The hexagon shape can take many forms but is often encountered as what is known as a benzene ring, which comprises of 6 carbon and 6 hydrogen atoms. Carbon and hydrogen are the fundamental building blocks for life and are found in some measure in nearly all known compounds.
Below you can find information about some of the most commonly abused drugs, what they look like,
how they might affect someone who uses them and the risks they pose both to the user and the people around them.
Stimulant drugs are those that speed up or increase the messages sent between the brain and body, and typically make people feel more awake, alert confident and energetic. People generally take stimulants to mask tiredness or help alleviate the effects of alcohol.
Adverse reactions can include anxiety, panic, aggression, and increased risk taking as well as health effects such as headaches, heart problems, elevated blood pressure and seizures. The come-down following use can often include feelings of depression and lethargy, anxiety, and paranoia.
The UK workforce works some of the longest hours in Europe, averaging 42.5 hours per week (1). Cocaine can help temporarily alleviate fatigue and help you stay awake for long periods; some workers may feel tempted to use the drug in an attempt to continue to work productively.
The effects of cocaine kick in around 5 to 30 mins when snorted and are fairly short lived. The initial high can last as little as 20 minutes but some physical effects such as an elevated heart rate can last some time after the initial high has gone.
Cocaine can make people anxious, or overconfident leading to erratic and edgy behaviour and the possibility of increased risk taking.
Following use, and often the next day, some users can find that cocaine makes them feel down and anxious. To avoid this feeling, some users will resort to using cocaine the following morning which can lead to a pattern of binge use and increase the risk of dependence and addiction.
Many people who regularly use cocaine also have an alcohol problem, or link their cocaine use with alcohol consumption. Individuals who frequently drink large amounts of alcohol may use cocaine the following morning to avoid the negative effects of the alcohol from the night before.
Cocaine was at one time used in dentistry as it’s a good aesthetic agent, however this hasn’t been the case in the UK since the early 1900s, and dentists now primarily use lidocaine. Although the name sounds similar, the compounds are not related and lidocaine will not produce a positive drug test for cocaine. The suffix “caine” simply refers to compounds which have local anaesthetic properties.
The use of cocaine is detected in oral fluid by the identification of Cocaine itself, and its primary metabolite benzoylecgonine. The presence of benzoylecgonine in oral fluid typically distinguishes between incidental exposure and consumption since benzoylecgonine is produced by the body when it breaks down cocaine.
People may take amphetamine illegally for similar reasons they may take cocaine; to alleviate tiredness, increase alertness and feel they have clearer thinking. In WWII, both Allied and Axis troops frequently used amphetamines. While part of the reason they were used was to reduce fatigue, a large part of the reason for their use was the mood-altering effects on the troops; particularly increased confidence, aggression and elevated morale.
The effects of illicit amphetamine usually last for a few hours but can last as long as 6 hours.
Amphetamine is addictive and users can build up a tolerance to its effects, meaning that they may have to take increasing doses to achieve the same effects.
The comedown from taking amphetamine can last several days and users may feel lethargic and down. Since amphetamine can have a negative impact on a user’s diet and sleep, it can put a lot of stress on the immune system and can lead to more colds, flu and sore throats. Regular use may lead to various mental health problems including anxiety, depression, and paranoia.
While prevalence of cocaine use has been fairly stable (or slightly increasing) in the last 10 years in the UK, the use of amphetamines has been steadily declining.
In oral fluid, amphetamine is detected by the presence of amphetamine itself.
Methamphetamine effects are longer lasting than cocaine and amphetamine and may last as long as 12 hours.
People take methamphetamine because it makes them feel alert and exhilarated and strong, and the effects are much longer lasting than drugs with similar effects such as cocaine and amphetamine. Some unintended effects can include feelings of paranoia, agitation, and aggression, and long-term use can lead to brain damage that causes memory loss, depression and coordination problems, and seeing or hearing things that aren’t there.
In oral fluid, methamphetamine is detected by the presence of methamphetamine itself, amphetamine may also be detected as this is a metabolite of methamphetamine.
The pills are usually swallowed although sometimes the pills are crushed and snorted and the powder is normally rubbed into the user’s gums.
When taking ecstasy, most people feel happy and feel affection for the people they’re with and the strangers around them. Ecstasy is often taken at nightclubs and parties where it can make music feel more intense and enhance the experience.
The effects of ecstasy normally kick in after about 30 minutes and lasts for around 2 to 4 hours. Once the “high” wears off users may continue to have an elevated heart rate, or an inability to sleep for several hours. The following day, some people experience a “comedown” which causes them to feel down and have a low mood, which can last for several days.
The greatest risks of ecstasy use typically come from the unpredictability of the ingredients in an ecstasy pill. The dosages can be highly variable, and ecstasy is often “cut” with other drugs which the user may not be aware of.
