Addiction: A Guide for Friends and Family (4)
Written by David Partington.
You can download the PDF of this resource here.
The whole subject of drugs is fraught with so much debate and mythology. What do street nicknames like ‘gear’, ‘smack’, ‘snow’, ‘crack’ mean?
What effect does heroin have compared with LSD or ecstasy?
Is it easier to withdraw from heroin or tobacco?
What follows answers those questions and other related issues. I will discuss each group of drugs in turn, in order to provide some important basic information about them. However it's important to remember:
· The most important thing about addiction is not the drugs themselves but people.
· You don't have to be an expert on drugs to help people.
· There is no such thing as a ‘soft’ drug.
· All drugs affect the central nervous system in some way or another.
I've included legal drugs for at least two reasons: first, millions more people are addicted to legal drugs such as alcohol, tobacco and tranquillisers than those addicted to illegal drugs; secondly, alcohol and tobacco each contribute to far more ill health and death than all the illegal drugs put together. As I write, it's predicted that in the coming year over 122,000 people will die from smoking-related illnesses.
Bearing in mind that most children's' first contact with drugs is in a home or similar social setting, it’s easy to see that parental example sets a very real trend for them. Therefore, if they do start to use legal or illegal drugs themselves, what objection can parents have who smoke or drink heavily themselves?
The proliferation of coffee shops speaks a lot about the growing popularity of coffee, but none of them can be looked upon as dens of drug iniquity. Yet locked in the coffee they sell, unless it’s de-caffeinated, is a drug which affects the central nervous system. Its effect is low key in small quantities, but it is still a mild stimulant which causes increased alertness and can cause heartburn. It's clear, however, that its consumption is growing very significantly. An article in Hospital Doctor 1 described how average use in the States is now ‘500mg of caffeine a day’; this is apparently the equivalent of 5 cups of coffee. Other drinks contain significant quantities of caffeine as well: 41mg in a cup of tea, 45mg in a drink of Coca Cola, 40mg in a can of ‘Dr. Pepper’.
The impact of caffeine at these levels is disturbing. It affects sleep, especially if drunk just before going to bed. It influences our mood and particularly levels of anxiety and irritability. One study reported in the New England Journal of Medicine confirmed that ‘Men who drank five or more cups of coffee a day had an estimated, relative risk for coronary heart disease of 2.49 compared with non-coffee drinkers’. Maybe there is something to be said for keeping an eye on how many cups of coffee (or tea!!) we drink.
More than one heroin addict has told me, ‘It has been much easier to quit heroin than tobacco’.
Why do people smoke? ‘To relax’, ‘to be sociable’. Smoking is also said to reduce stress and to taste wonderful after sex or a good meal. The fact is however that, once started, most people who smoke carry on simply to get relief from their craving for nicotine.
What problems does smoking cause? For those who are addicted to nicotine the problems are serious: they include bronchitis, emphysema (leading to permanent damage to the lung tissue), heart disease, cancer, gum diseases, shortness of breath, etc., etc.
On the bright side, it is an amazing fact that 11 million people in the UK gave up smoking in omne recent 16-year period!2 Who said that positive prevention doesn't work? But there is still a long, long way to go, with something like 30% of people over 16 smoking.
The popularity and availability of alcohol today speaks volumes about why young people have a problem with our attitude toward other drugs. They read that 25,000 people a year die of alcohol related illnesses, compared with about 500 people who die from all the other illegal drugs put together. It is not only the vast quantities of alcohol that are consumed either; it's the lengths that the industry goes to in working overtime to tempt us to drink more. No wonder it’s a £200 million business! 3
It is, of course, only legal to purchase alcohol if you are 18 or over, and then only from licensed premises. But it’s said that over 90% of us use alcohol as a normal social activity, and young people are catching on at a very early age. One survey concluded that 5% of 10 year olds are drinking in excess of sensible adult limits. Another surveyed 20,000 teenagers of 4-15 years old, and when asked what they did when they had a problem, 32% of boys and 21% of girls said they had a drink.4 Little wonder that people are saying that, if alcohol had just been discovered, it would be banned like heroin or crack!
