The Risks of Drugs

[Dr Bunsen]

The Risks of Drugs


This information has been produced to help people who use drugs to do so more safely.

Almost any human behavior involves some kind of risk. The principle of managing risks and hazards is a simple one:

Assess the risks
Plan appropriate action
Implement the plan
Review risk assessment
...and repeat as necessary.

If this sounds simple, it's because it is. Any drug use involves risk. If you use drugs you can minimise the possibility of harm by assessing risks and reducing them.

So, what are the risks?

Assessing the risks

There are lots of ways of assessing risks. One simple way is to break the task down into smaller tasks. Thinking about the context of 'drug use' in smaller chunks. Thinking about the things that will affect the experience, and the risks involved.

Way back when, the man (man) who is widely believed to have created the sixties mantra encouraging hip young things to "turn on, tune in, drop out", Timothy Leary, also came up with some ideas about what affects people's LSD trips.

The Drug - the quantity, purity and drugs used

The mind Set - how someone is thinking-feeling, how their mind is 'set' at the beginning of the experience

The Setting - the people and location, the environment, whatever is happening on the outside of the person

The idea is that any change to the Drug, Set or Setting will significantly change the experience...and you want 'good' experiences, so choose contexts that will produce 'good' experiences.

It can also be a useful way to think about risks. Just a simple way of organising some questions that you could ask yourself, so you can assess the risks. You don't have to answer them all, right now. If you want time to think about it first, this might be a good time to choose File > Print, or click on that print icon.

Some simple questions, to help you think about risk. Honesty is important, by the way.

'Drug' risks

What specific risks are linked to the drug?
Have you used the drug before?
What are the likely physiological effects?
What are the likely psychological effects?
What will the after-effects be?
What quantity will you be taking?
What will the purity be?
How much do you trust the supplier?
How will you be taking the drug?
and so on...

'Set' risks

How happy are you (scale 1 to 10)?
Are you feeling stressed?
Are you feeling anxious?
Are you trying to avoid something?
Do you use everyday?
Can you afford it?
How do you cope with 'difficult' feelings?
Anything you're not coping with?
Are you feeling pressured?
Would it be OK if you couldn't take it?
Any important meetings tomorrow?
Do you have fun without using drugs?
and so on...

'Setting' risks

Can you control the environment?
Will other people be around?
Will you be with friends?
Do you mix with people who don't use?
Will someone get help if you need it?
Will someone be able to use a telephone?
Can you get away or get home easily?
Will you need to drive?
Will the environment be safe?
Will you need to cross any roads?
and so on...
...and there are lots of other questions, too.

Planning appropriate action

Well, it's not rocket science. You've asked yourself a whole bunch of questions. Some were easier to answer than others. Some you weren't sure about. Some led you to go off and do more research, find out more things about different drugs and what different people think they might or might not do to you. Some research is fruitless, and some bears fruit that you're not sure about. The important thing is that you're thinking about risks. You've already got some way of deciding what risks you're prepared to take in life, and you're just applying some of that thinking to this behavior.

So, if normally you're the kind of person who uses a pedestrian crossing to cross a busy road, your 'acceptable risk threshold' will be different to someone who just runs across that busy road wherever they want, without looking, believing that either 'all cars will stop' or that 'God (or whatever) will protect me'. And I guess that's the 'art' in all of this. It's about what works for you. About how important safety is for you. About how important it is for you that you keep on being able to keep on enjoying the things you enjoy in just the way that you enjoy them, now.

So you spend some time thinking, and maybe talking, and maybe even writing some things down. And you've identified some of the risks that you know you'll be exposing yourself to, and so now you plan some action that will reduce that risk.

It's simple. If you want to make sure you're near a telephone, make sure you've got a mobile or you know someone who has. If you're going clubbing with some friends, discuss what you'll do if one of you starts feeling faint, or dizzy, or loses consciousness. Check you know where exits are. Carry condoms. If you're taking something for the first time, take a little at first. Find out what the effects will be, and how long it takes to work.

Sometimes it's the effect of a drug on our body that can cause harm. Sometimes it's risky because of what we do.