When taking ecstasy, the body’s temperature regulation is disrupted. This can cause users to overheat and become dehydrated, especially if they are taking ecstasy in a hot atmosphere such as a nightclub. Ecstasy can also stop the body producing urine, which can lead to users drinking too much water and affecting the body’s salt balance, which can be dangerous and even deadly in extreme circumstances.
There is evidence to show that long term health effects of ecstasy use can include memory problems and an increased risk of depression and anxiety.
Ecstasy use is tested for in oral fluid by the detection of MDMA, the chemical name for ecstasy.
Codeine is a painkiller used to treat mild to moderate pain and is available on prescription and is usually given in tablet form, although it is also available as a syrup and a liquid for injection.
On its own, codeine is a prescription-only painkiller meaning you can’t buy it over the counter, or at a pharmacy without a prescription. However, small amounts of codeine, combined with other medicines like paracetamol are available from a pharmacy.
Alongside pain relief, codeine can cause drowsiness, and feelings of relaxation. Similar to other opiate-based drugs, it may also cause constipation, nausea and itchiness especially in larger doses.
The effects normally take effect within an hour and last for around 3-4 hours.
When taken according to a prescription, side effects are rare and limited, but may result in drowsiness and feeling tired or washed out. Abuse of codeine, especially taking high doses, or combining with other drugs carries increased risks, including low blood pressure, risk of respiratory problems (including stopping breathing altogether), and kidney and liver failure.
Some people take codeine without a prescription to help them deal with stress and depression. However, this can result in dependency and can eventually make symptoms such as anxiety and depression worse. Long term use can also result in an increase in tolerance to the drug, meaning more needs to be taken each time to achieve the same effect.
Codeine, like many opioids is addictive, and users may experience withdrawal symptoms if they have been prescribed it for physical pain.
The use of codeine is detected in oral fluid by the identification of codeine itself.
Heroin is usually sold as a white or brownish powder. It’s an opiate painkiller extracted from the opium poppy.
Heroin can be smoked, dissolved in liquid and injected, or snorted.
Heroin is highly addictive and over time heroin can cause cravings and a strong desire to keep using.
People take heroin to feel relaxed, sleepy, euphoric and happy and the effects can last for around an hour. When smoked, the effects typically kick in within a few minutes, and when injected the effects are almost instant.
Heroin kills far more people in the UK than any other drug, and this is often due to overdose. Users build up a tolerance to heroin following repeated use, meaning they must take more of the drug each time to experience the same effects. However, if heroin use is stopped, the tolerance rapidly drops, meaning that there is a high risk of overdose if a previously tolerant user attempts to take the same dose they were using before stopping.
Heroin is often “cut” with other drugs which are often more potent and dangerous than heroin itself, including other opioids such as Fentanyl. Mixing heroin with other drugs greatly increases the risk, especially if those drugs have similar effects, such as alcohol or benzodiazepines.
Following use of heroin, the heroin molecules are quite quickly broken down by the body to form a compound called 6-MAM (6-monoacetylmorphine). The body will also break down this 6-MAM compound further to morphine. Additionally in illicit forms of heroin, a compound known as 6-AC (6-Acetylecodeine) may be present, which the body breaks down into codeine. So, someone who has used heroin may test positive in oral fluid for one or all of the following; 6-MAM, Morphine and Codeine.
Tramadol is powerful painkiller available on prescription for pain relief, usually after certain surgeries. It is an opioid-based painkiller and is considered to be less addictive than other opioids, however users can develop addiction.
Tramadol is most commonly in the form of white pills or tablets, but can come as a capsule or liquid.
Although tramadol isn’t as strong as heroin it shares a lot of the same effects. Its primary purpose is to relieve pain, but it may also make the user feel calm, relaxed, and happy. People who abuse tramadol and take it illegally without a prescription may do so following legitimate prescribed use, where they want to avoid symptoms that may arise after stopping taking the drug as prescribed, or they have developed an addiction. Some people may also use tramadol to self-medicate pain, both physical and mental and to help anxiety or depression.
Tramadol can make people feel tired and lethargic, confused, moody and irritable. Cognitive function may seem to improve when a person starts taking tramadol, but changes in the brain over time impair reasoning, decision-making and other cognitive functions.
It is a drug that the body can develop a tolerance to, meaning users will have to take increasing amounts to achieve the same effects. This increases the risk of addiction, overdose and more negative effects. People who self-medicate with tramadol in an attempt to alleviate symptoms of anxiety and depression, especially over the longer term may make their symptoms worse.
Tramadol use is typically detected in oral fluid by the identification of Tramadol itself.
Methadone is a synthetic opioid drug that is used to treat moderate to severe pain and it is used to substitute heroin for managing and treating heroin addiction. A patient who is addicted to heroin may be prescribed methadone instead and their dose will be gradually reduced over time. Methadone has similar effects to heroin but doesn’t provide the same high. Its withdrawal effects are much less pronounced and so coming off of methadone is easier than heroin with fewer adverse effects.