There can be very few people reading this feature who have not experienced the bad effects of alcohol - if only once in their lives. Alcohol is a depressant, in spite of the way it can make us get very voluble and animated. Then there are the hangovers, the lack of co-ordination (hence the need to not drink and drive’), the lethargy, the irritability, the aggression and violence. Alcohol is physically, mentally and psychologically addictive, and it leads to untold despair and misery. Alcohol has been called the ‘great remover’:
It will remove stains from clothing. It will also remove clothing from a man, a woman and children. If used in sufficient quantity, alcohol will remove furniture from the home, rugs from the floor, food from the table, lining from the stomach, vision from the eyes and judgment from the mind. Alcohol also removes reputations, employment, friends, sanity, freedom, happiness from children’s hearts, people’s ability to adjust and live with others, and even life itself. As a remover of things, alcohol has no equal…
‘Sally was 13 and doing OK at school. She went around with a group of friends of about the same age, and one evening they were messing around at a friend's house when his parents were out. But it was rather boring, and one of the gang got a can of anti-perspirant and suggested that they each have a sniff to get high and have “dreams”. Each member of the gang inhaled from the can, and some felt a strange effect, rather like being drunk. When it was Sally's turn she took a large breath. She became frightened by the effects. She ran up the stairs to go to the toilet to be sick but collapsed on the landing. Fortunately, one of her friends had done a first aid course so he put her in the recovery position, cleared her airway then gave her the kiss of life. The others called an ambulance.’ 5
Sally's story ended happily thanks to the doctors in her local hospital. Others are not so fortunate; and solvent abuse is growing. It is also difficult to control with over thirty abusable, volatile substances in some households, including aerosol sprays, lighter fuel, solvent based glues, dry cleaning fluids, paint, thinners, correcting fluid and petrol. One Parliament research paper (94/104) suggests that roughly 10% of secondary school children will try sniffing solvents. Why? ‘It’s easily available, gets you “drunk” and I can do it with my mates without anyone interfering.’ (Andrew who said this is an ordinary lad from a good home, but he took some persuading to admit he actually does not like the feelings of being dizzy and spaced out.)
What are the dangers of sniffing solvents? They are very real, including damage to the heart, kidneys, liver, lung and brain, plus suffocation from butane gas (which freezes the air passages when sprayed directly into the mouth), using plastic bags, or choking on your own vomit if you pass out.
In some recent years over 16 million prescriptions have been issued for tranquillizers in the UK. There are hundreds of different types available on prescription. However, they become 'illegal' when stolen and sold for people to abuse. The group of tranquillizers which are subject to misuse are mainly from the benzodiazepine family and include Lorazepam (Ativan), Temazepam (Normison), Diazepam (Valium), and Nitrazepam (Mogadon). Street names include ‘Moggies’, or yellow or green eggs.
Tranquillizers are sometimes given by doctors to help people cope with a crisis, because they reduce anxiety and stress or help people to sleep. In helping people to cope, they don't of course remove the problems, and sooner or later those problems have to be faced. But what are the problems associated with tranquillizers? They not only decrease alertness but cause drowsiness so that driving, using machinery or climbing a ladder can be potentially dangerous. They are particularly hazardous when used with other sedatives and alcohol. The greatest concern about tranquillizers however relates to the fact that many folk are prescribed them for very much longer than the recommended four to six week period. Addiction results, and the withdrawal symptoms include severe irritability, anxiety, confusion, and failure to cope with everyday activities.