Drugs affect how we think-feel, our behavior and our perception of the world. Some risks are about these changes - your behavior might become less inhibited; you might be more likely to have unsafe sex, react aggressively to situations or make decisions which you later regret. All substance use changes your perception to some extent. This can make a 'normal' activity like crossing the road or walking up stairs more dangerous than usual. Plan ahead!

Implementing your plan

So you spend some time thinking, and assessing risks, and planning. The only thing left to do is to put you plan into action. Become the safer drug user that's just bursting to get out. If you've got this far, it would be a shame to waste all the time you've already invested by not following through.

Most changes won't take any energy. It'll just be about doing something in a slightly different way, sometimes. Some people say they take drugs because of the risk, and to make it safer makes it less fun. The same must be true of driving, or sex, or hang gliding, or cycling, or air travel, or any of the myriad other fun things we do every day that involve risk. I guess we all have our own acceptable risk threshold.

Reviewing your risk assessment

...and keep on keeping on. The more you do this, the easier it is. Go back over the Drug, Set and Setting thinking. What's changed? What's new? What could be improved? What more could you learn? How could you find out more about the drugs you use?

Experiment - Recreation

...and sometimes the risk has very little to do with the drug, and everything to do with your relationship with drug use.

Everyone who uses any drug starts of as an 'experimental' drug user. Indiscriminate, occasional, not knowing what to expect, affected by things like what their friends are doing, what's available, what's current.

Some people use once or twice, and leave it there. Some because they noticed they liked it too much, clever people. Others for other reasons.

...and other people keep on using, as time goes on, more often. The vast majority of people who use drugs describe their drug use as 'fun', 'for pleasure', 'something to do' and not a problem, at all. I'd call them 'recreational' drug users. People who do it for leisure, or for pleasure.

It's not about the drug, it's about the person. I'd say there is no such thing as 'a recreational drug'. And yet, I'd say that most drug use is 'recreational drug use'. So what's going on?

In my mind, there is a big difference between taking a drug to change how you feel and taking a drug to enhance how you feel. Or taking a drug to get away from things, and taking a drug when you've nothing you want to get away from.

Some people notice they like drugs too much, and stop using them. They notice that drugs work, in the short term.

Taking anything to lift you out of a depression, give you energy, brighten up your weekend, make you feel happy or relieve you from stress will only ever produce short term results. It seems a bit obvious, and drugs don't take problems away. They can mask problems, or make them seem less important, and they don't resolve them.

One of the risks of drug use is that they can give you the illusion of improving your life. Some people describe 'life changing' and 'very positive' experiences both during and after using a drug. "So what?" you might say. "How is that at all risky?" The danger is that someone who uses a substance to improve their mood, to deal with an unchanging situation, to meet a need that isn't met anywhere else in their life will have to continually use the substance to keep on having that experience.

Hello dependence. Welcome to addiction. If you like it too much, it can easily take over your life. No, really. Until you start to notice that you're using whatever a lot of the time, and other things a lot, too. And all your friends seem to be using. And a lot of your money is going that way. And it's affecting your physical health, and your mental health, and your relationships with other people, and work or school or whatever, and money, and, well...just about everything. And it's not really fun like it used to be. So you get stoned again...

Most substances (especially hallucinogens) enhance and amplify our feelings - taking LSD when you're in a 'bad' mood is pretty unlikely to result in a 'good' experience. And notice how subjective that is. Drugs that dull how you feel will not make you feel happy if you're feeling down. They'll just make you feel a whole lot less bothered about feeling down. They'll also tend to make you feel a whole lot less bothered about doing anything about it, too.

I don't have a drug problem

Great! And what could you do to keep it that way? When we get down to the individual, you yourself will know better than anyone else what problems your drug use causes in your life, if any. You also know best what you get out of using drugs, and what you want more of in your life, now.

Most people are organised in a fairly straightforward way. As long as the rewards of virtually any behavior outweigh the cost, they'll keep at it. Even when it seems entirely irrational from the outside, it all makes absolute sense. Even if the only benefit is familiarity, and the whole behavior has become a conditioned response, a habit, it's entirely coherent.

