Brand names: Amytal and Amytal Sodium, Soneryl, Prominal, Nembutal, Luminal, Tuinal.

Street names: Angels (Amytal), Nembies (Nembutal), Chewies (Tuinal).

Street use: Barbiturates can be swallowed but more often heavy users dissolve the powders in water and inject.

Drug effect: Barbiturates are depressants or ‘downers’. They work by depressing the activity of the entire nervous system. At low doses they decrease motor activity and produce sedation and drowsiness. Paradoxically they may produce excitement, elation and euphoria, slurred speech and general weariness. At high doses, barbiturates further decrease cognitive activity, distort judgement and provoke hypnosis. Higher doses produce anaesthesia.

Dependency: Develops very rapidly as the level of the drug increases.

Withdrawal: Symptoms appear within 24 hours of the last dose, peak about the second day and then fade over the next week. Symptoms include: restlessness, anxiety, and insomnia. Among heavy users there may be delirium and seizure. This is particularly likely to follow sudden withdrawal and so doses should be reduced gradually over time.

Long-term use: Can lead to chronic inebriation, aggressive behaviour, impaired judgement and severe insomnia.

Overdose risk: Although tolerance develops rapidly, the gap between a safe (for a heavy user) and lethal dose is very narrow and so accidental overdoses are very common. Large doses can lead to respiratory failure, coma and eventual death. Overdose risk increases if mixed with other drugs such as cocaine, alcohol and opiates.

Risk in pregnancy: Large doses of some barbiturates in pregnancy have been associated with congenital malformations.

Legal status: Barbiturates are a prescription only medicine and a Class B controlled drug. If prepared for injection, barbiturates become Class A drugs.

Class A – Maximum penaltyFor possession: 7 years and/or an unlimited fine.For dealing: Life and/or unlimited fine.

Class B – Maximum penaltyFor possession: 5 years and/or unlimited fine.For dealing: 14 years and/or unlimited fine.

SPECIAL NOTE: Seconal and Tuinal are dangerous drugs because of the risk of overdose, seizures following sudden withdrawal and hypothermia.

Brand names: Diazepam, Flurazepam, Temazepam, Nirrazepam, Tirazelam.

Street names: Vallies (Diazepam), Moggies (Nirrazepam), Rugby balls, Eggs (Temazepam).

Street use: Benzodiazepines are swallowed in large numbers or can be injected by crushing tablets or injecting jelly from the capsules. Benzodiazepines are often mixed with other drugs.

Drug effect: Benzodiazepines are depressants or ‘downers’. They act on the part of the brain associated with anxiety, reduce tension and induce sleep. At high doses they produce ‘drunken’ and sometimes aggressive behaviour.

Dependency: At low levels within the therapeutic range, tolerance does not develop to any great extent and only small increases in doses are reported over time. But among street users who are using large amounts, tolerance to the sedative effects ( but not to the calming effects) develops rapidly and doses escalate.

Withdrawal: Some people report withdrawal symptoms after only four weeks use. Sudden withdrawal from Benzodiazepines is dangerous as seizure can occur.

Long-term use: The effects include mental confusion, depression, aggressive behaviour and loss of physical co-ordination. Injecting with dirty or used needles can cause serious infections like hepatitis B and HIV. Injecting crushed tablets or jelly can cause serious circulation problems and in some cases loss of limbs.

Overdose risk: Death from overdose is rare with this drug because large doses are needed but the risk increases if benzodiazapines are mixed with other ‘downers’ like opiates, barbiturates and alcohol.

Risk in pregnancy: Babies born to mothers who continue to take benzodiazapines during pregnancy may have withdrawal symptoms which include tremor, irritability, and hyperactivity.

Legal status: Prescription only medicines and Class C controlled drugs. This means they can be possessed in medicinal form without a prescription but it is an offence to supply them to others. All benzodiazapines carry the same penalties, as listed below.

Maximum penalty: For possession: (if not in medicinal form): 2 years and /or unlimited fine.For dealing: 5 years and/or unlimited fine.

SPECIAL NOTE: Temazepam – gel filled capsules have now been developed to replace liquid capsules in order to prevent use by injection.

Street name: Blow, draw, hash, dope, grass, smoke.