Tranquillizers are possibly worse than any other drug mentioned in this feature, in that it can take weeks and even months to withdraw from them. But it can be done by reducing the dosage by half a tablet a weekm or even a month. It is very important to do this under medical supervision, and with the love and care of family and good friends, and/or while belonging to a support group. John was eventually helped by a support group, but his story until then was truly disturbing. He was 41 and unemployed, and came off tranquillizers after a decade of addiction. He had originally been prescribed valium for anxiety following promotion. ‘I felt under pressure’, he wrote, ‘but it doesn't matter if you initially take tranquillizers for a sprained ankle through playing football, in the end they automatically give you mental problems. The mental feelings are like having a gin and tonic before going into a meeting - an artificial confidence. But they catch up with you, and the side effects are very unpleasant: fear, panic, a pounding heart, sweating, headaches, shaking and insomnia. I used to travel the world, but when taking tranquillizers my reaction to a knock on the door was to crawl under the table. I was terrified.’ 6
Over the counter drugs
Many people are surprised that medicines which can be bought over the counter, such as cough mixtures and travel sickness preparations, can be used to obtain a ‘buzz’ or ‘high’. It's for this reason that care needs to be taken to keep your home medicine cabinet locked. Drugs which can be misused include Gees Linctus, Benylin and Sudafed. Many of them contain opioid drugs, such as codeine, or mild stimulants such as ephedrine. Alcohol is also a popular ingredient.
Amyl nitrite (poppers, TNT, liquid gold) is a recreational drug particularly used to heightened sexual arousal. It is sold in tiny bottles. Like all drugs it has its downside, causing blackouts, vomiting or worse if used by someone with low blood pressure or a heart problem.
Ketamine (Special K), originally used as a veterinary drug, is abused as a relaxant which also gives hallucinations. It has been found on the rave scene making some users very aggressive.
Khat has been part of the culture of Somalia, Ethiopia and particularly the Yemen. It is the leaves of a bush and is chewed until it breaks down into a green paste. Khat is a stimulant but leaves the regular user ‘in neutral’ so that he or she loses interest in everyday issues. It can result in the loss of sex drive and is said to cause oral cancer.
‘I was chronically shy. I was the last person I know out of my generation to start on drugs. I was 13 when I was smoking cannabis.’ So wrote Denholm Elliot's daughter Jennifer. She continued, ‘The point is that you can't predict how you will react, even with cannabis. No one could have known how I was going to turn out after smoking a few joints. But you become tolerant to it. After I started smoking pot, I got into everything.’
Cannabis (also known as pot, grass, wacky backy, hash, weed, shit, dope or blow) is the most commonly used illegal drug in our society. It is now a readily accepted part of social life, especially among young people. The availability of ‘pot’ is amazing, no doubt accelerated by the fact that most police forces will no longer charge anyone with its possession the first time. Add to this the fact that a great many young people are being conned by the ‘cannabis is safer than alcohol’ brigade, and we have a recipe for disaster.
Facts about cannabis belie the myths! One article confirms that - in comparison with alcohol, which is water soluble - all 61 cannabinoids in the drug are only lipid or fat soluble. The consequence of this is that many of them remain in the body for far longer than alcohol does - up to 4 months, in fact. This 'hold-over' effect has been seen in pilots tested 24 hours after smoking just one ordinary-strength joint. They were unable to land their plane properly (fortunately they were in flight simulators).7
It has also been confirmed that ‘the tar content in a cannabis cigarette equals 12 tobacco cigarettes!’ 8 In the proceedings of a symposium in Paris involving 40 scientists from different countries the plenary session concluded that ‘The toxicity of cannabis is well established, experimentally and clinically. This drug adversely affects the central nervous system, the lungs, immunity and reproductive functions.’ Such conclusions are reinforced by over 10500 accredited scientific papers collected by the University of Mississippi, none of which give cannabis a clean bill of health.
Why then do people take cannabis? Because it makes them feel relaxed, talkative, gives them a sense of well-being, and makes some people giggle a lot. But what are the everyday problems associated with cannabis? Impaired judgement is a fact of life when people use pot, which makes driving cars or other complicated tasks something of a risky business - not only for them but for other people! Some people experience profound anxiety attacks or very disturbing hallucinations. One 19 year old sat in my office and told me, ‘Pot changed my attitudes. I used to try and forget my troubles, but they were still there and twice as bad in the morning. I also did not care what time I got up in the morning or whether I went to work or not.’ In addition to these psychological effects, smoking pot causes bronchitis and lung cancer.
