Drugs and Alcohol

Know the risks

You can't smell it, taste it or see it. It can be deadly in very small amounts and it's on the streets of London.

Fentanyl is an opioid that can be 100 times more potent than morphine. And an even more toxic opioid - carfentanil which is 1000 times more potent - is making its way to London's streets.

An increasing number of young people are knowingly or unknowingly taking these illicit opioids and there are more overdoses as a result.

Protect yourself and those you love - know the risks and know the signs of an overdose.

"We know there is an increase in the number of people suffering from addiction and overdoses in London." 

"It doesn't matter who you are, how old you are, what your background is; this drug is crossing all lines and people are dying."

DET. SGT. ROB MERRIMEN, LONDON POLICE SERVICE, GUNS AND DRUGS SECTION

A MESSAGE FOR PARENTS

Stay calm and let them know that:

• fentanyl and other dangerous opioids can be mix into other drugs such as cocaine, heroin, ecstasy, and oxycodone
• trying any of these drugs - even just one time - could kill them if it's mixed with fentanyl or carfentanil
• fentanyl can be in pill, powder, patch or liquid form
• because it is mixed into other drugs, they may not know they are taking it

By having a conversation, you can decrease the risk of your child experiencing an overdose and increase the chance they could prevent it from happening to a friend.

A MESSAGE FOR YOUTH

The safest way to avoid illicit opioids is to take a pass on illegal drugs. But if you or your friends are going to take any illegal drug, don't use alone and make sure you know the signs of an overdose.

If you or a friend experiences any of the following signs, call 9-1-1 immediately:

• Difficulty walking, talking or staying awake
• Blue lips or nails
• Very small pupils
• Cold and clammy skin
• Dizziness and confusion
• Extreme drowsiness
• Choking, gurgling or snoring sounds
• Inability to wake up even when shaken or shouted at
• Slow, weak or no breathing

NALOXONE

Naloxone is a potentially life-saving drug that can temporarily reverse the effects of an opioid overdose. Essentially, it will buy some time to get emergency medical help.

If you use opioids, or are a friend or family member of someone who does, you are eligible to receive a free naloxone kit.

They are available in London at various pharmacies and community organizations.

RESOURCES

Further information about the use & effects of fentanyl can be found on the following sites: 

Middlesex London Health Unit

Alcohol and other Drugs section

YouTube videos resources - CBC

How fentanyl kills: A CBC News explainer

WHERE TO GET HELP

The following local treatment facilities are available for people suffering with substance abuse:

• Quinton Warner House
  477 Queens Avenue, London
  519-434-8041

• Addiction Services of Thames Valley
  200 Queens Avenue, London
  519-673-3242

• Ontario Addiction Treatment Centre
  425 Wharncliffe Road S., London
  519-204-8430

If you have any information regarding anyone involved in the illegal sale of any opioid, please contact your local police or London Middlesex Crime Stoppers at: 1-800-222-TIPS (8477)

If you have a substance abuse problem, there is help. You can also call if you are worried that someone you know needs help.

• Call the Addiction Services of Thames Valley at 519-673-3242
  • ADSTV provide screening, assessment, treatment planning and addiction treatment services to persons who are concerned about substance use, problem gambling, and other behavioural concerns. We provide support, education and treatment for family members.
• Go online to Narcotics Anonymous for information about meetings in your area to help you with your drug addiction
• Go online to Al-Anon/Alateen for information about meetings in your area for:
  • People with drinking problems
  • Friends and families of people with drinking problems

It may be hard to say "no" to someone who offers you drugs, but you can do it. It is your choice and your body. Do not let someone else decide what you should do.

You do not need drugs to make you feel grown up and you definitely do not need them to fit in. If you are stressed or depressed, using drugs or alcohol will not make it any better and it might make it worse. Do not be afraid to talk to someone or ask for help. If you are worried about talking to your parents, call the Kids Help Phone. It is free and you do not have to tell them who you are.

