $20-$30/ 1/4 gram (referred to as a '1/4 paper' or 'paper') which can actually weigh as little as 1/10 gram and contain very little actual product.

Most of the crank bought on the street is mixed, referred to on the street as 'cut'. The cut is usually something as innocuous as baking soda or 'Fruit Fresh'. Crank obtained in powder form is usually cut before purchase. Cut makes the original product go farther, thus bringing more money per gram. The more hands it passes through before it is used, the more cut there is, as usually each person will cut it before selling it. It is important to be able to tell what crank is cut with and how much it is cut, for several reasons:

People have been known to cut product with poisonous substances, such as boric acid. The consequences of this type of cut should be obvious.

Crank is often cut with cocaine, heroine, or crushed codeine tablets (referred to as 'speed balls'). This is done to increase the rush or 'buzz' of an inferior product, or done by the user himself.

California crank, and sometimes other crank, directly from the manufacturer should be cut with some innocuous material, since it is concentrated enough to kill with as little as 1/4 gram or less, depending of course on the batch and individual user tolerance.

Crank in rock form usually should be creamy yellow to a lemon-drop color and uniform throughout the rock. A marbled or layered rock is usually cut and 're-rocked' crank or not cooked or finished right. Crank that is not made right will be tarry/dark(over cooked); green ,burning (too much muriatic acid), sticky, melting (not finished off right), pink (slightly over cooked), layered,etc.

Dexedrine is a prescription dextroamphetamine that is gaining popularity here in the states. It can't be cut, doesn't require a lab, and usually comes with more lenient punishment from the law when caught.

Tranquillizers (Nitrazepam, Temazepam, Diazepam, Lorazepam): Brief History, Law

There are more bad points about tranquillizers than good ones in this profile. This isn't hiding the real facts from you - it's simply the truth. Benzodiazepine tranquillizers decrease your heart rate, lower your blood pressure and cause slow and shallow breathing. One tranquillizer per session or day relieves stress and anxiety, but can make the user feel drowsy. More than this may make the user feel:

• very dopey
• completely detached from any anxiety and stress
• drunk, uninhibited and sociable.

Going off the tracks with tranx

If you misuse tranquillizers by taking a high quantity, you'll encounter problems.

Extreme mood swings You may feel euphoric one minute, irritable and AGGRESSIVE the next.

Paranoia You'll think that everyone is against you, that they're laughing at you, excluding you or ganging up on you. Paranoia combined with a lack of inhibition can make you become aggressive towards people you wouldn't normally dream of hurting.

Hangover A night on tranquillizers will leave you with the hangover to end all hangovers. If you've been drinking or taking other drugs as well, it'll be even worse.

Depression Tranquillizers aren't called "depressants" for nothing. Long-term use can make you so depressed that you'll just want to hide away from the world. In this desperate state you're likely to become even more dependent on tranquillizers or other drugs.

Chronic fatigue You'll become so drained of energy that you can't even eat or wash properly. You'll lose weight and look terrible.

What are tranquillizers?

Tranquillizers are depressants, which means they dull and slow down the central nervous system - the opposite of stimulants such as amphetamine and cocaine. Tranquillizers are prescribed for people who suffer from anxiety or those who have difficulty sleeping. Modern tranquillizers are based on the benzodiazepine group of drugs that largely replaced barbiturates in the 1950s.

Form

There are many different brands of tranquillizer available on prescription. The following are just a few of the varieties favoured by illegal street-users:

Nitrazepam - "Mogadon" A long-acting (up to 12 hours) benzodiazepine hypnotic. It's an oval white tablet and was used as a sleeping pill in the 1970s and 1980s, but it's no longer prescribed in the UK.

Temazepam - "Normison" Another benzodiazepine hypnotic, but it only lasts 6-8 hours. It's legally prescribed in pill form, but gel capsules do turn up on the streets from abroad. Temazepam is one of the most commonly abused tranquillizers; it's sometimes used as a cheap alternative to heroin.

Diazepam - "Valium" A benzodiazepine anxiolytic, which means it reduces anxiety. It's a small white, yellow or blue tablet, of which white is the weakest and blue the strongest. It can last up to 24 hours.

Lorazepam - "Ativan" An anxiolytic like diazepam, but it only lasts 4-6 hours.

Strange behaviour

A high quantity of tranquillizers can affect your judgement and make you act out of character. You're likely to take risks and do something stupid, such as shoplift or break into a car, because you'll believe you're invincible or even "invisible". The problem is that tranquillizers affect your judgement to such an extent that you're likely to be completely blatant about your behaviour and get caught.


