Harm reduction information

Skunk Free

HARM REDUCTION INFORMATION

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

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SKUNK


What is Skunk?

Skunk is a type of female, seedless cannabis plant, which is the result of cross-breeding two varieties of cannabis called Cannabis Sativa and Cannabis Indica, although there are also other combinations of plant which are referred to as Skunk. 

When combined these two plants provide the best characteristics for artificial growing and THC content, which can range from 6% to 20%. 

The term ‘Skunk’ is often used to describe any
leaf-based, strong smelling herbal cannabis. For the purposes of this booklet we have used the term to refer to indoor farmed herbal cannabis, grown in the UK.

How common is Skunk?

Over the last decade skunk has become the most common type of cannabis in the UK and accounts for nearly 70% of all cannabis smoked.

Most of the Skunk used in this country has been grown on indoor farms, producing commercial quantities of plants, under artificial lights and soil based pots. Less than 10% of Skunk is grown using the more advanced hydroponic growing systems, which grow plants in nutrient rich water systems.

The bits that get you stoned

The cannabis plant contains over 480 natural elements. 60 of these have been classed as elements which occur only in the cannabis plant and are called cannabanoids.

Of these, two elements, THC (tetrahydrocannabinol) and CBD (cannabidiol) are the main players.

THC gives you a feeling of euphoria and being high, while CBD causes drowsiness, and the ‘can’t be bothered moving’ stoned feeling. THC also contributes to the feelings of paranoia and anxiety you can sometimes feel when smoking skunk. It is believed that CBD can act as a brake for the THC and takes some of  the edge of its effects. Skunk contains very low levels of CBD.

Although the evidence is unproven on CBD, if you are having panic attacks or feeling edgy or anxious and are going to continue smoking cannabis try switching to resin (Hash) which has much higher levels of CBD. See if it works for you. 

How strong is Skunk

‘30 times stronger’ and ‘Mad Skunk’ are some of the lurid headlines in the media concerning the potency of herbal cannabis and how much stronger it is today than in the past. 

According to a recent government report, the average potency for factory-farmed herbal cannabis in the UK was 15% an increase from 13.98% reported in 2004. Although there have been some samples reported which have been higher than this average, the thirty times stronger claim seems somewhat exaggerated.

Strength and potency are two different things. The term potency is normally used to describe the amount of THC, usually expressed as a percentage (by weight), within the resin which covers the cannabis plant (see the image on the next page). 

You could have high potency but very a small amount of resin on the plant which wouldn’t give you a very strong high, but a concentrated amount of resin with a low potency could actually be quite strong. So potency and strength, when used in relation to cannabis can be misleading.

The strength of Cannabis also varies depending on the strain or variety of the plant, the way in which the plant is grown, the part of the plant that is used, and the way the plant is prepared for use and stored.

HEALTH

Mental Health

Current evidence around cannabis and mental health suggests that it may make existing mental health issues worse in some people, particularly if you are smoking
high THC Skunk. It may also bring on mental health
issues in people who have an underlying condition they
may not yet be aware of.

Young People and Mental Health

Teenagers and young adults whose brains are not yet fully grown are particularly at risk. It is thought that cannabis may cause physical changes within the brain which can lead to schizophrenia and psychosis. Higher THC cannabis has been linked to an increased chance of developing these conditions.

Physical Health

Smoking is harmful to the lungs, throat and heart, so mixing it with tobacco, or not, isn’t really the issue. Inhaling any burning organic matter releases harmful toxins into your body. Skunk can also contain pesticides and fertilisers which have been used during its production as well as bacteria which can grow on the buds and can compromise the immune system. This can be a problem for those living with HIV/AIDS or cancer. You can get rid of the bacteria  by heating your cannabis in an oven at about 66-93 degrees Celcius.

The flowering bud of the cannabis plant. you can see the crystal like resin drops which contain the THC

REDUCING THE RISKS 

AVOID TOBACCO

Although cannabis has its own share of tar and toxins there is no point in adding to the negatives by combining it with a damaging and addictive substance like tobacco.

SMOKE UNFILTERED JOINTS

Using a normal cigarette filter will cut out some of the THC, leading you to inhale harder and longer on the joint to get the effect you want. This is going to increase the levels of tar and toxins you inhale. Just use a plain rolled up piece of card with no print on (roach).

ONLY USE GLASS, STAINLES STEEEL, OR BRASS BONGS OR PIPES

Bongs made from plastic, wood, rubber or aluminium cans give off toxic fumes when they get hot. Remember, when passing the bong or pipe around that it could contain bacteria or viruses from everybody else that has used it. Probably best to stick to using your own.

TAKE SMALLER PULLS FROM YOUR JOINT

Most of the THC in the joint is absorbed quite easily by your lungs in the first few seconds, so no need to show off by holding the smoke for longer or deeper. This just increases the damage to your lungs.

VAPORISERS

One of the least harmful ways of using cannabis is to use a vaporiser. This is a device which heats up the cannabis enough to release the THC but not enough to produce damaging smoke.

EAT IT

You can add cannabis to food when you are cooking But remember, the effects of cannabis when eaten take a lot longer to hit you than when you smoke. 

The effects can take an hour or two to start and a few hours to reach their peak and may last for up to 12 hours or more. So don’t eat a piece of hash cake and then, a few minutes later, eat some more because it hasn’t ‘started working’. Give it  a chance to get going before you neck some more.

Are you happy with your cannabis use?

Most people will have a positive experience when using cannabis, But for some of you, cannabis will become an issue. The list below will help you identify some of the warning signs.

Are you using more cannabis than you used to? 

Are you developing a tolerance and need more to achieve the same effect?

Getting Moody?

If you don’t smoke your normal amount of cannabis are you irritable, feel a bit moody and have trouble sleeping?

Time and Stress?

Do you spend a lot  of  time getting hold of cannabis and recovering from its effects? Stressing out when your dealer doesn’t answer their phone straight away or doesn’t answer their door after the first knock?

Has your Life Changed?

Think about what you used to get up to before you started using cannabis. Do you still do them? If not, then maybe cannabis is taking their place.

Do you want to give up or cut down but can’t seem to get your head around it?

If two or three of these apply to you then maybe you should think about cutting down or stopping altogether.

Fed up with being stoned?

You may be getting bored with being stoned, it may be affecting your health, using all your money, getting in the way of relationships. These are all good reasons for wanting to make changes.

There are a number of steps you can take which may help.

1. Think about why you want to change.

  • Put together a list of good and bad things about your cannabis use.  You can refer to this during your moments of weakness to remind yourself why you decided to make changes in the first place.
  • Create a cannabis diary.

    Create a diary of how much you smoked in the last week or two, how much you spent, where you smoked and who with. It will help motivate you and identify high risk situations.

2. Plan ahead

  • Tell your friends or family about what you are about to do.

    It will make it easier to refuse a; joint when offered, and your friends and family may be more understanding when you are feeling a bit on edge and being a pain.

  • Think about high-risk situations

    These are times when you may be tempted to go back to your old ways, this could be meeting your mates somewhere where you would all spark up, a programme you watch or even a piece of music you would normally listen to while you are stoned. During the first few days it is probably best to avoid these situations.

  • Avoid the friends you normally smoke with for a while. It will make it easier if you don’t place temptation in your way.
  • Cravings and withdrawal symptoms How withdrawal symptoms affect you depend on how much you used to smoke and how long you have been smoking for, but these can include:
  • irritability
  • urges to smoke (cravings)anxiety
  • feeling depressed
  • feeling angry
  • confusion

these symptoms appear in the form of:

  • sleep problems
  • restlessness
  • loss of appetite
  • tremors
  • sweating (mainly at night)

Symptoms start between one and three days after stopping cannabis and last for around two weeks. They are not going to harm you and are a positive sign that the body is adapting to being cannabis free.

Individual cravings will only last for a few minutes so put off the decision to smoke for say 10 minutes and go and do something else, maybe go for a walk or read a book or magazine. The urge will pass. Every time you get through a craving without giving in it will get easier.

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Drugs Staying Safe Free

HARM REDUCTION INFORMATION

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

Free to use

Just a few things to remember:
  • Only use for non-commercial purposes
  • Link to, or credit the Substance website
  • This email address is being protected from spambots. You need JavaScript enabled to view it. where you used the information

DRUGS

STAYING SAFE - ADVICE&INFORMATION FOR YOUNG PEOPLE


Growing up can be tough - always under pressure from you friends and family to do the right thing - look right, sound right and behave right.

But, as a young person, what is the ‘right’ when it comes to drugs and alcohol - should you take that white powder, or neck that pill. What’s in it, how will it make you feel, what are the risks?

The only way to avoid the risks of using drugs and alcohol is to not use them at all. But if you are thinking about, or are already using drugs and alcohol, it is important to learn as much as you can about the substances you are using.