Street form: Cannabis resin/hashish – most commonly used form is small blocks/lumps of brown resinous material. Marijuana/herbal cannabis – preparation resembles dried grass or leaves. Cannabis oil – strongest preparation, brown to black coloured thick oil.

Street use: Smoked, eaten.

Drug effect: Naturally occurring hallucinogen from the plant Cannabis sativa.

Dependency: Chance of psychological dependency.

Withdrawal: If smoked, effects last for up to three hours. If eaten, the drug is absorbed more slowly and the effects may last for 24 hours. No physical withdrawal symptoms reported but heavy users may experience restlessness and depression.

Long-term use: Can result in respiratory problems associated with smoking, psychological disturbance with very heavy use.

Overdose risk: Very unlikely, although vomiting is common when taken for the first time. However, people with cardiovascular problems might have an increased heart rate.

Legal status: Cannabis is a Class 'B' drug. The maximum penalty for dealing is fourteen years in prison.

Street name: K, Special K.

Street use: By mouth, sniffing, smoking or by injection.

Therapeutic use: Used as an anaesthetic, most commonly in emergency surgery.

Drug effect: An anaesthetic with analgesic (pain killing) and hallucinogenic properties. Takes between 30 seconds and twenty minutes to take effect depending on how it is administered. Drug effects, which include cocaine – like ‘rush’, loss of muscular co-ordination and LSD-like hallucinations.

Street form: Clear liquid or awhite powder.

Dependency: Yes (psychological).

Withdrawal: There are no physical withdrawal symptoms but heavy users report a strong psychological dependency.

Long-term use: Information on the long-term use of Ketamine is limited. LSD ‘flashbacks’ have been reported, together with loss of appetite and weight loss.

Overdose risk: No deaths have been reported. However, as with any anaesthetic, inhalation of vomit (after eating) is a serious risk if doses sufficient to induce anaesthesia are taken.

Legal status: From January 2006 Ketamine became a Class 'C' controlled drug.

Street name: Acid, Acid – tabs, Trips, and design names e.g. ‘Strawberries’

Street form: Considerable local variation: paper squares, microdots, tablets.

Street use: By mouth.

Drug effect: Hallucinogen.

Dependency: No evidence of physical dependency.

Withdrawal: Trips begin up to one hour after dose and last for 2 – 12 hours depending on strength. Tolerance develops quickly after a few days so that further doses are ineffective. No physical/psychological withdrawal symptoms reported.

Long-term use: Can result in flashbacks. Temporary psychological disturbance with heavy use.

Overdose risk: Only one recorded overdose death worldwide, although suicides and accidental deaths also reported.

Legal status: LSD is a Class A controlled drug. This means it is an offence to possess the drug or to supply it to others.

Maximum penalty: For possession: Seven years and/or unlimited fineFor dealing: Life and/or unlimited fine.

SPECIAL NOTE: If a user has a ‘bad trip’, it helps to reduce all external stimulation to a minimum – low lighting and noise levels.Users with a family history of mental illness run the risk of triggering long - term psychological illness.

Street name: Acid, Acid – tabs, Trips, and design names e.g. ‘Strawberries’

Street form: Considerable local variation: paper squares, microdots, tablets.

Street use: By mouth.

Drug effect: Hallucinogen.

Dependency: No evidence of physical dependency.

Withdrawal: Trips begin up to one hour after dose and last for 2 – 12 hours depending on strength. Tolerance develops quickly after a few days so that further doses are ineffective. No physical/psychological withdrawal symptoms reported.

Long-term use: Can result in flashbacks. Temporary psychological disturbance with heavy use.

Overdose risk: Only one recorded overdose death worldwide, although suicides and accidental deaths also reported.

Legal status: LSD is a Class A controlled drug. This means it is an offence to possess the drug or to supply it to others.

Maximum penalty: For possession: Seven years and/or unlimited fineFor dealing: Life and/or unlimited fine.

SPECIAL NOTE:If a user has a ‘bad trip’, it helps to reduce all external stimulation to a minimum – low lighting and noise levels.Users with a family history of mental illness run the risk of triggering long - term psychological illness.

Brand name: Diamorphine BP.

Street name: Smack, H, Brown, Scag, Horse.