DEPENDENCE ON TRANQUILLIZERS CAN HAPPEN VERY QUICKLY


Some users take tranquillizers by grinding up the pills into a powder, dissolving it in water and injecting the liquid. Heavy tranquillizer users, and heroin users who can't get their habitual drug are more likely to inject the jelly-filled temazepam capsules.

Infection
Tranquillizers reduce your control and judgement, so you're more likely to be careless when injecting. You won't know whose works are whose, and you won't care anyway. All this makes the risk of being infected with HIV/AIDS and hepatitis B or C from shared needles and works even greater.

Vein blockages
Temazepam may give a faster hit when injected, but there's a price to pay. The liquified gel from the capsule can re-form once it's inside the veins so it's like injecting wine gums - vein blockage can easily occur, leading to abscesses, ulcers, blocked blood vessels and gangrene.

Overdose
There's always a greater risk of overdosing on a drug when you inject. Once the drug is in your system it's too late to change your mind. If you overdose on tranquillizers, your system slows down and eventually you could stop breathing, go into a coma and die.

Tranx and alcohol

Tranquillizers minimize the control you have over your actions. Alcohol does the same. If you take them together, the combination can be lethal. Alcohol exaggerates the hypnotic effects of tranquillizers and can make you feel incredibly drowsy. This can then lead to all sorts of unpleasant and unpredictable problems:

• you could fall asleep, vomit, choke and die
• you could feel so spaced out that you accidentally overdose. You may just take a few more tablets and have another drink without thinking about the consequences. Eventually you'll slip into unconsciousness and could die
• alcohol also intensifies the anxiolytic effects of tranquillizers: anxiety and tension are greatly reduced so you'll think you're indestructible, and will end up getting into a fight. If you do, you'll be so unco-ordinated that you'll come off worse.

A risky way to come down
More and more people are taking tranquillizers to "chill out" after clubbing. This is a distinctly bad idea as tranx and other drugs do not mix well at all.

Staying out of trouble
DON'T take a stimulant, such as speed, to combat the chronic fatigue. The combination of a tranquillizer comedown and a speed comedown will leave you feeling even worse.
DON'T cross the danger line. The difficulty is knowing what a safe amount is, since the "safe amount" can still be very close to the danger line and, because of the nature of the drug, you can easily overdose without even knowing it.
DON'T drive, ride a bike or operate machinery. When you're on tranquillizers, you'll be in no state to do any of these things, even if you think you are. The same applies for the day after when you're struggling with a debilitating hangover.
DON'T be careless if you're having sex. Despite what people say, tranquillizers are not aphrodisiacs, but they do lower your self-control, so you're more likely to have casual and unprotected sex.
DON'T take tranquillizers if you're pregnant. If you do, your baby may be born with a tranquillizer dependency and will have to go through withdrawal after birth.


INJECTING TRANQUILLIZERS IS EVEN MORE DANGEROUS THAN INJECTING HEROIN

Tranquillizer addiction

Physical and psychological dependence on tranquillizers can happen in an alarmingly short space of time. The higher the quantity and the more often you take them, the greater the chance of dependency. You reach a stage where you can't cope without tranquillizers and are terrified of trying to stop taking them.

Withdrawal

Suffering withdrawal from tranquillizers is no joke, but it can be done.

• Those who have gone through it say that it must be harder than coming off heroin.
• Sudden withdrawal is very dangerous and potentially fatal. It can lead to paranoia, depression, panic attacks, shakes, waves of psychosis, hallucinations, nausea, insomnia and nightmares.

These symptoms are particularly bad when coming off short-acting benzodiazepines, such as lorazepam.

Tolerance
The body quickly develops a tolerance to tranquillizers. It learns to cope with the effects so you have to take a stronger dose more often to achieve the same effect. But, equally, if you stop taking tranquillizers for as little as a few weeks, your tolerance will reduce. If you then take what was your normal dose you're more likely to overdose because of the shock to your system.
If you're trying to come off tranquillizers you have to be weaned - so GET PROFESSIONAL HELP. Don't try to go it alone.

If something goes wrong

unconsciousness

• If your friend is breathing, place her in the recovery position. Call an ambulance. Tell the medical staff what your friend has taken - it could save her life. Be prepared to resuscitate your friend if she stops breathing.
• If your friend vomits while unconscious, check that she's still breathing.