But perhaps the problem which affects most cannabis users is that it can be a ‘gateway’ drug to other dangerous drugs. Having experienced instant gratification they want an even bigger ‘buzz.’
There are often other drugs available where you buy it; or as one person put it,’It's like going to get a packet of biscuits and ending up buying other things in the supermarket.’
Ecstasy use is extremely widespread; over 20% of adults in one survey in Scotland stated they took ecstasy frequently.9 Why do people use ecstasy? One reason is that it can give a calming affect which dissipates anger and hostility. At the same time it gives a heightened perception of colour and sound with a perception of increased energy and euphoria; no wonder it is used at raves! It is sold in tablet form (white, yellow or brown) going under names like white doves, disco burgers, Adams, New Yorkers, XTC, fantasy, 'E's.
What problems are normally involved with ecstasy? The list includes anxiety, confusion attacks, temporary paranoia, heightened sex drive, insomnia, depression; plus dehydration and exhaustion when used at raves. The other thing that has cropped up with so many other drugs is co-ordination problems, making using machinery and driving particularly dangerous. Ecstasy also lowers inhibitions, with implications for exploitation, sexual contact and HIV transmission. And because it is a stimulant it can be dangerous if you have a heart problem, high blood pressure, an increased tendency to epileptic fits or mental illness. An article in Blitz magazine described a worrying and growing situation: ‘Ecstasy casualties have rocked clubland. Week-end E-heads have complained of depression and paranoia after withdrawal. On the street, Tom is a young entrepreneurial type, a wideboy at the warehouse raves who now works in the City. “People ask you for things, you ask for things, you know what I mean?” He took E a few years ago when it was considerably more pure. ‘These days with the competition, everyone trying to sell E, you don't know what you're getting.’ He has personally avoided the smack-Es, but has observed the result. ‘You don't want to dance. You don't want to talk. You're in your own little world.’
Amphetamines have been around a long time; they were once sold as a nasal de-congestant. They were also given to troops in World War Two to keep them awake in combat. Amphetamines (or speed, uppers, whizz, ice) are the most commonly used stimulants, although experts expect ‘crack’ to take over in the not too distant future. Speed is normally sold as an off-white crystallized powder, and is usually ‘snorted’ through the nose, or injected by more serious users. People use amphetamines to keep awake to enjoy themselves, to party, and to give them confidence and apparently endless energy.
What are the problems and dangers associated with amphetamines? They give high-level mood swings coupled with paranoia, or even major mental disorder (psychosis). You lose your appetite, which is why they were once used as slimming pills. Users quickly develop a tolerance and need more and more speed to get the same effect. Feelings of acute anxiety may also exist even years after they have stopped using the drug. Further dangers are involved if a user has a heart problem or psychological disorder.
Cocaine and crack
Cocaine (also known as coke and snow) is often described as the ‘champagne’ drug because it is used in the City, whilst crack is associated with inner-city poverty and deprivation. But in reality the fact that the impact or ‘rush’ of crack is far greater than that of cocaine means it is used right across the class barriers. Both cocaine and crack are expensive compared with other drugs.
Crack (known as rocks) is cocaine converted into a very pure form, in which it can be smoked instead of injected, sniffed or swallowed. Crack carries with it a growing reputation of its impact on its users which has been described like this: ‘The difference between snorting cocaine and smoking it is like the difference between firing an air gun and a mortar. The user sets off on a steady downward spiral towards a state of depression and paranoia, as intense and agonising as the drug's high was euphoric. It is while sliding towards that state, desperate for more crack, consumed by the paranoid's angry view of the world enveloping him or her, that abusers are at their most dangerous. In that cycle, abusers can and frequently do explode into wild, irrational behaviour, violence and criminality. One of the legends of the New York police department's narcotics division is of a youth in a crack -induced state of paranoia who sliced off his grandmother's head with a kitchen knife, then went strolling through the neighbourhood carrying it by the hair as though it was a sack of groceries. Crack has been described as a marketing miracle. It might have been, but it was no accident. It was rather the consequence of a well-calculated strategy by the drug barons in the South American country of Colombia, the centre of the world's cocaine trade, using the same marketing acumen Procter & Gamble devotes to bringing a new soap powder to the marketplace.’ 10
Why are crack and cocaine used? Because they give a rapid stimulant affect bringing alertness and aggressive confidence. What are the problems? One drug rehabilitation worker put it this way: ‘Heroin users can go on for twelve years without losing their mental stability, but crack can provoke a crisis within two to three years because of its powerful effects.’ Other problems related to smoking crack include shortness of breath, severe chest pains, depression, nose ulcers, sleeplessness, weight loss, convulsions, and paranoid psychosis; as well as all the problems associated with the intravenous injection of any drug - HIV etc.