This booklet provides you with clear, non-judgemental information about some of the most commonly used legal and illegal substances, including:

  • Alcohol
  • Amphetamine
  • Cannabis
  • Cocaine
  • Ecstasy
  • Ketamine
  • Legal Highs
  • Solvents
  • Mephedrone

The final section is called ‘staying safe.’ It includes information about mixing drugs and alcohol, feeling unwell,  and looking after yourselves and your mates.

Remember, there are new substances coming out all the time, make sure you do your own research before you make a decision. There are numerous websites and forums out there - some bad, some good. So keep up-to-date, stay informed and stay safe.

ALCOHOL

Alcohol is a chemical called Ethanol. It is produced by brewing grains or fruits containing sugar, with water 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. Different drinks have a different number of units. 

The number of units in a bottle or can of alcohol is printed on the label or packaging.

>The effects of alcohol

Can slow down your brain which, in small amounts, can make you feel relaxed and sociable.

Can cause slurred speech, blurred vision, confusion, loss of co-ordination, and heightened emotions, the more you drink.

> The problems with alcohol

Can damage your liver, stomach, kidneys, brain, muscles, skin and bones and causes cancer.

Can cause impotence (brewer’s droop), infertility (shooting blanks), shrink the testicles, and grow breasts, in men.

May cause loss of periods, infertility (can’t have a baby), and fat redistribution, in women.

Can cause addiction.

Can result in unconsciousness and sometimes death, if you drink a lot very quickly.

Young people, under 16, should not drink alcohol at all as this can damage developing organs. The best advice is not to drink alcohol until you’re 18.

When over 18, men & women should drink no more than 14 units a week, spread evenly across a few days with a couple of alcohol free days.

> Alcohol and the law

If you are under 18 it is aginst the law:

For anyone to sell you alcohol or for an adult to try and buy it on your behalf.

For you to buy alcohol, attempt to buy alcohol, or to be sold alcohol.

For you to drink alcohol in licensed premises, with one exception - 16 and 17 year-olds accompanied by an adult can drink (but not buy) beer, wine, and cider with a table meal in a pub or restaurant.

AMPHETAMINE

> Amphetamine

Amphetamine sulphate is a stimulant, commonly known as ‘speed’, which normally comes as a grey, dirty-white or pinkish powder.

> The effects of amphetamines

Can cause feelings of energy and alertness, suppressing hunger and reducing the need to sleep.

Can speed up your heartbeat and breathing.

Can also cause anxiety, paranoia, irritability, twitchiness and insomnia.

> The problems with amphetamines

Can lead to tolerance, meaning you have to take more to get the same effect.

Excessive use can lead to psychosis (loss of contact with reality), chest pain, heart problems and high blood pressure.

Can cause something called formication, which is the excessive itching and scratching of the skin, leading to skin infections.

The purity of some amphetamines can be as low as 5%.

> Amphetamines and the law

Amphetamines are illegal, Class B drugs. 

Possession of Class B drugs carries a maximum sentence of 5 years’ imprisonment and a fine. 

Supplying (selling or giving away) carries a maximum sentence of 14 years’ imprisonment and a fine.

CANNABIS

Cannabis comes from a plant called Cannabis Sativa.

Normally comes in a solid brown lump called hash (the resin scraped from the plant), or the  dried flowers of the plant, known as grass, weed or Skunk.

The main chemical in cannabis is called THC (Tetra-Hydro-Cannabinol) which is the bit that makes you feel trippy. Different types of cannabis have different levels of THC.

It is normally smoked, rolled with tobacco in cigarette papers, or in a pipe or bong, but it can also be eaten.

> The effects of Cannabis

Can make you feel relaxed, trippy, talkative and giggly.

Can make you feel tired, lazy and sleepy.

Can make colours, music and taste seem more intense.

> Problems with Cannabis

Can cause paranoia, anxiety and panic attacks.

In some young people cannabis can bring on mental health problems. The earlier you start smoking cannabis the more likely you are to have problems with it.

Can cause lung damage if smoked.

Can become a habit and lead to a lack of motivation and problems concentrating at school or work.

> Cannabis and the law

Cannabis is an illegal, Class B drug. It is illegal to have, sell, grow or give away.

If you are under-18 and caught with cannabis your parents or guardian will be contacted, you could get a reprimand and possibly a referral to a Youth Offending Team.

If you are over-18, a first-time offence will usually get you a ‘cannabis warning,’ a second offence will get you an on-the-spot fine, and a third offence will result in prosecution and a criminal record.

There are products that you can buy in some shops which claim to have the same effects as cannabis (Spice, Black Mamba, etc.), but these can also be harmful and may be illegal.

COCAINE

Cocaine is a substance obtained from the leaves of the coca plant. It normally comes in a white powder form

The purity of cocaine can vary greatly throughout the UK, from between 15-55%.

> The effects of cocaine

Can cause an energy rush, and feelings of exhilaration, confidence and wellbeing.

Can also cause effects like edginess, paranoia, anxiety and shaking.

> The problems with cocaine

Cocaine is normally snorted through a rolled up note or straw. The cocaine and the chemicals it is mixed with are acid and can burn or damage your nose.

The note or straw you use may have been up others peoples’ noses and can be covered in snot, viruses and germs.

The initial effects of cocaine only last between 15 and 30 minutes. Using again and again to achieve the same effect can lead to tolerance, where you have to use more and more to get the same buzz and, further down the line, addiction.

Cocaine increase blood pressure, heart rate and body temperature. 

Using cocaine increases the risk of stroke or a heart attack.

> Cocaine and the law

Cocaine is an illegal, Class A drug. 

Possession of Class A drugs carries a maximum sentence of 7 years imprisonment and/a fine. 

Supplying (selling or giving away) carries a maximum sentence of life imprisonment and a fine.

ECSTASY

The active chemical in Ecstasy is MDMA, or to give it its full chemical name, 3,4 methylenedioxymethamphetamine.

MDMA usually comes in tablet form, known as ‘ecstasy’, or powder, known as ‘MDMA powder.’

Tablets come in various shapes and colours. MDMA powder usually comes in white or off-white crystals or powder. But remember, not all tablets claiming to be ecstasy or powder claiming to be MDMA, actually contain any real MDMA.

> The effects of MDMA

Can cause an initial rush, jaw clenching, nausea, and nervousness.

Can increase energy levels and give a warm ‘loved-up’ huggy feeling.

Can cause sounds, colours, and feelings to be more intense.

> The problems with MDMA

MDMA can cause you to overheat, particularly if you are jumping up and down (sometimes called dancing!) in a nightclub and don’t drink enough liquid, take a break, or get some fresh air.

MDMA causes your body to retain water (you can’t pee!) which alters your body’s chemical balance. If you also drink a lot of water, this can cause your brain to swell.

Deaths from ecstasy have often been caused by drinking either not enough or too much water. Your body needs about a pint of fluid - water, isotonic drink or fruit juice - an hour, to function properly in a hot environment.

MDMA normally takes half an hour to an hour to start working, but can take longer. Being impatient and taking more can increase the dangers.

The comedown from MDMA can leave you feeling tired and depressed for a few days afterwards.

> MDMA and the law

MDMA is an illegal, class A drug. 

Possession of Class A drugs carries a maximum sentence of 7 years imprisonment and/or a fine. 

Supplying (selling or giving away) carries a maximum sentence of life imprisonment and a fine.

 

KETAMINE

Ketamine is an anaesthetic that comes in the form of a clear liquid, tablets, or powder ranging in colour from off-white to light brown.

> The effects of Ketamine

The effects of ketamine vary depending on your environment. In small doses it normally acts as a stimulant, boosting your energy levels, and making you feel high and trippy.

Larger doses can cause a strange ‘out-of-body’ effect, with hallucinations, feelings of calm and serenity, distorted reality, panic attacks, unpleasant feelings and fear.

These feelings can last up to 90 minutes.

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

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

> The problems with ketamine

Obviously, if you are having an out-of-body experience and can’t move your arms and legs then you’re particularly at risk, especially in unfamiliar surroundings.

Because ketamine is an anaesthetic and numbs your body you can’t feel pain as much as you would normally, so you can injure yourself without realising.

Regularly using a lot of ketamine can cause serious bladder problems, with severe pain and difficulty peeing.

Too much ketamine can affect your breathing, leading to unconsciousness or heart failure.

Ketamine can be addictive.

> Ketamine and the law

Ketamine is an illegal, Class C drug. 

Possession of Class C drugs carries a maximum sentence of 2 years imprisonment and/or fine. 

Supplying (selling or giving away) carries a maximum sentence of 14 years imprisonment and a fine.

LEGAL HIGHS

Legal highs are substances that have been created to copy the effects of illegal drugs. These normally come in two types - white powders that are supposed to have stimulant effects similar to speed or cocaine, and herbal substances that claim to have cannabis-like effects.

The stimulant-type substances normally come in various shades of white or off white colours, whilst the cannabis type, not surprisingly, look like skunk-type cannabis.

> The effects of Legal Highs

The effects of these substance are similar to the illegal versions. See the pages on cannabis, cocaine and amphetamine.

> The problem with Legal Highs

Just because someone says something is ‘legal’ doesn’t mean it is legal or safe.