Description: Brown/white powder normally containing around 30 – 40% pure heroin. Often cut with adulterants or other drugs. Diamorphine BP – clear solution in ampoules.

Therapeutic use: Severe pain.

Street use: Smoked, sniffed, ‘chasing the dragon’ (inhaling the fumes of heated heroin), injected. Heroin produces little effect if taken by mouth.

Drug effect: Painkiller and depressant.

Dependency: Yes.

Withdrawal: Effects of heroin last for 2 or 3 hours and withdrawal symptoms appear 8 to 24 hours after last dose. Symptoms resemble severe flu together with diarrhoea. They peak around the third day and fade after five to ten days. Sleeplessness may continue for some months.

Long-term use: Can result in constipation, breathing difficulties, irregular periods (menstrual cycle). If injected, possibility of infection and circulation problems.

Overdose risk: Deaths from heroin alone are relatively infrequent. However, the overdose risk increases after a period of abstinence or if heroin is mixed with other drugs like benzodiazapines, cocaine, barbiturates or alcohol.

Legal status: Diamorphine is a prescription only medicine and is a Class A controlled drug. This means it is an offence to possess the drug without a prescription or to supply it to others.

Maximum penalty: For possession: Seven years and/or unlimited fine.For dealing: Life and/or unlimited fine.nly medical practitioners licensed by the Home Office can prescribe diamorphine to those dependent.

Brand name: Physeptone

Street name: Meth, Phy.

Description: White scored tablet marked ‘Wellcome’ (5mg.), 1ml ampoules (10mg/ml.), Mixture (1mg/1ml.), Linctus (2mg/5ml.).

Therapeutic use: Severe pain and opiate dependence. Cough in terminal illness.

Street use: By mouth or injecting crushed tablets, linctus or ampoules. Injection of linctus is rare.

Drug effect: Painkiller and depressant.

Dependency: Yes.

Withdrawal: The effects of methadone last up to 24 hours, which is longer than heroin. Withdrawal symptoms are slower to develop but last longer. Flu – like symptoms appear up to 2 days after the last dose, peak after 5 or 6 days and fade after 14 days. Sleeplessness may last for longer. It has been suggested that withdrawal is more difficult than from heroin.

Long-term use: Can result in constipation, breathing difficulties, irregular periods (menstrual cycle). If injected – risk of infection/circulatory problems.

Overdose risk: Deaths from the use of methadone alone are relatively infrequent. However, the overdose risk increases after a period of abstinence or if methadone is mixed with other drugs such as benzodiazapines or alcohol.

Legal status: Methadone is a prescription only medicine and is a Class A controlled drug. This means it is an offence to possess the drug without a prescription and to supply it to others.

Maximum penalty: For possession: Seven years and/or unlimited fine.For dealing: Life and/or unlimited fine.

Street name: Sulphate, Sulpha, (Billy) Whizz, Speed, Powder.

Street form: White/yellow crystalline powder, usually sold in ‘wraps’.

Street use: Eaten, sniffed, or injected.

Drug effect: Strong stimulant.

Dependency: Yes (mainly psychological).

Withdrawal: Tolerance to amphetamine sulphate develops rapidly and users can increase dose up 50 – fold. Effects of amphetamine sulphate last for 3 – 4 hours. Withdrawal from this drug is divided into 2 phases – the immediate ‘crash’ or rebound, which lasts one to three days and is characterised by hunger, extreme fatigue and long periods of disturbed sleep. In the second phase, heavy users become irritable and depressed. The second phase can last for weeks or sometimes months.

Long-term use: Can result in excessive restlessness and insomnia. Weight loss. Amphetamine psychosis. If injected – risk of infection and circulatory problems.

Overdose risk: Death from overdose is possible with large doses but rare. Overdose risk increases if amphetamine is mixed with drugs such as heroin or depressants like barbiturates or alcohol.

Legal status: Amphetamine sulphate is a Class B controlled drug. It is illegal to possess amphetamine sulphate or to supply it to others.

Maximum penalty: For possession: 5 years and/or unlimited fine.For dealing: 14 years and/or unlimited fine

NOTE: If prepared for injection the increased maximum penalties apply.For possession: 7 years and/or unlimited fine.