If the pressure to take drugs or drink alcohol is getting to you, remember that you can:

• Ask for support and help from friends and family
• Leave if you are somewhere people are trying to get you to do drugs
• Do not go to parties or events where you know there will be drugs or alcohol
• Make friends who respect your decisions; even if they do drugs, a true friend would respect your choice not to use them and would not pressure you

We hope you choose not to use drugs or alcohol. It is not because you might break the law, but because they can ruin your life. The risks just are not worth it. There are other ways to feel good, relax and have fun. Maybe you are already using drugs or alcohol or maybe nothing anyone says will stop you.

If you are going to take drugs or alcohol we want you to think about what you plan to do before you do it.

If you are going to drink alcohol, remember to:

• Eat before you go out and eat throughout the night; food helps slow the absorption of alcohol
• Drink in moderation
• Keep an eye on your drink at all times, do not accept drinks from people you do not know
• Never drink and drive
• Never get in the car with a driver who has been drinking
• Plan your night; set a drink limit and stick to it
• Pace yourself; drinking too fast can lead to getting drunker than planned
• Do not play drinking games. They are just too dangerous. Period.

If you are going to use drugs, remember to:

• Know what you are taking and know how to reduce the risks of injury or overdose
• Tell a friend what you are using; if anything goes wrong and you need medical assistance, this can save your life
• Never accept drugs from people you do not know
• Never take something if you do not know what it is
• Be careful with any drug; whether it is cannabis, ecstasy or something else, there could be other drugs like cocaine or methamphetamine mixed in
• Never drive if you have consumed drugs and do not get in the car with a driver who has
• Remember that prescription medications can be lethal if taken improperly
• Never share needles

• If you or someone you are with requires medical attention because of alcohol or drugs, call 9-1-1 immediately
• Do not be afraid of getting in trouble; your life or someone else's is far more important
• Although we may attend with paramedics, we are more concerned about people's safety and health than any illegal activity

Alcohol is legal in Canada and the government controls sales of alcohol, restricting it to people nineteen years of age and older.

A standard drink has 13.5 grams of alcohol. The following beverages contain one standard drink:

• 341mL (12 ounces) of beer at 5% alcohol content
• 142mL (5 ounces) of champagne or table wine at 12% alcohol content
• 43mL (1.5 ounces) of hard liquor at 40% alcohol content

Remember that at a bar or restaurant the drinks are usually standard. At home, the amount of alcohol depends on how strong you make the drink or how much you pour.

 Effects

Alcohol is a central nervous system depressant with effects that get stronger the more you drink. The effects include:

• Feelings of relaxation
• Loss of inhibitions - you will do things that you otherwise would not
• Loss of motor control like hand-eye coordination
• Slurred speech
• Confusion
• Impaired senses
• Reduced life expectancy

Over three million people die every year due in part to alcohol (approximately 6% of all deaths globally). Alcoholism can reduce your life expectancy by ten years.

Overdose

Acute alcohol intoxication can cause death in less than an hour and you should call 9-1-1 if you feel you or someone you know may have overdosed. Keep an eye on friends or family members who have consumed a great deal of alcohol in a short time period and be careful with your own consumption.

Signs of intoxication

When alcohol intoxication reaches dangerous levels, users may show the following symptoms:

• Deep sleep
• Very noticeable loss of coordination
• Moist skin (excessive sweating)
• Cold skin (hypothermia)
• Loss of bladder control
• At risk of death by inhaling vomit

• Loss of feeling
• Loss of consciousness
• Loss of reflexes
• Loss of bowel control
• Noticeably depressed breathing
• Death by respiratory failure (stops breathing)

What should you do? 

If a person you are with shows the above signs of intoxication:

• Call 911
• Watch to ensure they continue to breath until EMS arrives

Cocaine comes from the dried leaves of the coca plant and is generally a powder. Users "snort" the cocaine (inhale it through the nose) but may also smoke or inject the drug.