It also doesn’t mean that what you bought this week contains the same
substance, or amount, as the one you bought last week.

The substance you buy this week might take longer to work than the one you had last week, and taking more because you think it’s not working can be dangerous.

Mixing legal highs with other drugs, particularly with alcohol, will increase your chance of having a bad time.

Drugs can interact in your body in unpredictable ways, causing you to overheat, become dehydrated or incapable of looking after yourself.

> Legal Highs and the law

The law around legal highs can be confusing. Substances that claim to be legal highs actually may contain an illegal substance, new products are popping up on a regular basis.

Despite you thinking that what you have is legal, if you are stopped by the police and have something that looks like a drug, you will have it taken off you and you could be arrested until the police can confirm what it is.

SOLVENTS

Solvents come in many forms, such as household products like glues, lighter fluid and aerosol sprays, and are normally inhaled.

> The effects of solvents

Can cause intoxication (feeling very drunk), dizziness and drowsiness.

Can cause sickness and vomiting.

Can lead to aggressive and risky behaviour.

> The problems with solvents

Can cause your heart to beat irregularly or stop, even on first-time use. This can happen whether they are sniffed from a bag, an aerosol or sprayed into your mouth.

Can cause loss of consciousness. If used in a dangerous location or your head is placed inside a bag there is the added danger of you having an accident or suffocating.

Can cause burning or a rash around your mouth and nose.

> Solvents and the law

It is illegal to supply solvents to persons under the age of 18 if the supplier knows or suspects the product will be sniffed.

STAYING SAFE

The best way to stay safe and avoid the risks of using drugs and alcohol is not to use them at all, but if you intend to, then the information on the next couple of pages will help you and your friends have as safe a night out as possible. 

PRE-LOADING

A few drinks with your mate to loosen up as you get ready to go out can turn into a session. You are two and a half times more likely to get into a fight or have an accident than people who only start drinking when they go out.

MIXING DRUGS AND ALCOHOL

Using drugs is risky in itself but mixing them with alcohol can make the effects of both very unpredictable and dangerous. Alcohol dehydrates you so mixing it with other drugs that do the same, like cocaine, ecstasy or mephedrone, or some of the legal highs, can be very risky. 

PACE YOURSELF

It can be tempting, on a night out, to get as hammered as possible, as quickly as possible. This is going to ruin your night!  Try to pace yourself. Don’t drink on an empty stomach. Have a soft drink or water. You don’t have to have  an alcoholic drink at every round. Drink lower alcoholic drinks, or drink slower. Sip your drink and then put it down somewhere you can keep an eye on it, holding your drink will mean you drink faster.  

Don’t take more drugs because you think the ones you have taken are not working. The effects of drugs can vary for lots of reasons, such as the way you feel, where you are, how much you have taken. 

Or there may be different amounts of the drug in the substance you have taken. It may even be a completely different substance. Taking more could mean you overdose. Be patient, pace yourself!

VIOLENCE

Alcohol and drugs reduce our ability to think straight. If you are someone who loses their temper easily, alcohol and drugs can make things worse. If you are on the receiving end of someone giving you grief just walk away. It can be hard to lose face in front of other people, but it has got to be better than being the victim of a serious assault or being locked up for giving someone else a hiding.

SEX

Alcohol and drugs increase your self confidence and makes it easier to approach someone you fancy, but if you’ve been using drugs or alcohol you can end up going further than you intended.

If you intend to have sex, use a condom. Having sex without a condom can leave you open to sexually transmitted infections (STI’s) and unplanned pregnancies. If you are worried you might have an STI, visit your GP, walk-in centre or visit the GUM clinic at your local hospital

Women can get oral emergency contraception from their GP, Walk-in-centre and most pharmacies. This can be taken 72 hours after unprotected sex and is available to anyone over 16 years of age.

DON’T FLASH YOUR VALUABLES

Don’t flash your expensive phone around, it could end up being stolen. Buy a cheap phone to use when you are going out. Make sure it has credit and is fully charged.

If you are drawing cash from a machine be aware of who is around and don’t let anyone distract you, shield your pin and put your money away quickly. Use a machine in a well-lit public area.

KEEP AN EYE ON YOUR DRINK

Never accept drinks from a stranger or someone you don’t trust. These could be spiked.

LOOKING AFTER YOURSELF AND YOUR MATES

If you are going to leave the club or pub with someone you have just met, make sure your friends know what you are doing and where you are going, maybe you could take a pic of your new friend and text it to your friends. If a friend is telling you where they are going and who with, listen to what they are saying.

FEELING UNWELL

If someone goes too far and starts to feel unwell, take them somewhere quiet and cool. Keep them sitting up and awake, give them water if they’re able to drink. If you are unable to wake them and their breathing is erratic, lie them on their side in the recovery position and get medical help.

GETTING HOME SAFELY

Have a plan of how you are going to get home after a night out.

Try to pre-book and pay for a taxi to take you home from a pre-arranged location. Use this location as a meeting point if you get split up from your friends.

If you do end up walking home alone, be aware of your surroundings, stay on well-lit public roads, don’t be tempted to take the short-cut across the dark, deserted park because you can’t wait to crash into bed.

USEFUL STUFF

Some useful sources of information about drugs and alcohol

Young Addaction

If you’re a young person and you have questions about drugs and alcohol, you can speak to Addaction in complete confidence.

It won’t cost you anything, either, their support is free of charge.

They will listen to what you have to say, and help you with any problems you may be having.

W: www.addaction.org.uk

TheSite.org

TheSite.org provide factsheets and articles on all the key issues facing young people, including alcohol and drugs.

W: www.thesite.org

Talk to Frank

National drugs awareness site for young people and parents/carers.
24 hrs a day, seven days a week.

W: www.talktofrank.com
T:  0800 77 66 00 (calls are free and confidential)

You can buy printed versions of this information in the Substance shop

Go to shop

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MEPHEDRONE INFORMATION FOR HUMAN CONSUMPTION - free

HARM REDUCTION INFORMATION

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

Free to use

Just a few things to remember:
  • Only use for non-commercial purposes
  • Link to, or credit the Substance website
  • This email address is being protected from spambots. You need JavaScript enabled to view it. where you used the information

MEPHEDRONE

methylmethcathinone - 4-MMC - 4-methylephedrone - Meeow! Meeow!

INFORMATION FOR HUMAN CONSUMPTION


If you are using, or thinking of trying, mephedrone this guide will help you
understand what is known (so far) about it, describe how it is used, the effects and potential risks, and highlight harm reduction advice.

Mephedrone is known by many names. Its chemical names are 4-methylmethcathinone (sometimes shortened to 4-MMC) and 4-methylephedrone, hence the shortened version ‘mephedrone’. Over the past few years it has been sold by the names M-CAT, Bubble, Magic, Plant Food, amongst a long list of product names.

Usually a white powder commonly sold in gram bags, it is a short-acting, stimulant-type drug with effects similar to cocaine and amphetamines, so any problems attached to its use will be similar too.

After “killer drug” style headlines in 2009 it was made illegal in 2010. Despite this, mephedrone is now established as one of the most popular illegal drugs, on a par with ecstasy and cocaine. But mephedrone is only the tip of the iceberg. Underground chemists have hundreds of new compounds lined up for manufacture and new drugs are being identified at the rate of one a week.

WHERE DID IT COME FROM?

Mephedrone is a synthetic (man-made) chemical modelled on the natural stimulant drug cathinone, which is found in the plant ‘Khat’. 

The leaves of the Khat plant have been chewed by people in East Africa (mainly Somalia and Ethiopia) for centuries. Chewing Khat leaves has a similar effect to caffeine (coffee) and is used as mild social stimulant. In the UK, possession of the Khat plant itself or its leaves is not illegal, you can buy it in some African food shops, but the chemical it contains, cathinone, is banned.

The first European synthesis of mephedrone was recorded in 1929, but it remained an obscure chemical compound up until 2003 when it was rediscovered by an underground chemist and publicised on the internet. From these early and enthusiastic postings on discussion forums, interest in mephedrone grew and it eventually became available to buy over the internet in 2007.

At that time the quality of both cocaine and ecstasy was dubious, to say the least: cocaine purity had dropped from 60% in 1999 to 22% in 2009; and almost all the ecstasy pills tested in 2010 contained no active ingredient, MDMA, but were made up of other substances including mephedrone. Consequently, the UK drugs market was primed for a new, cheap and, most importantly, legal alternative.

Mephedrone is one of a family of compounds known as Beta-Ketones that also include Methylone and Methylenedioxypyrovalerone (MDPV). As these are synthetic relatives of cathinone they weren’t covered by existing laws at the time so they were sold as so called ‘legal highs’.

It is thought that much of the mephedrone available in the UK today is manufactured in India or China (although it is now illegal there), bought from internet sites and shipped by post. When it was legal, in January 2010, one kilo of mephedrone from China cost £2,500 which, when sold for £10 a gram, made a profit of £7,500. When it was made illegal in the UK in March 2010 the wholesale price jumped to £4,000 a kilo, retail prices for a gram doubled, and it was more likely to be cut with other powders (caffeine, glucose, monosodium glutamate, etc.) or mixed with other drugs. 