Street name: Coke, Snow, Crack, Freebase, Rock, Charlie.

Description: Cocaine – white powder.Cocaine freebase – small white chips.

Therapeutic use: As a local anaesthetic for eyes, ears and nose (rarely used).

Street use: Cocaine hydrochloride: sniffed/injected. Cocaine freebase: heated and inhaled, increasing reports of injection.

Drug effect: Strong stimulant, local anaesthetic.

Dependency: Yes (mainly psychological).

Withdrawal: Effects last for 15 to 30 minutes. Effects of freebase/crack last for only 5 to 10 minutes. Mild feelings of sleepiness, hunger and depression. After the ‘high’, users experience a ‘crash’ or rebound dysphoria when they feel extremely tired or depressed.

Long-term use: Can result in excessive restlessness and insomnia. Weight loss. Mental confusion. Increase in blood pressure. Paranoid psychosis.If sniffed – damage to nasal membrane, damage to septum between nostrils.If injected – circulatory problems, infection risk.If inhaled – respiratory problems and lung damage.

Overdose risk: high doses can result in increase in body temperature, extreme agitation, convulsions and respiratory arrest. Overdose risk increases if cocaine is mixed with other drugs such as heroin or depressants like barbiturates or alcohol.

Legal status: Cocaine is a prescription only medicine and a Class A controlled drug. It is illegal to possess cocaine or to supply it to others.

Maximum penalty: For possession: 7 years and/or unlimited fineFor dealing: Life and/or unlim

Street name: Meth, Ice.

Street use: Smoked or injected.

Description: White/yellow/pink crystalline powder, clear liquid, ampoules (Meth). Small whitish chips (Ice).

Drug effect: Has a very strong and long - lived stimulant effect.

Dependency: Yes, though mainly psychological.

Therapeutic use: Methedrine is no longer available on prescription.

Withdrawal: Tolerance to methylamphtemine develops quickly. The effects last from three to four hours. Like amphetamine sulphate, withdrawal is in two phases. Firstly, the ‘crash’ or ‘comedown’ which produces tiredness and depression. In the second phase, users can become irritable and severely depressed; this lasts for three to four weeks and in some occasions will last for months.

Long-term use: Prolonged use of methlamphetamine can lead to severe weight loss, insomnia, exhaustion, paranoid psychosis, and severe depression. Smoking Ice over long periods causes severe psychotic episodes with both visual and auditory hallucinations, presenting not unlike schizophrenia.

Overdose risk: Overdose is not so common with methylamphetamine, but when it does occur it can result in heart and/or a predisposition for a heart condition are at risk due to the excess stress placed on the cardiovascular system.

Legal status: All amphetamine - based drugs are controlled under the Misuse of Drugs Act, within Schedule 2 Class B. However, once an amphetamine has been prepared for injection it comes under Class A, resulting in higher sentences.

Maximum penalty: For possession: 5 years and/or unlimited fine.For dealing: 14 years and/or unlimited fine.If prepared for injection increased maximum penalties apply.

For possession: 7 years and/or unlimited fine.For dealing: Life and/or unlimited fine.

SPECIAL NOTE: Most amphetamine-based drugs are manufactured illicitly and are of questionable purity.

Street name: Ecstasy, E, Adam, Eve. Often known as ‘brand names’ such as ‘Doves’, ‘Speckled Doves’, and ‘New Yorkers’ though these names frequently change.

Street form: Off-white or occasionally coloured tablets. Clear or coloured capsules. White powder (rare).

Street use: Originally associated with the dance scene. Now more widespread among young people not necessarily associated with the dance scene. Usually taken by mouth.

Drug effect: Stimulant with mild ‘psychedelic’ effect. Possible hallucinogenic effect, particularly in high doses.

Dependency: Psychological.

Withdrawal: Tolerance to Ecstasy develops with time, but not as rapidly as cocaine or amphetamine. Drug effects begin within 20 to 60 minutes after use. There is no evidence of physical withdrawal, although after-effects of the drug can include fatigue, depression and anxiety. ‘Flashbacks’ following repeated use over several days have been reported.