"Crack cocaine" (crack) is made from cocaine and turns the powder to a "rock". A user will heat the rock and inhale the smoke. Crack cocaine and cocaine have similar effects; the effects of crack cocaine are immediate and more intense in part because it is smoked.

What else is in cocaine?

Cocaine is rarely pure; dealers cut it with other substances to sell more while using less of the actual drug. From sugar to gasoline, dealers will put just about anything into it to make more money. Recent cocaine seizures by our Service have tested at only 35% purity. That means that 65% of what was presented as cocaine was actually something else.

Effects

Cocaine is a major stimulant of the central nervous system and has the following initial effects:

• Euphoria
• Suppresses appetite
• Reduces fatigue
• Increases pain tolerance
• Causes feelings of intellectual and physical prowess

As time passes since the initial dose, the following occurs:

• The euphoria wears off
• Feelings of unease and anxiety start
• Anxiety and agitation increases
• Users often use alcohol, sedatives or marihuana to reduce the negative feelings or so they can sleep
• This is often why users take more hits

Dangerous effects

• Contraction of blood vessels deprives the tissues of necessary blood and can lead to tissue death
• Irregular heartbeat and high blood pressure can lead to stroke
• Mental health problems in susceptible users or heavy cocaine users, including:
  • Psychological disorders
  • Intense mood swings
  • Paranoia
  • Delirium
  • Hallucinations
  • Panic attacks
• Increases mental activity leading to memory problems and insomnia
• Reduces inhibitions and can cause feelings of power and superiority; this can lead to violence, sexual aggression and other criminal behaviour

Dependence

Cocaine is a powerful stimulant and leads to dependence (addiction). This makes cocaine very hard to stop using.

Ecstasy (also known as "E", "X", and "Molly") contains the chemical MDMA (3,4-methylenedioxy-methamphetamine) which was developed as an appetite suppressant. Ecstasy got popular as a rave drug but has now spread to bars, clubs and any other party locations.

Most users swallow ecstasy tablets but the drug can be snorted, smoked, or injected.

What else is in ecstasy tablets?

The dose of MDMA in an ecstasy tablet averages around 60-70mg, however there may be no MDMA at all in a tablet or as high as 120-130mg. In place of MDMA, or in addition to it, other substances from soap to methamphetamine may be found.

Effects

Ecstasy is a psychoactive substance that has stimulant and hallucinogenic effects, such as:

• Excitation, feelings of physical and intellectual prowess (superiority)
• Suppression of fatigue, hunger and pain
• Hallucinogenic effects are minor and occur generally only with high doses

The initial effects of ecstasy include:

• Slight anxiety
• Raised blood pressure
• Increased heart rate
• Clenched jaw muscles
• Damp skin
• Dry mouth

• Users then experience the following:

• Euphoria (feelings of wellbeing and satisfaction)
• Relaxation
• Enhanced self-confidence
• Lowered inhibitions
• Reduced fatigue
• Heightened senses and experiences of emotional communion and openness
• Feelings of relatedness to others and to the self (generating states of empathy and understanding)
• As the positive feelings wear off, users experience:
• Tiredness
• Sadness
• Depression (which can last for a few days after taking the drug)
• Irritability
• Panic attacks and anxiety
• Nightmares

Dangerous effects

Frequent users may experience:

• Weakness
• Mood swings
• Aggressive behaviour
• Serious long-term psychological issues

Dangers of taking ecstasy include:

• Dehydration and an increased body temperature is the short term danger
• Rapid and irregular heartbeat, high blood pressure and other heart problems can appear
• Serious or fatal cases of hepatitis (inflammation of the liver) in regular users
• Interactions with other substances, whether in the tablet or taken separately
• Interactions with prescription medications such as Viagra, certain AIDS medications and some antidepressants
• It is very dangerous for people with irregular heartbeats, asthma, epilepsy, kidney disease, diabetes, chronic fatigue, and/or psychological disorders

Dependence

People can quickly develop a tolerance to ecstasy; they then have to take more and more to feel the effects they felt the first time. Ecstasy may also cause a psychological dependence.