To Avoid The Risks Don’t Take Mephedrone!

However, if you are determined to go ahead with it, limit yourself to small amounts (no more than half a gram per session) and occasional use (no more than once a week). 

The more you take the more likely you are to have problems.

WHAT IT LOOKS LIKE

As mephedrone usually comes in the form of a white powder, it is difficult to tell it apart from other ‘white powders’ sold as legal highs. 

And here’s the problem - there is no way of knowing for sure what is in the white powder bought from online suppliers, street dealers or even friends - you’ve got to believe what they tell you! There is also no way of telling that the ‘mephedrone’ bought from a trusted supplier last week is the same product on offer this week.

In South Wales in 2012 a mixture of mephedrone and ketamine was being sold as a cocktail called ‘kit-kat’, whilst in other areas of the UK it has been reported that crystal methamphetamine is being passed off as mephedrone. it is a case of ‘you pays your money and you takes your chance’ because there really is no way of knowing what it is!

Slow & Low

If your going to use Mephedrone take a small amount and wait. 

Don’t take more because you can’t feel anything happening after half an hour or so. Yes, it could be some blag white powder, or even a completely different substance, but how do

you know? 

Give it time to start. Taking too much too soon could put you on a bad one. 

Learn to recognise, and handle, the effects

HOW IT WORKS

Stimulant-type drugs like mephedrone cause a sudden release of brain chemicals (neurotransmitters). 

These include noradrenaline (which gives you the rush), dopamine (which gives you the euphoria) and serotonin (which gives you the loved-up feelings). However, as mephedrone is a short-acting drug, it also causes a sharp decrease in these chemicals and the effects wear off quickly.

As it comes on fast but wears off quickly this causes the urge to take more, or re-dose, that many users describe. This, in turn, sets up a pattern of compulsive use that may lead you to take more than you originally intended.

EFFECTS

Users report a definite feeling of ‘coming up’ or ‘rushes’, as the drug starts to work. 

The main effects include alert, a sense of calm wellbeing, excitement, energy, elevated mood and feeling sociable and talkative.

Common unpleasant side-effects

Unwanted effects include dry mouth, teeth grinding, reduced appetite, poor concentration and short-term memory, increased heart rate, increased body temperature, palpitations of the heart, anxiety, depression, sweating, and pupil dilation.

REDUCE THE HARM

Cutting down on the amount you take and cutting back on the times you take it will help reduce unpleasant side-effects and other risks.

Mephedrone can seriously dehydrate you. Make sure you keep your fluids topped up - sip water, fruit juice or, better still, isotonic sports drinks as these help replace the vital salts and minerals lost through sweating.

Mixing mephedrone with other drugs also increases the risks. Drinking alcohol and taking mephedrone can cause confusion and aggressive, erratic behaviour. Taking other stimulant-type drugs at the same time as mephedrone can increase the risks of dehydration and heatstroke, which could prove fatal.

The comedown can leave you feeling miserable, tired and drained but unable to sleep, and wanting to take more. These feelings can last well into the next day. So look after yourself through the week, eat and sleep well, get plenty of exercise to build stamina and resilience. Plan for the comedown, take the next day off, stay in bed, eat & drink (but no alcohol!), watch TV, just slob out or go for a refreshing walk and the bad feelings will soon be gone.

Mephedrone has been confirmed as causing or contributing to the deaths of 42 people (so far). So it’s clear that mephedrone can kill. Heatstroke may be a contributing factor, so stay hydrated and keep cool.

The Law!

Mephedrone is illegal here and in most of Europe. In the UK, mephedrone is a Class B controlled substance under the Misuse of Drugs Act (1971). This means it is illegal to possess (maximum penalty five years in jail) or supply (maximum penalty 14 years in jail).

SO WHY WERE THEY CALLED ‘LEGAL HIGHS’?

Under the Consumer Protection Act it is illegal to sell food, drinks or anything else for human consumption without rigorous safety checks. To get around this, suppliers initially described mephedrone as plant food, usually clearly marked ‘NOT FOR HUMAN CONSUMPTION’.

Some products are also sold as ‘research chemicals’ or ‘incense’, as in the case of cannabis-like substances such as Spice. Spice and other smoking preparations like Back Mamba and Annihilation are now illegal. Interestingly, six weeks after mephedrone was made illegal (in March 2010) products being sold as NRG1, NRG2 and MDAI were found to contain mephedrone 

HOW IS MEPHEDRONE USED AND WHAT ARE THE RISKS?

SWALLOWING

The powder could be wrapped in a cigarette paper and swallowed (bombed), or dissolved into a drink. Capsules or tablets are usually swallowed.

How much?

Users say an effective oral dose is around 150mg, it comes on within about half an hour and lasts for 2-3 hours. Swallowing is possibly the least harmful way to take it, but if you take lots of it you risk damaging your stomach.

Reducing the harm

Drink plenty of water to dissolve it fully and help flush it through your system.

SNORTING

The powder can be snorted but it is reported to be very unpleasant, causing a burning sensation and nosebleeds.

How much?

Users say an effective snorting dose is around 50mgs, it comes on within a few minutes and lasts about an hour.

Reducing the harm

Mephedrone can damage the skin in the nose and nasal passages, causing inflammation, pain and nosebleeds. Washing your nose out with warm water between lines, or at least at the end of a session, will help reduce the damage.

SMOKING

Mephedrone melts at around 670c which is much lower than the direct heat generated by a match, lighter or joint. 

To release the vapour without burning the drug, indirect heat needs to be applied, usually on tinfoil or in a glass pipe.

How much?

Users say an effective dose is around 50mgs, it comes on within seconds but only lasts about half an hour.

Reducing the harm

The more you smoke the faster it comes on and wears off and you will want to take more to keep the buzz going. So have a look at the time when you take it and don’t have another hit for half an hour.

LONG-TERM HARM

As it is such a recent addition to the drug scene no long-term studies have been conducted. 

Many users report a strong desire to continue taking it (craving) so it is possible that mephedrone could be psychologically addictive, on a par with cocaine and crack. 

It may be too early to say whether it is physically addictive or not.  

We don’t know if mephedrone can cause specific damage to your heart, liver, brain or central nervous system.

Basically, it’s not yet known what long-term harm might be caused by mephedrone. The only way to avoid the potential risks is not to use mephedrone.

 

Overdose!

Mephedrone, like all stimulants-type drugs increases heart rate, blood pressure and body temperature. Taken to excess they can cause overdose and convulsions.

Early signs of stimulant overdose include:
  • Sudden rise in body temperature
  • Flushed face
  • Hot, dry skin but no sweating
  • Muscle cramps and stiffness in the arms and legs

What To Do

  1. If the person is panicking and hyperactive,
    reassure them that they will be alright if they relax and calm down. Explain what’s happening to them and what you are going to do.
  2. Get them to breathe in and out, deeply and slowly. Count with them the breaths in and out to slow the rhythm down. If they can’t control their breathing - hyperventilating - use a paper bag to breathe in and out of.
  3. They will start to feel very hot so take them to a cool place, loosen their clothing, particularly around the neck (but be careful not to panic them, they may interpret your movements as an attack!) and apply cold/wet towels or ice to the back of their neck.
  4. If they stop sweating or collapse, phone an ambulance IMMEDIATELY!
  5. Lay them gently on their side in the recovery position (see illustration) so they are comfortable and if they vomit it will drain away from them.
  6. Stay with them until the ambulance arrives, and tell the medics what they have taken. Don’t worry, you won’t get into trouble and this could save their life.

FURTHER HELP AND SUPPORT

FRANK

www.talktofrank.com
Helpline 0800 77 66 00

Call 24 hours a day, 365 days a year, FRANK is around to give you FREE info on drugs

RELEASE www.release.org.uk
Helpline 0845 4500 215

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

EROWID

www.erowid.org

Erowid is a member-supported organization providing access to reliable, non-judgmental information about psychoactive plants, chemicals, and related issues.

URBAN 75

www.urban75.com

A resource for people who want  to access drug  information and make their own, informed decisions.  

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KETAMINE FAQ

Harm Reduction information

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KETAMINE FAQs


What is Ketamine?

Ketamine is a general anesthetic normally used on animals as a painkiller, but which also has hallucinogenic qualities.

Does it have any other names?

Some street names for Ketamine are,  K, Super K, Special K, Techno Smack, Vitamin K.

What does it look like?

Ketamine for medical use is in liquid form, but the stuff that is used illegally has been dried out and is normally in the form of white or off white crystals, similar in appearance to cocaine, but also appears occasionally in tablet form.

How is it used?

In liquid form it is injected but when in powder form it is usually snorted or wrapped in cigarette papers and swallowed (bombed)

What’s the law on Ketamine?