Long-term use: Ecstasy use can be associated with anxiety, panic attacks and insomnia, especially in cases of long-term use, or use of large doses. Increased susceptibility to minor infections such as colds, flu and sore throats have been reported. Pre-existing conditions such as high blood pressure, and epilepsy can be exacerbated. In addition, there is some evidence to suggest that Ecstasy may have the potential to cause brain damage associated with mood disorders. Evidence from research of an association between heavy Ecstasy use and liver damage. Ecstasy controls the body’s temperature control mechanism and can cause an increase in body temperature to dangerously high levels in rare cases. The cumulative effects of the high ambient temperature of a dance venue coupled with dehydration due to dancing have the potential for ‘double heat-stroke’. Ecstasy can cause the release of a hormone called Anti-Diuretic (ADH) that prevents the production of dilute water. Excessive drinking in turn causes water build – up inside the body cells. Users should take care to replenish lost body fluids and take regular breaks from physical exertion to help avoid dehydration and overheating. In acute cases of Ecstasy related overheating and dehydration, the body’s temperature regulation system can be impaired, or break down altogether.

Overdose risk: Overdose risk still needs to be properly assessed. However, there have been a number of deaths in the UK linked to the use of Ecstasy. Most of these deaths are thought to have been associated with a rare but fatal drug reaction, which can cause lung failure. Furthermore, heat stroke or dehydration are also thought to be possible contributing factors. Some deaths have been attributed to dilutional hyponatremia; i.e. people have drunk too much water in attempting to counteract the dehydrating effect of the drug.

Legal status: MDMA (Ecstasy) is a Class A controlled drug. This means it is an offence both to possess the drug and to supply it to others.

Maximum penalty: For possession: 7 years and/or unlimited fineFor dealing: Life and/or unlimited fine.

SPECIAL NOTE: A range of drugs including amphetamine, ketamine and over the counter cold remedies have been sold as Ecstasy.

Street name: Khat, Chat, Qat.

Street use: Chewing leaves or drinking infusion of leaves. Use in U.K among Somali residents and groups from Ethiopia and Arabian peninsular.

Description: Green leafy plant cultivated throughout Africa.

Drug effect: Khat is a mild stimulant. Users often report a calming effect.

Dependency: No record of physical dependency.

Therapeutic use: Khat is used socially in many African countries in much the same way that coffee is used in Western culture.

Withdrawal: There is no recorded withdrawal syndrome. It would be reasonable to expect listlessness and tiredness experienced by other stimulant users.

Long-term use: In the main Khat is chewed and this can lead to medical problems associated with the oral cavity and digestive tract, leading to inflammation and secondary infections. Excessive use can lead to drug induced psychosis. There have been some reports of poisonings of Khat chewers as a result of the inappropriate use of fertilisers used in farming. There is also some evidence of increased risk of oral cancer.

Overdose risk: There is no known record of Khat resulting in overdose, although it would be likely to act with other stimulants causing palpitations and agitation.

Legal status: The khat plant is not controlled under the Misuse of Drugs Act. However, the active ingredients, cathinone and cathine, are Class C. This does not mean that khat leaves are illegal. They may be considered illegal by a court if it is felt that the active ingredients have been prepared. There have been no test cases.

Street use: Vapours from volatile substances are usually inhaled directly from their containers or from polythene bags.

Drug effect: Vapours from volatile substances pass rapidly from the lungs to the brain causing depression of the central nervous system. Effects similar to acute alcoholic intoxication occur within two to three minutes. Feelings of euphoria are very common and some users report hallucinations. If inhalation continues there is further depression of the central nervous system, which leads to loss of awareness, judgement and muscular co-ordination and eventual coma. The intoxicating effects last for 15 to 60 minutes after sniffing ceases. Sniffers often report a mild ‘hangover’ for up to a day after use.

Dependency: Tolerance develops so that, over time, larger and larger quantities of volatile substances are required to produce the same effect.

Withdrawal: Occasional mild physical withdrawal symptoms, such as headaches, have been noted. However, psychological rather than physical dependency is more common.

Long-term use: ‘Sniffers rash’, memory impairment and loss of concentration have been reported. With chronic use, loss of muscular co-ordination, slurring of speech and vision impairment are common. However, these effects are usually reversible if sniffing stops. Long – term heavy use may lead to permanent brain damage.