Methadone is commonly a bright green liquid that is swallowed, but it does also come in tablet or injectable forms.
Methadone may be abused for its pain-relief, or to achieve a high. While methadone is designed not to produce an opioid-like high, in fact it is designed specifically to prevent it, some high-like effects can be felt from methadone use – especially when taking higher than prescribed doses. Effects can include sedation, euphoria and drowsiness.
In oral fluid, methadone use may be detected by the presence of methadone itself, or its metabolite EDDP.
Cannabis comes in many different forms. Weed refers to dried leaves and flowering parts of the cannabis plant and can look like dried herbs. Skunk has increased in popularity in recent years and is typically far more potent than weed. Skunk is either bright, pale or dark green in colour and covered in small crystals. Dab refers to concentrated forms of cannabis that have been extracted using butane. Dab is a solid which can be used in vapes.
There are many chemicals found in the cannabis plant, but the primary psychoactive compound is Δ9-THC (THC). The other important compound is CBD. Different forms of cannabis have varying ratios of THC to CBD, with some forms such as Skunk having lots of THC but very little CBD.
Cannabis can be used in many different ways too. Most commonly cannabis is smoked with or without tobacco, in a cigarette. Edible forms have also become very popular, and people often mix cannabis into brownies and sweets. In recent years with the increasing popularity of vapes, cannabis vape liquids have become available illegally.
The effects of cannabis can vary widely, depending on the individual, their mood, their surroundings and the type of cannabis and dose taken. For some people, taking cannabis makes them feel relaxed and content within their own thoughts, while others can feel giggly and chatty. Cannabis affects your judgement and people often think conversations or thoughts that have while taking cannabis are much more important than they would do normally.
Effects can start a few minutes after smoking but may take an hour or so after eating an edible form of cannabis. The effects last from about 10 minutes to an hour after smoking, and after eating cannabis, peak effects can last for as long as 2 to 4 hours with some effects lasting several hours beyond that.
Taking cannabis isn’t without risk. Smoking cannabis is likely to have similar health impacts to smoking tobacco even if it isn’t mixed with tobacco. Cannabis can have an impact on mental health, and it can affect motivation, impair memory, affect how well you sleep, and increase the risk of depression and anxiety. There is a link between cannabis and an increased risk of schizophrenia especially in people who have a family background of the illness.
Cannabis use is detected in oral fluid by the identification of THC.
The benzodiazepines are a group of drugs that are used to treat anxiety and sometimes trouble sleeping. There are lots of different benzodiazepines but none are available over the counter.
The most commonly prescribed benzodiazepine is Diazepam, also known as Valium.
Benzodiazepines are most frequently taken as tablets and come in various shapes and colours.
Benzodiazepines have a calming effect and slow the brain and body down. The effects are typically felt 30-90 minutes after use and the effects last between 1-4 hours depending on the type of benzodiazepine taken.
People may take benzodiazepines without a prescription as a chill-out drug after a party and to help them sleep after taking stimulants such as cocaine or MDMA. People who are addicted to strong opioid based drugs (such as heroin) may also use benzodiazepines to lessen the come-down effect from taking these strong opioids. It increasingly appears that some people are effectively self-medicating with prescription drugs using online pharmacies.
As highlighted in the mainstream UK news(2), it is currently possible to acquire prescription-based medications (including benzodiazepines such as Diazepam) through these online pharmacies many of which don’t carry out the same robust background checks that would normally be performed by traditional pharmacies. This allows some people to obtain these prescription-only medications that otherwise would not have been able to, had they gone via a traditional pharmacy.
Due to the structural similarity of many benzodiazepines, the breakdown products from different benzodiazepines can be the same, meaning it is sometimes difficult to distinguish between the use of closely related benzodiazepines. However, in oral fluid, a combination of the unchanged drug(s) and their breakdown products are tested for.
Ketamine is a type of drug known as a dissociative anaesthetic, which means that is causes memory loss and provides pain relief. At certain doses it can cause hallucination and detachment from reality.
It has legitimate medical devices typically reserved for emergency traumatic injuries where it offers pain relief and its dissociative properties help patients deal with the shock of their injuries. Recreationally, people may take ketamine to experience a state of dissociation and detachment from their physical body and the world around them. The effects of ketamine typically last for a few hours and can make people feel dream-like, chilled, relaxed and happy. It can also stop people from being able to move properly or make sense when they speak, and can stop people from feeling pain, putting them at risk of injury.
Use of ketamine can cause lots of serious effects including bladder, kidney and liver damage. The longer-term effects of regular ketamine use can include memory loss and difficulty in concentrating, and may cause depression, or worsen existing mental health problems.
Ketamine is addictive but does not cause withdrawal symptoms upon stopping, so dependence on ketamine is psychological rather than physical.
In oral fluid, ketamine use is typically detected through the identification of ketamine itself.
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