GHB (gamma hydroxybutyrate) is a central nervous system depressant. GHB is a party drug and comes in powdered form, capsules, and small vials of clear, odourless liquid. GHB is often dissolved in or mixed with alcoholic beverages and has very little flavour (there is a slight salty, soapy taste).

Since GHB is colourless, odourless and nearly tasteless, offenders may slip it into a person's drink without their knowledge. Offenders take advantage of GHB causing a drunken state, a possible loss of sexual inhibitions, and memory loss. That is why GHB is referred to as a date rape drug.

Effects

The following effects occur in order with increasing doses of GHB (and closely mimic the effects of alcohol intoxication):

• Reduced anxiety
• Muscle relaxation
• Disinhibition
• Euphoria (sensation of wellbeing and satisfaction)
• Sedation
• Sleepiness
• Loss of coordination
• Hypnotic state
• General loss of feeling
• Coma
• Death

Dangerous effects

High doses of GHB can also cause convulsions and hallucinations. When paired with alcohol, high doses of GHB can lead to coma or death.

High doses of GHB, as with high doses of alcohol, can lead to a user falling unconscious. This effect, along with amnesia, is what allows offenders to use the drug to facilitate criminal activity such as sexual assault.

Dependence

Much like alcohol, GHB is susceptible to abuse because of the pleasant effects of the drug. Prolonged use leads to tolerance that requires the user to take more and more to achieve the same effect. Users can become physically dependent on GHB and can experience withdrawal symptoms if they stop using suddenly. The main withdrawal symptoms are:

• Anxiety
• Insomnia
• Trembling
• Muscle cramps

Heroin and morphine are opiates derived from raw opium. Raw opium comes from the seedpods of a species of poppy flower and looks like a milky white sap. Producers collect the sap and it is dried and processed into heroin.

Opioids are artificially made opiates that have the same effects. Some common opioids are Hydrocodone, Oxycodone, Methadone and Fentanyl.

Heroin comes as a white, beige or brown powder. Users dilute and heat the heroin and then inject it (or they snort or smoke the drug).

Opioids are generally in pill form and take on different shapes and sizes. Fentanyl is a patch that can be placed on your body.

Effects

Opiates and Opioids are central nervous system depressants. The effects are:

• A powerful analgesic (pain-killing) effect
• Euphoria including feelings of tranquillity
• Powerful anti-anxiety and antidepressant effects

After the initial feeling or "rush", the user experiences:

• Sleepiness
• Possible nausea
• Dizziness
• Slowed breathing
• Reduced heart rate

Users often seek the anti-anxiety and antidepressant effects to ease psychological pain and suffering or the analgesic effects to ease chronic physical pain.

Dangerous effects

Opiates and opioid overdoses are quite common; each year roughly 1% of addicts die from overdoses. The overdose causes slow breathing and loss of consciousness and, if severe enough, breathing can stop entirely and cause death.

A danger of opiate and opioid use is risk of infection from dirty or shared needles. HIV, AIDS, hepatitis B and hepatitis C are common among intravenous drug users despite efforts to provide safe injection kits and clean needles to users. These efforts have reduced, but not eliminated, needle-sharing and new cases of infections among users.

Fentanyl patch abuse can be extremely dangerous. One Fentanyl patch is designed to slowly release small amounts of the drug into your body over a period of 72 hours. Cutting open the patch will exposes all of the fentanyl at once which greatly increases the risk for overdose and death.

Dependence

Opiates and opioids are extremely addictive; users quickly become dependent. The physical and psychological dependence is very strong and users experience strong cravings.