Ketamine is a class B drug it is illegal to possess, supply or make. Possession carries a maximum sentence of 5 years in prison and/or a fine. Supplying Ketamine to other people, and this can include your friends, carries a maximum sentence of 14 years in prison and a fine. These are all maximum sentences. The actual sentence you receive will depend on several factors, such as your age and if you have been in trouble with the police before.

How does it make you feel?

As with all drugs, its effects will depend on how much you have taken, how you are feeling if you have taken any other drugs etc. 

When snorted the effects will start within 5-10 mins with a speedy rush like feeling, and last between a one and two hours. When using small amounts people report feeling dreamy with the sensation of being outside or disconnected from their body, with larger amounts the effects become stronger and can become a fully blown hallucinogenic trip, sometimes referred to as a K-hole. 

You can find it difficult to move your arms and legs, patterns may look like they are moving, colours will shift and change and you feel like you can ‘see the music’ a phenomenon know as synesthesia. Some users find this spiritually uplifting whilst others can find it quite scary.  The trippy effects of Ketamine can be more full on than LSD or magic mushrooms.

What are the risks?

  • Larger amounts of Ketamine can leave you so out of it that your co-ordination falls apart and you are unable to move, not a great idea in the middle of a club. This can leave you very vulnerable. Try to have a friend around who can keep an eye on you when you are using Ketamine.
  • Ketamine is an anesthetic, you are less likely to feel any pain and may be unaware you have injured yourself.
  • The effects of Ketamine are unpredictable and are particularly dangerous when mixed with other drugs, including alcohol.
  • There is increasing evidence that Ketamine can damage the bladder. If you experience an increased need to urinate, passing blood in urine (wee, piss), leakage of urine and pain on urination, consult your GP and let them know you use Ketamine.
  • You can quickly build up a tolerance to Ketamine, so you need to take more to achieve the same effects. This is very habit forming and can have a very bad effect on your wallet, your body and your mind.

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Hi - Five_ free_Harm_Reduction

HARM REDUCTION INFORMATION

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

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HI-FIVE


Amphetamine

Amphetamine is a man-made chemical, also known as speed and whizz. Appears as a white/yellowish powder. It is 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 is a Class B drug. Illegal to have, sell or give away.

Mephedrone

Mephedrone, also known as M-cat, bubble, meow meow, is a man-made chemical similar to amphetamine. It is usually a white or off-white powder, found in tablets, capsule or powder form. It is a stimulant which can make you feel alert, confident and talkative. Can cause anxiety, panic attacks, irregular heartbeat. It raises blood pressure, which can put additional strain on the heart and can become habit-forming. It is a Class B drug. Illegal to have, sell or give away.

Cannabis

Cannabis comes from a plant called Cannabis Sativa. It is normally 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 the dried flowers of the plant, known as grass or weed. Cannabis makes you feel relaxed, trippy, tired and sleepy. But can also make you feel edgy, anxious and frightened. Smoking cannabis mixed with tobacco can cause lung damage and cancer. It is 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, which are 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 sociable. Too much alcohol can damage your health and lead to addiction. Drinking large amounts quickly, can result in unconsciousness and sometimes death. It is illegal to attempt to buy, attempt to buy, or sell to anyone under the age of 18.

Tobacco

Tobacco is the chopped up leaves of the Nicotina plant, which are usually rolled into cigarettes. It is 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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KETAMINE GUIDE FOR DRUG WORKERS - free

HARM REDUCTION INFORMATION

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

KETAMINE GUIDE FOR DRUG WORKERS

Free to use

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  • Only use for non-commercial purposes
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Engaging with problem Ketamine users

This Ketamine guide for drug workers has been prompted by a number of requests from drugs workers for more detailed information on engaging with ketamine users who are experiencing problems but do not fit the traditional ‘problem drug user’ (i.e. heroin) profile and who wish to provide practical, effective interventions.

The use of ketamine has been on the increase in the past few years, particularly on the gay clubbing scene. Although not included in the British Crime Survey (BCS) until 2006/7, when it was made illegal, the proportion of 16-24 year-olds reporting using it ever in their lifetime has gone from 1.3% in 2006 to 2% in 2009/10. Although this may not sound a lot in statistical terms, it equates to around 113,000 persons having used it at some time.

Although most use it for recreational purposes (occasionally, in the context of a night out clubbing) with few problems, anecdotal evidence from outreach workers in several areas is emerging which does give cause for concern. Some ketamine users have developed more chaotic, daily, even dependent patterns of consumption with a range of negative and unwanted side-effects.

What is ketamine

Ketamine is an anaesthetic drug with dissociative properties. First developed in the1960s, it was routinely used in surgery up until the 1980s. Because of its speed of action and safety (unlike traditional anaesthetics it does not affect breathing) it was recommended for use on the very young and the elderly.

Ketamine in crystal form, produced by evaporation or 'cooking' liquid Ketamine

Ketamine seems to have the unusual capacity to disconnect the physical being from the psychic self, which some describe as an ‘out-of-body’ experience. This was often interpreted as a near-death experience, although patients were in no physical danger as overdose is very rare. Because of this, ketamine is more commonly used in severe trauma cases, such as burns or traffic accidents.

Although ketamine is not used as a primary anaesthetic in humans it is more widely used in veterinary surgery, which is probably where the popular ‘horse tranquilliser’ misnomer has arisen. As a marketing ploy, something that could knock out a horse sounds like a winner for dealers. Even though it is mainly used on a wide range of small animals, ‘hamster tranquilliser’ just doesn’t have the same ring to it.

Ketamine in liquid form

The non-medical use of ketamine became popular in the UK in the early 1990s rave scene, often sold in tablet form as ecstasy. These days ketamine is usually sold as ketamine and comes as a white powder which can be snorted (most common), swallowed (less common as it takes too long to work and acts as a laxative!), smoked (rare, as it tastes awful and wears off too quickly) or injected (very rare and not recommended).

When snorted, the effects begin within a few minutes and last around 30-45 minutes, depending on how much is taken. A common method in a club would be to dip the end of a key into the bag of powder and sniff a small amount (around 200mg) from the tip, known as ‘keying’. This short duration of action leads to re-dosing at regular intervals throughout the night. If swallowed, the effects begin around 15-30 minutes and last for 1-3 hours.

What are the effects of ketamine?

Despite what many users feel, ketamine is not a depressant-type drug and does not slow the heart. In fact, at anaesthetic doses it is a powerful stimulant that increases heart rate. However, at low doses the subjective effects of ketamine are experienced as a slowing down and heaviness of the body, what used to be known as ‘sledging’.

Sought after mental effects include a trance-like state, disconnection from the reality, feelings of floating or flying, and visual (sometimes shared) hallucinations. The ketamine experience is very dependent on the environment within which it is taken. Taken at low doses in a club or rave where there is loud music, lighting effects and the buzz of the crowd, it can be stimulating with increased energy and euphoria.

Consumed in a quiet, relaxed setting, at home with friends, users say it can provide a transcendental, spiritual experience, with apparent travel to other worlds and places (the ‘out-of-body’ experience), a welling up of long-forgotten (or suppressed) memories, apparent insight into the nature of existence, distortion of time, and the belief that one has died and been re-born. There can also be panic and very unpleasant feelings and nightmare-like experiences.

Physical effects can include loss of control over the body, loss of coordination, difficulty speaking, moving, hearing and seeing (delirium), numbness, and nausea. Ketamine has been described as ‘psychedelic heroin’ and ‘L.A. coke’, emphasising the mixed and complex nature of the effects.

Short-term side-effects of Ketamine

  • Increase in heart rate
  • Slurred speech
  • Confusion, disorientation
  • Out-of-body experience
  • Shifts in perception of reality
  • Nausea
  • Cardiovascular effects, including hypertension and tachycardia
  • Respiratory depression
  • Hypersalivation
  • Pleasant mental and/or body high
  • Increase in energy
  • Euphoria
  • Sense of calm and serenity
  • Meaningful spiritual experiences
  • Enhanced sense of connection with the world (beings or objects)
  • Distortion or loss of sensory perceptions (common)
  • Open- and closed-eye visual hallucinations (common)
  • Dissociation of mind from body
  • Analgesia, numbness
  • Ataxia (loss of motor coordination)
  • Significant change in perception of time

What are the problems?

The main problem associated with ketamine is physical helplessness as disconnection from the body can be dangerous, especially in the disorienting environment of a club or rave. This is similar, in many ways, to being extremely drunk in a public place where accidents are more likely. This can leave the user vulnerable to assault (both physical and sexual) and having unprotected sex, increasing the risk of unplanned pregnancy, sexually transmitted infections (STIs) like gonorrhoea, and blood-borne viruses (BBVs) such as hepatitis and HIV.

Fatal overdose is extremely rare as the upper limit for safe use in medicine is very high. What is more likely is that the user would pass out before reaching a fatal dose, which is dangerous in itself. Unconsciousness is an emergency situation and should be treated as such.