When you're deciding whether you want to change your behavior or not, it's usually a lot easier to change behavior before it's become a habit. You've got a lot less to unpick, so to speak. If the choices that you make and the decisions that you follow and the behaviours that you do are reflected in the patterns of neural pathways in your brain, you'd be best advised to make sure that the really wide pathways, the roads, the motorways, the well-traveled routes that you travel most often are the ones that help you to get more of what you want in your life, now and in the future. Or start building new ones.

Dependence?

Some drugs cause a 'physical dependence'. In essence, this means that if you consume the substance regularly, a time will come when you will become ill if you do not consume the substance.

The key milestones in this process are:

Regular use: because it won't happen unless you use the drug on a regular basis

Tolerance: when you need to take more of the drug to have a similar effect

Withdrawal syndrome: when observable signs and symptoms are experienced if the drug isn't used

There are clearly strong links with the 'addiction' model listed below, and a physical withdrawal syndrome will really reinforce the idea that you need the drug.

Some people talk about a 'psychological dependence'. This could also be languaged as 'addiction', using the model below.

Addiction?

I don't know how many different newspaper reports and articles I've read about 'drug addicts...' this and 'alcoholic...' that. The terms seem almost interchangeable with so many other labels describing the often vulnerable and socially excluded people (two more delightfully vague labels) who have a drug problem.

Lots of myth and anti-drug propaganda is based on the idea that the main risk involved in substance use is a 'long slippery slope' inevitably leading to addiction and death. 'Drug addicts' and 'alcoholics' as powerless victims of the demon that has them in its merciless grip. This idea is mistaken and misleading.

It might be more helpful to think about addiction as a manifestation of dependence, needing the drug to stay well, feel OK, to keep it together.

It might be helpful to consider the idea of a 'problem drug taker', someone who takes drugs and has a co-existing social, financial or health problem that is related to the drug use in some way.

About 1 in 30 drug users is thought to develop significant problems linked to their drug use in some way (and rarely as a simple causal relationship).

It takes time to develop an addiction. The usual process runs something like:

1. Something happens. Some 'negative' thing. Some thing 'bad'. Some thing that is then stored as an unresolved need, either consciously or unconsciously: I need. Some people would suggest that this can happen even before you have acquired language.

2. At some point in time later, the person takes a drug, and has a 'positive' experience. A 'good' thing: I feel good. In some way this is interpreted as resolving some of the unmet need coded in [1]: I take drug, need met.

3. The person learns that if they take more of the drug, more often, they resolve that unmet need coded in [1] more often: I keep taking drug, I don't need.

4. If the person stops taking the drug, the unmet need coded in [1] becomes apparent. I stop taking drug, I need.

5. I need the drug.

This is a specialised and very destructive behavior pattern. It's unusual. It's persistent. If you wanted to, you could replace the 'drug' part of the relationship with sex, gambling, work, helping people, shopping, stealing, cleaning...this behavior has everything to do with the person, and very little to do with the drug.

So, 'addiction'. A behavior that a very small number of drug users will get involved in, regardless of drug. It sometimes gets languaged as 'dependence'. It's not inevitable. It is recoverable. And the most difficult thing for many people to understand is how on Earth someone who is systematically destroying their life by using a drug in this way can still think about the drug as something that makes them feel better. It all hangs together, on the inside. Except for when it doesn't - and then of course you can always just take more.

The law

And it's best to remember that for most people, most of the time, using drugs (with the exception of alcohol) will be something that requires them to break the law.

Being busted will bring most people down with a crash. It's a sobering experience, and one that carries risks of its own. A criminal record can be with you for a very long time.

There are many people who suggest that with so many people now breaking the laws about drug use, the time for change is long overdue. However, right now the law is as it is. If you are taking illegal drugs, find out about the legal issues involved and your rights.

In the UK, if you are searched, questioned or arrested by the police and are not sure of your rights, the charity RELEASE are available 24 hours a day to advise you. Their help line number is 020 7603 8654, and you can ask the Desk Sergeant to contact them for you if you are taken to a Police Station. You would be well advised to say nothing to the police until you have spoken to a solicitor.

[p0ly]

don't do drugs kids, u may end up like me