Inhalants are a group of substances, which, when the user inhales their fumes, produce psychoactive effects. Many of these substances are household, industrial and medical products and fall under three categories:

• Volatile solvents
• Nitrites (known as "poppers")

Volatile general anaesthetics (nitrous oxide, ether, chloroform)

Volatile solvents

Volatile solvents are powerful, inexpensive and easily available psychoactive substances. They include substances such as:

• Various glues
• Lacquers
• Varnishes
• Spray paint
• Paint thinner
• Gasoline
• Correction fluid (white-out or Liquid Paper)
• Cooking sprays
• Refrigerants
• Cleaning fluids
• Other household and industrial uses

Effects

      The effects of volatile solvent are similar to alcohol intoxication, however with almost instantaneous effect.

Dangers

Solvent abuse has severe health risks, including:

• Mental health problems
• Blood and liver disorders
• Disorders of the neuromotor, cardiovascular and respiratory systems

Dependence

Long-term abuse can lead to withdrawal symptoms when trying to quit; these symptoms are similar to withdrawal from alcohol and heroin.

Nitrites

Nitrites, also known as poppers, consist of two main chemicals: amyl nitrite and butyl nitrite. Both are volatile liquids and have medical uses for dilating blood vessels to treat certain heart conditions.

Effects

The effects of inhaling the vapours of nitrites are almost immediate, but very short-lived lasting only two to three minutes. The user experiences:

• Feelings of euphoria
• Sexual arousal
• Feelings of inner heat

There are also undesirable effects that are just as immediate, including:

• Dizziness
• Headaches
• Buzzing in the ears
• Pressure behind the eyes
• Light sensitivity

Dangers

Nitrites are a vasodilator - a substance which causes blood vessels to dilate (widen). The dilated blood vessels can hold a larger volume of blood and this deprives the brain of oxygenated blood. In high doses, nitrites can cause:

• Fainting
• Extreme dizziness
• Loss of consciousness
• Depressed breathing

Long-term use causes a number of problems including:

• Runny nose and sneezing
• Inflammation inside the nose
• Yellowish crust around the nose and lips
• Septum damage (the dividing wall between the nostrils)
• Facial swelling and redness
• Distorted perception
• Serious form of anemia
• Temporary erectile difficulties

When used with other vasodilators, nitrites can cause cardiovascular collapse, while use with other psychoactive substances can cause toxicity issues in the body.

Dependence

Regular use can lead to psychological dependence; however, there is little physical dependence and no withdrawal symptoms.

Nitrous Oxide 

Also known as "laughing gas", nitrous oxide is a liquefied gas stored in metal cylinders. It is used for pressurization, as an aerosol propellant (as in whipped cream containers) or for general anaesthesia in surgery.

Effects

Nitrous oxide causes the following:

• Euphoria (often accompanied with uncontrollable laughter)
• Sedative effects
• Headaches
• Altered consciousness
• Distorted vision and hearing
• Agitation
• Anxiety
• Nausea
• Vomiting
• Muscle weakness

Dangers

The effects of nitrous oxide come on very quickly and dissipate very quickly which may lead the user to inhale more and more of the gas. The immediate risks of nitrous oxide use include:

• Suffocation due to lack of oxygen
• Suffocation due to aspiration of vomit (inhaling vomit into the lungs)
• Risks increase when mixed with use of alcohol, marihuana, and/or ecstasy

The long-term effects cause vitamin B12 deficiency which causes nervous system disorders such as trembling and poor coordination. Chronic use can also cause falls and result in severe injuries.

Dependence

There does not appear to be any physical dependence, however users can become psychologically dependent on nitrous oxide due to the euphoria the substance causes.

Ketamine is an anaesthetic developed for veterinary use and is a hallucinogen closely related to PCP (phencyclidine). Ketamine ("Special K", "Vitamin K", and "Ketty") comes in the form of tablets, capsules, crystals, liquid, and powder. Ketamine can be swallowed, snorted, smoked, or injected.