Overdose risk: Every year there are over 100 deaths in the UK linked to sniffing. Over half are linked directly to the toxic effects of substances inhaled. The remainder are caused by a combination of accidents, inhalation of vomit and suffocation caused by a plastic bag over the head.

Pregnancy risks: Volatile substances pass the placental barrier but there is little information about their effects on the foetus.

Legal status: In England, Wales and Northern Ireland the Intoxicating Substance Supply Act 1985 makes it an offence to knowingly supply solvents for inhalation to anyone under the age of 18 years.

SPECIAL NOTE: In 1998, of all deaths in the UK linked to volatile substances, 53% resulted from inhalation of gas fuels, 11% from the inhalation of aerosols and 13% from the inhalation of solvent – based adhesives.

Street name: Iron Brew.

Street use: To increase body weight and build muscle.

Description: Tablets, injections, capsules.

Drug effect: Users will take the drug as an aid to muscle development. There is a chance that users will become more aggressive.

Dependency: Psychological dependence is common.

Therapeutic use: Can be used in the treatment of anaemia and thrombosis, and often used to build muscle for patients who are long – term bedridden.

Withdrawal: Some steroid users have reported lethargy and depression on stopping use.

Long-term use: It is difficult to offer conclusive evidence regarding the effects of the long-term use of steroids as most users are taking multiple combinations and at doses that are well above the recommended level. There is some clear evidence that persistent and heavy use may cause infertility or lack of sex drive in men. Conversely some men may become sexually violent. Women may develop masculine side-effects such as deeper voice and smaller breasts. Some of these effects are irreversible.

Overdose risk: Can cause high blood pressure. In extreme cases liver damage can result and there is some evidence of liver cancer.

Legal status: Anabolic steroids are prescription only medicines and Class C controlled drugs. They may be possessed in their medicinal form without a prescription but it is an offence to supply them to others.

Street name: GHB, GBH, Liquid Ecstasy.

Street use: Taken orally, some reports of injection (rare).

Description: Colourless liquid (purchased in small bottles). Coloured capsules.

Drug effect: Euphoric sedative effect. Effects noticeable within 10 minutes to 1 hour and can last for up to 24 hours.

Dependency: Physical and psychological dependency.

Therapeutic use: Anaesthetic use with a sedative quality. GHB has been used as a premedication to surgery and more recently it has been used in treatment for sleep disorders.

Withdrawal: Withdrawal produces an agitated state as with other types of sedative drugs, though little has been recorded on the true nature of the withdrawal.

Long-term use: There is also little evidence concerning the long-term use and therefore the consequences of such use are unknown.

Overdose risk: Similar to barbiturates, there is a fine line between the amount that is required to achieve the desired effect and that which will lead to coma. There is also a high risk of overdose should GHB be mixed with similar substances such as alcohol or other central nervous system depressants.

Legal status: Since July 2003 GHB has become a Class 'C' drug under the Misuse of Drugs Act. Possession of the drug could lead to a 2 year prison sentence.

SPECIAL NOTE: GHB is not only used by people on the dance scene but also by bodybuilders, though as yet with unknown effects.

Opiate type: These OTC medicines contain opiate – like substances. They are designed to suppress the coughing reflex or reduce pain. Some drug users will buy these drugs to help with withdrawal, while others will use them to supplement the effects of illicit drugs. Some of these preparations are made from a syrupy base, so injection is unlikely. A danger that remains is the injection of powder or tablet formulations. Usually these are a combination of codeine and aspirin/paracetamol, which can lead to aspirin/paracetamol poisoning.

Stimulant type: These OTC medicines contain caffeine or ephedrine and act in a similar way to amphetamine. They are found in nasal decongestants, cough syrups and cold remedies.

Sedative type: Many OTC cough and cold remedies contain antihistamines which can produce a noticeable sedative action, the danger of which can be increased by its combined use with alcohol.

Legal status: There are OTC preparations containing drugs open to misuse which are not fully controlled under the Misuse of Drugs Act because of their low strength, but they do come under the Medicines Act. These preparations can be purchased legitimately from any pharmacist. There have, however, been a number of prosecutions of pharmacists who have been selling OTC drugs knowing they were likely to be misused. This has also applied to the sale of solvents and other volatile hydrocarbons.