Ketamine in tablet form

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

Although not considered physically addictive, tolerance to ketamine builds up very quickly and higher doses are needed to achieve the desired effects. As mentioned earlier, some users are getting into patterns of compulsive binges. This can lead to problems with memory, word/name recall, reduced attention span, damage to relationships, loss of productivity, isolation, and neglecting other interests. Despite evidence of harm the compulsive user often finds it difficult to cut down, all the hallmarks of dependence.

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

There is evidence of some physical damage caused by excessive use, particularly to the bladder and urinary tract. One study linked urinary tract disease with ketamine as users reported a range of symptoms associated with ulcerative cystitis, including an increased need to urinate, passing blood in urine, leakage of urine and pain on urination. It is thought that these may be associated with scarring and shrinking of the bladder which, if use continues, could go on to cause irreversible damage and harm the kidneys.

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

Ketamine is illegal. Under the Misuse of Drugs Act (1971) it is a Class C drug. The maximum penalty for possession is two years in jail plus an unlimited fine. The maximum penalty for supplying to another person (dealing or giving away) is 14 years imprisonment plus an unlimited fine.

How you can help

The law

Let’s take that last point first. Ketamine is illegal. If the client wants to avoid the risk of arrest, prosecution, fine, jail or a criminal record – don’t go near ketamine. Simple. All ketamine users should be made aware of the legal risks they run.

Engagement

It is quite likely that mainstream drug services will not see ketamine users presenting for help. This is due, in part, to services being set up to deal with other drugs and are not geared towards the needs of ketamine users. This will also be the perception of ketamine users who don’t see themselves in the same league as heroin or crack users and may feel unwilling to attend such a service.

Contact is more likely to be made through advertising, in the appropriate places, your agency as a more broad-based service, ready and willing to support all forms of drug user. It is not the drug that is important but the behaviour. If you can get this across you may attract a more diverse clientele.

Even more effective will be outreach workers who can get to know ketamine users on their own terms. This approach has proved useful in many areas and helps to provide a bridge into mainstream provision. Outreach workers can also act as an early warning system, picking up on new trends developing in the community before individuals arrive on your doorstep needing help.

If you don’t currently have an outreach team, get one.

Education

Making ketamine users aware of the potential risks, particularly when mixed with other drugs, and ways of reducing harm is vital. How this information is put across will also determine the uptake of the service. Unrealistic, scaremongering will put people off, whereas honest, non-sensational, culturally attuned awareness raising will engage more effectively.

But, to be effective, it’s the credibility of the sender rather than the message itself that is often more important. If your agency has a user-friendly, non-punitive reputation in the community then individuals will feel more comfortable about coming forward. This is where outreach, again, can prove useful. Outreach workers can gain the trust of clients and explain what your service has to offer, as well as providing advice and information at the point of contact.

Vulnerability

Friends shouldn’t need reminding that, on a night out, they must look after each other. Even so, it’s worth reinforcing the message that if someone is really out of it they are vulnerable to all kinds of danger.

So make a plan before going out – stick together, agree meeting places if you get separated, before you go out order a taxi to pick you all up afterwards, make sure everyone has got each other’s phone numbers, try to keep tabs on who has taken what and how much. If someone is really out of it they should never be left alone or put in a taxi to be taken home on their own. They may not be in a fit state to make rational decisions, so they should not go off with their new ‘best friends’.

This may sound improbable, and boring, but if it’s not discussed no-one will think about it.

Collapse and unconsciousness

All drug users need to know how to react if someone collapses and this is important knowledge that you can pass on. Because of the ‘sledging’ effects of ketamine, this may prove very important.

Simple First Aid techniques (recovery position, stay with them + call an ambulance), applied at the point of need, saves a lot of bother. If you don’t currently teach First Aid to your clients, see about setting something up.

Compulsive use

Remember, it’s the behaviour not the drug. Clients who feel they can’t control their ketamine use are no different from the alcohol or heroin user who feels they can’t control their use either. An experienced worker will know where to use a brief intervention, how to assess need, or when to suggest more in-depth interventions such as CBT or MI.

Brief interventions, such as quantifying consumption, exploring the pros and cons of using or keeping a diary of use, has been shown to be very effective in reducing alcohol consumption. It has been used successfully with other drugs, so why not ketamine. Helping a client to define their frequency and level of use, and the gains to be made by cutting down, can help to break up patterns of consumption.

Cognitive Behavioural Therapy (CBT) has been used successfully in helping clients understand their motivation to use other drugs and could be equally applied to ketamine. Understanding how patterns of behaviour develop, identifying cues and triggers that stimulate the desire to use, and devising strategies to cope with high-risk situations can all help to bring about change.

And change is the goal. If a client is concerned enough about some aspects of their ketamine use, a Motivational Interviewing (MI) approach can help to identify how change can be incorporated into behaviour. Maintaining that change over time will help move the client through the process and into a less harmful situation.

Mental health

Ketamine has profound psychological effects. It can take the user to some very strange places inside their own head. If they do have unpleasant or suppressed memories, or do have an underlying or overt mental health issue then ketamine could exacerbate these. If the client does have a bad experience they should stop using ketamine immediately. If something has come to the surface that won’t go away, they should seek help from their GP.

Most people who have a bad, transitory ketamine experience will return to normal and will have learned an important lesson - Ketamine is an interesting place to visit, but you wouldn’t want to live there. For many, this will help them re-evaluate the desire for a trip to the dark side and possibly deter them in future.

Physical health

Most of the physical problems associated with ketamine are due to accidents whilst under the influence. At high doses, numbness in the extremities (mainly fingers and toes) is not unusual, but this might mask a broken bone that does not become apparent until the ketamine wears off. Looking after each other when on a night out is good advice, but if everyone’s in the K-hole it’s not much use. In the event of an accident or fall, making others (bar staff, security, First Aiders, etc.) aware that ketamine has been used could help avoid major injuries going unnoticed.

As stated above, some heavy users of ketamine have developed bladder problems. If any of the symptoms outlined above are experienced, it makes good sense to stop using ketamine altogether and seek medical advice. As for K-cramps, even though the exact cause is unclear it has been suggested that Tyrosine, used only under medical supervision, can help alleviate the pain.

The bottom line is this – If you want to avoid harm don’t do ketamine.

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Alcohol Aware - Harm Reduction

Harm Reduction information

This is the same harm reduction information we use in our drug & alcohol leaflets. Please feel free to use it in your own resources or websites. Alternatively, you can buy designed and printed versions of this information from the Substance shop.

View all harm reduction information

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Just a few things to remember:
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Alcohol Aware


What is Alcohol?

Alcohol is one of the most commonly used drugs in the UK.
It affects different people in different ways, depending on when and where you drink, who you are with, and how you feel at the time.
This information in this booklet will help you identify the risks associated with alcohol and give advice on how to stay safe.

ALCOHOL

What we normally refer to as Alcohol is a chemical called ethanol, which is made through a process called fermentation.
During fermentation, yeast is combined with fruits or grains. The yeast converts the sugars in the fruits and grains into alcohol.
Distilled spirits, such as vodka, rum, gin, and whiskey, are fermented and then filtered/distilled to separate the ethanol from the water.

HOW ALCOHOL WORKS

When you drink alcohol it is absorbed into the bloodstream through the stomach and intestines. The alcohol is broken down by the liver and expelled as urine, at the speed of about one unit ( see page 4 for unit info) an hour.
While your liver works away breaking down the alcohol, the rest is circulated around your body and is sent to your brain where it starts to depress your heart rate and breathing, and affects your brain’s ability to control what your body does.

Effects of alcohol

Initially, one or two drinks generally produce feelings of relaxation and cheerfulness, but drinking more can lead to blurred vision and coordination problems.
Drinking even more alcohol can lead to a loss of control, blurred/double vision, dizziness, wobbly legs, vomiting and even loss of consciousness.
The effects start within about 15 -20 minutes of drinking and can last a few hours, depending on how much you drink.
Stronger drinks (like spirits) and fizzy drinks [like alcopops] are absorbed quicker into the bloodstream and will start to affect you sooner.
How alcohol makes you feel depends on lots of things, such as:

How quickly you drink it

Your liver processes alcohol at a steady rate no matter how quickly you drink, Drinking quickly increases the levels of alcohol in your bloodstream, making you drunker, faster.

If you have eaten any food

Food helps slow down the speed that alcohol is released into your system.

Your body weight

In general, the less you weigh the more you will be affected by a given amount of alcohol.

Your mood before drinking.

If you feel a bit down before drinking, alcohol may make you feel even more depressed, if you feel angry it can cause you to act aggressively.

Gender

Women’s bodies contain less water than men’s, so alcohol is less diluted, meaning women feel the effects more than men. This is particularly true either just before, or during a period.

Know your unit

This page contains advice on units, the term used to describe the amount of alcohol, and therefore the strength of your drink. A unit is defined as 10ml by volume, or 8gm by weight, of pure alcohol. Units are normally displayed on alcoholic packaging in a similar style to the label below

Government Guidelines

Government recommended safe drinking limits.

Unit guidelines are the same for men and women. Both are advised not to regularly drink more than 14 units a week.