Effects

Ketamine has a similar effect to PCP, however the effects are shorter lived (approximately one hour) and less intense. Users often take ketamine with a stimulant so that the combination mimics the effects of ecstasy.

Dangers

While there may be seemingly positive effects of ketamine, remember that it is an anaesthetic and can be very dangerous when used outside of a controlled medical environment. The dangers include:

• Loss of consciousness
• Nausea
• Vomiting
• Risk of suffocation from inhaling vomit
• Psychological problems (anxiety and panic attacks)
• Neurological problems (temporary paralysis)
• Toxic psychosis

An overdose of ketamine can cause the user to stop breathing and ultimately cause the heart to stop beating, obviously leading to death.

Dependence

Ketamine users become tolerant to the drug easily and require higher and higher doses to achieve the effects they are seeking. Ketamine can lead to both physical and psychological dependence.

LSD (lysergic acid diethylamide) is a human-made chemical that comes from lysergic acid amides (taken from a parasitic fungus called rye ergot that grows on rye and other grains).

Sold as a "blotter" (a piece of paper that a drop of LSD had soaked into) or as tablets or liquid, users take the drug by mouth.

LSD is rarely found in London today.

Effects

LSD causes hallucinations and intense changes in sensory perception. Users may also experience delirium and uncontrollable laughter. The effects are very powerful and can last five to twelve or more hours.

Dangers

LSD users can panic and may become dangerous to themselves or to others, even people who are trying to help them (called a "bad trip"). To calm them down, taking them to a quiet and dimly lit room can help. Do not give them alcohol as this may make things worse.

Use of LSD can lead to serious and potentially lasting mental illness. When coming off the drug, users can experience numerous side effects including:

• Extreme anxiety
• Panic attacks
• Paranoia
• Phobias (irrational fears)
• Delirium

Dependence

There is no physical dependence and no withdrawal symptoms. Some users may become psychologically dependent, but the urge to continue use is not as strong as with heroin and cocaine.

Cannabis causes, in low doses:

• Euphoria
• Calmness
• Drowsiness
• Spontaneous laughter
• Paranoia
• Anxiety

High doses of cannabis can cause:

• Lethargy
• Problems with visual perceptions
• Problems with perception of time
• Difficulty performing various tasks
• Short-term memory problems

 The physical effects of cannabis vary, but include:

• Swollen blood vessels (leading to red eyes)
• Reduced saliva production (leading to dry mouth)
• Increased heart rate
• Reduced blood pressure

The effects set in within minutes of smoking cannabis and within approximately thirty minutes of consumption of edibles (food made with cannabis as an ingredient, such as brownies, candies, etc.). Effects last for approximately two to six hours.

 Dangers

Cannabis is less dangerous than many other psychoactive substances but there are still risks associated with its use.

Cannabis however does impair your abilities, especially when operating a vehicle or machinery. Using cannabis before driving makes you two to three times more likely to get in an accident than a sober driver. It is against the law to drive while impaired by a drug or by alcohol.

THC, the psychoactive chemical in cannabis, has a very low toxicity; there have been no known fatal overdoses. Cannabis use can cause psychotic episodes; however, they generally resolve themselves within minutes or hours.

Smoking any substance results in the inhalation of organic and non-organic chemicals and carcinogens. The tar produced is similar to that produced by smoking tobacco and there have been over fifty known carcinogens found in cannabis smoke.

Doctors suspect that cannabis use contributes to cardiovascular disease; however, more evidence is required. Heart attacks and strokes may be associated to cannabis use, though it is difficult to isolate a cause as cannabis users may also use tobacco, alcohol, and other drugs.

Chronic heavy cannabis smoking is associated with bronchitis symptoms including wheezing and coughing. Compared to non-smokers, those who smoked cannabis chronically as youth had reduced connectivity in the parts of the brain linked to memory, learning, alertness, and cognitive behaviour control.