Two of the most commonly used hallucinogens are LSD (acid, tabs, tripe) and Liberty Cap mushrooms (mushies or shrooms). LSD (lysergic acid diethylamide) is illegal and is sold in minute quantitiesm often on sugar cubes or on small squares of printed blotting paper which are then put on the tongue. ‘Magic’ mushrooms are legal if they are eaten raw, but you could be charged with a criminal offence if you prepared them by drying or cooking them.
Why are LSD and Magic Mushrooms used? These substances are not addictive in the same sense as other drugs, but users are drawn back to experience the hallucinatory ‘trips’. In fact, various perceptual disturbances are more common than the hallucinations - distortion of colours, sight and sounds. The effect on the mind, however, is very dependent on the mental state you are in at the time you use the drug. The environment you are in also plays a part in the experience you enjoy or, alternatively, hate. Talkativeness or giggling incessantly are common results.
What problems are associated with hallucinogens? Flashbacks of ‘trips’ can be experienced even months after your last one. However, confusion, lethargy, depression and disorientation are more common experiences. Occasionally serious or fatal injuries are sustained as a result of acting up hallucinatory experiences, like thinking you can fly!
Once assumed to be the drug of the ‘loser’, heroin today is often the first drug of choice after alcohol or tobacco for some young people. It is also used in partnership with other drugs. Crack users, for instance, use it to minimise the dreadful depression which comes every time they use crack. Heroin (also known as H, junk, smack, horse or skag) is derived from the opium poppy. It invariably comes in the form of a greyish, brownish powder. It is injected, having been heated on a spoon with some water. Most people today, however, begin using heroin by ‘chasing the dragon’, which means sniffing the smoke from heroin heated on tin foil.
Some forms of synthetic opioid such as methadone are used as a means of helping heroin addicts. Methadone is either used to help them withdraw from heroin or, increasingly, to maintain addiction without the supposed need to buy heroin on the black market. Sadly most addicts will tell you it is very much more difficult to withdraw from methadone than it is from heroin.
Why do people use heroin? Because they enjoy the almost immediate sense of warmth, and because it makes pain or problems seem more tolerable. But what are the common problems and dangers involved in heroin use? Addiction to heroin develops very quickly. Some very basic problems are constipation, nausea, vomiting and abscesses. Withdrawal is very uncomfortable (although rarely as bad as portrayed in the media), and may be equated to extremely bad flu coupled with stomach cramp and insomnia, lasting anything from 7 to 14 days. Other dangers if you are injecting opioids include the risk of HIV, AIDS and hepatitis. It is also vital to be aware of the great danger of overdosing.
1 Hospital Doctor.
2 Office of Population Consensus and Surveys.
3 The Big Blue Book of Booze, Lifeline and Drinkline.
4 ‘Young People in 1992,’ John Balding, Exeter University Health Education Unit.
5 ‘Drugs and your Child’, Institute for the Study of Drug Dependence.
6 Health magazine.
7 Peter Stoker and Mary Brett, Policing Today.
8 ‘Research on the “Gateway Effect”: Alcohol, Cigarettes and Cannabis’ - Susan Kaplin, Life Education International.
9 ‘Drug Abuse in Scotland’, Scottish Affairs Committee.
10 Sunday Times.
This feature is written by David Partington. David is general secretary of ISAAC, the International Substance Abuse and Addiction Coalition, www.isaac-international.org.
© David Partington 2011.