Working out the units for yourself: Multiply the ABV by the total liquid (ml) and divide by 1000 12 x 750 ÷ 1000 =

Approximate units for popular drinks

  • Can of lager

    2 units

    500ml (Normal strength)
  • Bottle of strong lager

    2 units

    330ml
  • Bottle of alcopops

    1.4 units

    275ml
  • Pint of lager

    2 units

    568ml (Normal strength)
  • Shot (Tequila, Sambuca etc)

    1.3 units

    35ml
  • Bottle of wine

    9 units

    750ml
  • Glass of Wine

    1.5 units

    125ml
  • Spirits (Vodka Whiskey etc.)

    1.4 units

    35ml

Know your limits

Guidelines for both men and women recommend drinking no more than 14 units a week to reduce the risks to your health.
The more you drink, the more your risk developing a range of health problems (including cancers of the mouth, throat and breast) increases.
If you do drink up to 14 units a week, spread them over a few days and have some drink-free days a week.
There are no safe limits for young people - not drinking is the healthiest option.

Positive effects of drinking at ‘recommended’ levels

  • Increase relaxation
  • Sociability
  • Possible reduced risk of heart disease (for some men and women aged over 55).

Short term negative effects of drinking more than the recommended guidelines:

  • Low energy
  • Accidents
  • Injuries or violence
  • Unplanned sexual encounters
  • Problems with friends and familie

The long term negative effects of drinking more than the recommended guidelines:

  • Alcohol dependence
  • High blood pressure
  • Liver disease
  • Cancer

Spotting the warning signs

Different people react in different ways to alcohol. For some people alcohol can help them relax and enjoy social occasions, for others, it will damage their health and personal life.

Some signs that you are developing an unhealthy relationship with alcohol can be:

  • Finding it difficult to stop drinking once you’ve started.
  • Neglecting work, college or school.
  • People close to you worrying about the amount you drink.
  • Taking risks when you’ve had a drink, such as driving a car or getting into fights.
  • Drinking more than five days a week and regularly drinking more than nine units at each session.
  • Regularly thinking about when you can have your next drink.
  • Being unable to enjoy yourself or relax without alcohol
  • Getting involved in violence.

If any of the above apply to you then you should consider cutting down. If a few of these apply to you, contact your GP for help and advice, or contact any of the organisations on the back page of this booklet.

THE RISKS

Getting hooked on alcohol

Regular use of alcohol can lead to tolerance - having to drink more and more to get the same effect. This can lead to physical dependence

Mixing alcohol and other drugs

Mixing alcohol with other drugs, particularly depressants like sleeping tablets, or heroin, is very risky. The combination produces effects which are difficult to predict and can lead to increased risk of passing out or death.

Overdose

Alcohol slows down breathing and heart rate. In large enough quantities it can lead to loss of consciousness and even death.

Signs of alcohol overdose are:

  • Slow, shallow, or irregular breathing
  • Confusion
  • Difficulty awakening the person
  • No reaction from painful stimuli (such as pinching)
  • Unconsciousness (passing out)
  • Blue-tinged skin or pale skin
  • Seizures

Alcohol and sex

Alcohol can affect your judgement and make you feel confused. You are more likely to have unplanned sex when you have been drinking, or sleep with someone you normally wouldn’t go near when you are sober.

You are also at risk of rape, sexually transmitted infections (STIs) and pregnancy.

Always use a condom during sex.

Alcohol and violence

Alcohol lowers your inhibitions, causing you to over react in certain situations which can lead to aggressive behaviour. It’s not much fun waking up in a police cell with a hangover and a criminal record.

It might also lead to problems with your friends and family- being drunk isn’t much of an excuse if you say something to a friend you regret the next day.

Too much alcohol can make you a victim. Being drunk makes you an easy target for robbery and assault. So don’t flash your mobile phone, or any other valuables, around. Be aware of your surroundings.

Drink Driving

Driving while drunk or being in a car with a drunk driver is very dangerous both for you and other people in the car. You, your friends or a pedestrian could be seriously hurt or killed.

STAYING SAFE

PASSING OUT

As already mentioned,it is possible to overdose on alcohol which can be fatal. If someone you are with passes out, turn them onto their side so they can’t choke on their own vomit and ring an ambulance or find someone to help you.

HAVE A SPACER DRINK

Use soft drinks or water as ‘spacers’ between alcoholic drinks. Your night will last longer, it will stop you getting dehydrated and reduce the effects of a hangover.

DON’T DRINK ON AN EMPTY STOMACH

Food slows the release of alcohol into your system and helps to limit how quickly you get drunk. It’s a good idea to eat a meal before you go out, or snack while you drink. It’ll also give you more energy to enjoy yourself!

HAVE SMALLER DRINKS

Some measures in pubs and clubs can be very large and have 2 or 3 units in each drink. Where possible, choose a smaller glass.

HAVE THE DAY OFF

Give your liver a chance to ‘detox’ by having at least two alcohol-free days – this way it has time to recover and repair itself.

DRINKING BEFORE YOU GO OUT

Drinking alcohol before you go out means that you could already be drunk before you start on your night out. You are more likely to be involved in accidents and violence and more likely to be refused more alcohol at the bar

TRY TO STICK TO ONE TYPE OF DRINK

Avoid mixing your drinks. This will help you keep track of how many units you’ve had and avoid mixing different strength drinks.

MIXING DRUGS AND ALCOHOL

Mixing alcohol with drugs, particularly depressant drugs, can increase the chances of an overdose and can make the effects of the individual drugs unpredictable and dangerous.

GETTING HELP

If you feel your drinking is getting out of hand, consider talking to someone. Maybe a close friend, parent, teacher or a local advice centre.

Here are some organisations that can also help you:

Talk to Frank

National drugs awareness site for young people and parents/carers.
0800 77 66 00
www.talktofrank.com

Childline

Calls are free and confidential.
www.childline.org.uk
0800 1111

Addaction

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

Brook

Free, confidential advice on sex for young people.
Call 0800 185 023 or
visit www.brook.org.uk

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BINGE DRINKING - A NIGHT ON THE TOWN

HARM REDUCTION INFORMATION

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BINGE DRINKING - A NIGHT IN TOWN


For most people having a drink can be a positive experience. Having a night out and a laugh with your mates after a long weeks work or study, helps you to relax and wind down.

Alcohol can help you to chill out, make you less shy, give you the confidence to deliver the killer chat up line.

But hammering it every weekend and sometimes during the week can lead to some serious short-and long- term health issues to deal with.

This booklet will help you think about your drinking and offer practical and sensible information and advice about how to reduce the harm caused by alcohol.

ALCOHOL

Alcohol is a depressant drug. It is absorbed through the intestines and stomach into your blood and is sent to your brain where it slows down your central nervous system and alters your mood, perception, movement, vision and hearing. 

Your body flushes out most of the alcohol through your liver,  but a small amount of alcohol is also expelled in your sweat and breath, this is how a breathalyser measures the amount of alcohol in your system. 

Short-term effects of alcohol

  • Relaxation
  • Increased confidence
  • Talkativeness
  • Anxiety
  • Sexual difficulties such as impotence
  • Bad judgement, leading to accidents and injuries
  • Alcohol poisoning. This could lead to a loss of consciousness and could be fatal

Long-term effects of alcohol

  • Cirrhosis of the liver
  • Inflamed stomach or pancreas
  • Certain cancers such as throat cancer
  • High blood pressure

People’s reaction to alcohol can vary and depends on things like

  • Age
  • Gender
  • Body height and weight
  • If you have eaten
  • How quickly you drink
  • If you have used any legal or illegal drugs

BINGE DRINKING

Binge drinking means different things to different people, but generally, it means drinking lots of alcohol over a short period with the intention of getting hammered.

RISKS AND PROBLEMS

Accidents and violence

Alcohol can make you reckless and impulsive, binge drinking can lead to an increased chance of falls, car accidents and becoming the perpetrator or victim of violence.

Physical health


Consuming large quantities of alcohol over a short period of time means your body cannot process the alcohol quickly enough. Alcohol can build up to dangerous levels and the extra stress on your body’s organs can lead to an increased risk of high blood pressure, heart disease and certain cancers.


Alcohol poisoning


Alcohol depresses the nerves that control your breathing and gag reflex (which prevents choking). A fatal dose of alcohol can stop these functions. If you vomit while you are not conscious because of alcohol, you could choke to death.

How much do you drink?

Alcohol is measured in units. You can calculate the amount you drink by knowing how many units of alcohol are in your drink.

WHAT IS A UNIT?

A unit is 10ml by amount or 8gm by weight, of pure alcohol (Ethanol).

To work out the number of units in a drink, multiply the volume (in millilitres) by %ABV then divide the result by 1000.

WHAT IS %ABV?

ABV means Alcohol By Volume. A 750ml (75cl) bottle of wine which stated 12% ABV on the label means that 12% of the liquid in the bottle is alcohol. A 700ml (70cl) bottle of vodka which has an ABV of 37/38% on the bottle, would contain almost 3 times the amount of alcohol/units for roughly the same amount of liquid.