For users who are vulnerable, cannabis use can lead to hallucinations and altered perceptions. This may cause the users to suffer from breakdowns and extreme anxiety. There are also concerns that cannabis use by young people may increase their risk for schizophrenia.

 Dependence

Withdrawal symptoms can include:

• Cravings
• Irritability
• Boredom
• Anxiety
• Trouble sleeping

 Medical usage

There is evidence to support the use of cannabis in treating medical conditions. Cannabis is legal in some countries and states for medical use, but a prescription from a doctor is required.

Medically, cannabis can:

• Reduce nausea and vomiting during chemotherapy
• Improve appetite in those with HIV/AIDS
• Treat chronic pain
• Help reduce muscle spasms

Legality

It is legal to buy, use, possess and grow recreational cannabis in Canada within certain limits and in certain locations for those 19 years or older.

If you intend to buy, use, possess or grow recreational cannabis, you are responsible for ensuring you learn the limits established at the national, provincial and municipal level.

For more information, visit the Cannabis FAQ page.

Mescaline is the primary active ingredient in peyote, a small variety of cactus found in Mexico and Texas. Removing and drying the cactus heads into "buttons" increases the mescaline content. Users then chew the buttons or soak them in water to drink.

The indigenous peoples of Mexico have used mescaline in religious ceremonies for over five thousand years.

It is hard to find mescaline in Canada; most "mescaline" sold here is actually PCP. Mescaline is a hallucinogen similar to LSD but with somewhat different effects.

 Effects

The central effects of mescaline are fewer than those of LSD are and include:

• Euphoria
• Heightened senses
• Short-term memory impairment
• Impaired concentration
• Hallucinations
• Altered perceptions of shapes, colours, time, and space

The peripheral effects are stronger than those of LSD are and include:

• Altered vision
• Dilated pupils
• Increased heart rate
• Increased blood pressure
• Increased body temperature

 Dangers

Mescaline intoxication is similar to LSD and often described as a "bad trip" which is a series of reactions including:

• Anxiety
• Panic
• Loss of self
• Loss of control over oneself
• Loss of control over one's environment
• Dangerous behaviour

Chronic use can lead to:

• Decreased motivation
• Mood disturbances
• Flashback hallucinations

Dependence

Users develop a tolerance to mescaline even after having only taken it for a few days, but the tolerance is quickly lost once the user stops taking the drug. There is no known physical dependence to mescaline although users may experience psychological dependence.

Methamphetamine is a strong central nervous system stimulant known as "meth", "crystal meth", and "speed". While compounds of methamphetamine do have medical uses, many doctors prefer to use safer alternatives. Meth can be swallowed, smoked, snorted, or injected.

Methamphetamines come in tablet and powdered forms, or in crystalline shards ("crystal meth") which are generally a purer form of the drug.

Effects

Methamphetamine induces euphoria and alertness; this makes it popular for recreational use. At lower doses, effects include:

• Elevated mood
• Increased alertness, concentration, and energy
• Reduced fatigue
• Reduced appetite
• Hyperactivity
• Excessive sweating
• Dry mouth
• Teeth grinding (leading to "meth mouth")

Dangers

Methamphetamine is a very dangerous drug with numerous negative effects. At higher doses, effects include:

• Psychosis
• Seizures
• Brain hemorrhaging
• Rhabdomyolysis (muscle damage which can lead to kidney failure)

Chronic use at high doses can cause:

• Unpredictable rapid mood swings
• Delusions
• Violent behaviour
• Damage to the brain (reduction in gray matter, damage to dopamine and serotonin neurons)
• Anxiety
• Depression
• Increased risk of suicide

Users and addicts can lose their teeth quickly. "Meth mouth" is more severe in users who inject the drug. Factors contributing to "meth mouth" include:

• Dry mouth
• Teeth grinding
• Poor hygiene
• Frequent consumption of high-calorie carbonated beverages

As with any injectable, there is a high risk of transmissible diseases including Hepatitis A and B, HIV, and AIDS.

Dependence

Users rapidly become tolerant to methamphetamine and need to increase the amount used to get the same effects. Methamphetamine is highly addictive and withdrawal can last three to four weeks after a chronic user's last dose. Withdrawal symptoms include:

• Anxiety
• Extreme cravings
• Low mood
• Fatigue
• Increased appetite
• Lack of motivation
• Changes in sleep patterns
• Vivid and/or lucid dreams

PCP (phencyclidine) is a highly toxic hallucinogen known on the street as "angel dust". In a pure state, PCP is a white powder that dissolves in water and alcohol; on the street, users buy it as powder, tablets, or capsules. A standard dose is approximately 5 to 10 mg. PCP is cheap and easy to make; some dealers and users cut other drugs (marihuana, cocaine, and LSD) with PCP to sell more or to increase their effects.

Effects

PCP alters perceptions in similar ways to LSD and has properties typical of both stimulants and depressants, including:

• An anaesthetic (pain-killing) effect
• Euphoria
• Relaxation
• Memory issues
• Dissociative feelings
• Hallucinations

Dangers

There are traumatic psychological effects associated with PCP use including:

• Disordered thoughts
• Feelings of alienation
• Paranoid symptoms
• Delirium
• Bizarre or violent behaviour
• Psychotic states (which can persist for months after use)

An overdose of PCP can also cause rhabdomyolyis, a muscle metabolism disorder, which can lead to kidney failure due to the metabolic waste. Overdoses and severe side effects can occur at doses just above the typical dose.

• Doses over 10mg (for users without a tolerance) can cause:
  • Delirium
  • Muscle rigidity
  • Muteness
  • Severe sedation
  • Stupor (state of near-unconsciousness)
• Doses exceeding 20mg can cause:
  • Convulsions
  • Coma
• Doses reaching 150 to 200 mg death usually occurs, caused by:
  • Kidney failure
  • Brain hemorrhage
  • Heart failure
  • Respiratory failure

Authorities consider PCP to be one of the most dangerous recreational drugs. Even though it can cause death in large doses, accidents and suicide are also contributing causes to PCP-related deaths.

Chronic PCP intoxication can lead to cognitive, behavioural, and psychiatric problems.

Dependence

Psychological dependence can occur due to PCP stimulating the pleasure and reward centres in the brain causing users to become obsessed with the desire to take more of the drug. Physical dependence is rare.

Psilocybin is a naturally occurring hallucinogen found in over 200 species of mushroom. Users eat the mushrooms ("magic mushrooms" or "shrooms") either fresh or dried. A typical dose is from 4 to 10 mg, which requires the user to eat between 2 and 40 mushrooms (depending on the size and type).

Effects

The hallucinogenic effect of psilocybin is about ten times less than that of LSD. Effects generally last for three to six hours. Other effects include:

• Disorientation
• Lethargy
• Euphoria
• Joy
• Depression
• Anxiety
• Paranoia

Physical effects include:

• Changes in heart rate
• Changes in blood pressure
• Dilated pupils
• Nausea
• Tremors

Psilocybin can influence how the user experiences time; it can appear that time has slowed down.

Users who have a pleasant experience with the drug report feeling connections to others, nature and to the universe.

Users who have a bad experience with the drug report experiencing fear, unpleasant feelings and dangerous behaviours.

Dangers

Some users may experience hallucinations for up to four days after taking psilocybin.

Use of psilocybin with alcohol or other drugs can increase the chances of a bad experience as can using during a low period emotionally or physically.

"Bad trips" can cause psychotic episodes marked by:

• Extreme anxiety
• Extreme confusion
• Extreme agitation
• Extreme disorientation
• Accidental injuries
• Self-injury
• Suicide or suicide attempts

Dependence

Tolerance to psilocybin can form quickly when used more than once a week, but the tolerance wears off just as fast.

There is no evidence to suggest that psilocybin leads to either physical or psychological dependence.