HOW MUCH SHOULD YOU DRINK?

The suggested alcohol limit for males and females is the same: Don’t regularly drink more than 14 units per week (6 pints of 4% beer, or 6 glasses of 13% wine). These limits will help reduce potential health problems.

If you drink up to 14 units a week, spread these across a few days and have at least two drink-free days a week.

  • Can of lager 440ml
    2 units
    (Normal strength)

  • Small glass of wine
    125ml
    1.5 units

  • Bottle of strong lager
    330ml
    2 units

  • Bottle of wine
    750ml
    10 units

  • Shot 35ml
    1.3 units
    (Tequila, Sambuca etc)

  • Bottle of strong cider
    1000ml
    9 units

  • Standard size bottle of spirits
    750ml
    26-28 units

  • Single pubmeasure ofspirit
    25ml
    1.3 units

STAYING SAFE

The information in this section will help make your night out as enjoyable and safe as possible.

PRE-LOADING

A few drinks with your mate to loosen up as you get ready to go out can turn into a session. You are two and a half times more likely to get into a fight or have an accident than people who only start drinking when they go out. You are more likely to be refused entry to a club or pub if you are drunk.

ALCOHOL AND THE LAW

Drunk and disorderly

It is illegal to be drunk and disorderly in public. If you have had a skinful try not to attract attention by acting like an idiot. If you are arrested by the police, once you are fit to be dealt with, you will normally either be cautioned, be issued with a Penalty Notice for Disorder (PND - £80 fine in ticket form) or, depending on the offence, end up in court.

Drinking outside

It isn’t illegal to drink in public but many areas, such
as city centres, have alcohol-free zones, where drinking outside is not allowed. Under-18s can have their alcohol confiscated if they drink outside, no matter where they are.

Entering the pub or club

It is illegal for a pub or club to sell alcohol to someone who is drunk or is conducting themselves in a ‘disorderly manner’. It is illegal for you to refuse to leave a licensed premises when asked by the police, the licensee or someone acting on their behalf, such as the door staff.

Pubs or clubs have the right to ask anyone entering the premises to be searched. If you do agree, and you have the right to refuse, the search can only be on the outside of the clothes, pockets and inside bags.

MIXING DRUGS AND ALCOHOL

Using drugs is risky in itself but mixing them with alcohol can make the effects of both very unpredictable. Your body will struggle to cope if you swamp it with too many substances and if it can’t flush them out they can rise to dangerous levels.

Alcohol and cocaine used together produce a third toxic substance called cocaethylene, which can increase the chance of seizures, heart attacks and strokes, even in healthy young people. It has also been linked to an increased risk of violence and impulsive and reckless behaviour.

Alcohol dehydrates you so mixing it with other drugs that do the same, like cocaine, ecstasy or mephedrone, or some of the newer drugs (formerly legal highs, can be very risky.

VIOLENCE

Alcohol affects the brain in a way which reduces our ability to think straight.

It makes us more likely to misread the signs, someone bumping into you or the ‘dirty look’ can be seen as an act of aggression, when normally you wouldn’t even notice it. 

The more you drink the more frustrated you can become as you try to get to the bar or queue to use the toilet, this can lead to aggression and violence.

If you are someone who loses their temper easily try not to get too drunk. Drink in pubs and clubs that are not so busy and avoid trouble hot-spots where you know there are always kick-offs. If you are on the receiving end of someone giving you grief just walk away. It can be hard to lose face in front of other people, but it has got to be better than being the victim of a serious assault or being locked up for giving someone else a hiding.

SEX

Alcohol increases your self confidence and makes it easier to approach someone you fancy, but if you’re too drunk you can end up going further than you intended.

Sexually Transmitted Infections (STI’s)

If you intend to have sex, use a condom. Having sex without a condom can leave you open to sexually transmitted infections (STI’s) and unplanned pregnancies.

Women can get oral emergency contraception from their GP, Brook, or NHS Walk in-centre. This can be taken 72 hours after unprotected sex and is available to anyone over 16 years of age.

Brewers droop

Alcohol affects the part of the brain that send the messages to your dick to get ready for action, alcohol suppresses the signals and can lead to brewers droop.

DON’T FLASH YOUR VALUABLES

Don’t flash your expensive phone around, it could end up being stolen. Buy a cheap phone to use when you are going out. If you are drawing cash from a machine be aware of who is around and don’t let anyone distract you, shield your pin and put your money away quickly. Where possible, use a machine in a well lit public area.

KEEP AN EYE ON YOUR DRINK

Never accept drinks from a stranger or someone you don’t trust. These could be spiked.

LOOKING AFTER YOURSELF AND YOUR MATES

If you or one of your friends are going to leave the club or pub with someone you have just met, make sure your friends know what you are up to and where you are going, maybe you could take a pic of your new friend and text it to your friends. If a friend is telling you where they are going and who with, listen to what they are saying.

Feeling unwell

If someone goes too far and starts to feel unwell, take them somewhere quiet and cool. Keep them sitting up and awake, give them water if they’re able to drink. If you are unable to wake them and their breathing is erratic, lie them on their side in the recovery position and get medical help.

GETTING HOME SAFELY

Have a plan of how you are going to get home after a night out.

Try to pre-book and pay for a taxi to take you home from a pre-arranged location. Use this location as a meeting point if you get split up from your friends.

If you do end up walking home alone, be aware of your surroundings, stay on well-lit public roads, don’t be tempted to take the short cut across the dark, deserted park because you can’t wait to crash into bed.

CUT DOWN

How often do you say to yourself ‘I am never getting that drunk again?’ These tips will help you keep that promise during your next night out.

  • Set yourself a limit
    Decide how much you are going to drink and only carry enough money for that number of drinks and your taxi or bus fare home.

  • Eat something before you go out
    Having some food in your stomach before you start drinking will help your body release the alcohol at a steady pace. While you are out have some bar snacks or maybe eat the kebab half way through the night rather than at the end.

  • Mix your drinks 
    Mix your drinks with soft drinks. Have a shandy or mix your wine with soda or lemonade. Or alternate between alcoholic and soft drinks.

  • Miss a round
    You don’t have to get a drink in every round. When it is your turn to get the round miss yourself out. Or simply say no and stick to it.

  • Go for lower alcoholic drinks
    Some premium lagers, beers and ciders can have almost twice the alcohol content as the normal alternatives.

  • Drink slower
    Sip your drink, and put it down on a table and do something else. Standing with your drink in your hand means you will end up drinking it quicker.

LONG TERM CHANGE

Regular heavy drinking sessions can become a habit. If you need to make long term changes the following advice will help.

Are you drinking too much?

Have a look at this list and see if any of the warning signs apply to you.

  • Drinking larger amounts to get the same effect.
  • Drinking more than nine units in one session, that’s roughly equivalent to five pints or 9 shorts or nearly a full bottle of wine.
  • Have you started doing things you normally wouldn’t do (e.g. missing work or college, letting people down)?
  • Do friends and family have a go at you about the amount you drink?
  • Have you got into bother, or injured yourself or others after drinking?

If one of these applies to you then you might want to cut-down your drinking. If three or more of these apply to you then you may need help or support before you start to cut down or stop drinking. You can find more help on the back page of this booklet.

Think about how will you benefit from cutting down on drinking

There are lots of benefits to cutting back on the drinking sessions and for everyone they will be different.
Some benefits might be:

  • Feeling less tired
  • Losing weight
  •  Having more money to spend on other things
  •  Better relationships with friends and family
  •  Healthier and less likely to develop serious health issues

Plan ahead and set your goals

Are you going to cut-down slowly or stop straight away? Think about how and when you are going to start.

You could make a decision to book your taxi home earlier than normal. Maybe just go to the local rather than going clubbing. Or choose a couple of days to be completely alcohol free.

Think about difficult situations and how to deal with them

Think of the situations you are in last time you got smashed, who were you with, where were you, how did you feel, what where you doing at the time? Situations that could trigger your drinking could be:

  • The end of a stressful day
  • After work
  • Celebrating at a party or a club
  •  Needing to relax
  • Feeling down

Dealing with difficult situation

Stay active

Plan activities for the times you used to spend drinking. If you are getting bored, stressed, or craving a drink, do something, the feelings will pass. 

Do something new

Start a new hobby or enrol on a course. It will occupy your mind, stop you getting bored and fill the time you used to spend drinking.

Look after yourself
Stick to a healthy diet, try to get as much sleep as you can, drink plenty of water and try to get some exercise, this will help make you feel better.

Avoid your friends who drink heavily for a while
Some of your drinking friends can act as a trigger to your drinking sessions.

 

Clear your home of any alcohol
No need to keep temptation within arms length.

Tell your friends or family what you are about to do

Having support and someone to talk to will make it easier to achieve your goals. You can also get help and support from your local GP, nurse or support service. There are some contact details on the back page.

Keep going

Don’t worry if you don’t succeed the first time you try. Don’t beat yourself up if this happens, you haven’t failed, you have just taken the first step. Try again - it will probably be a bit easier next time.

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