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Barbiturates
Barbs, barbies, blue bullets, blue devils, gorillas, nembies, pink ladies, red devils, sleepers Amytal, Sodium Amytal, Soneryl, Seconal and Tuinal
What are barbiturates?
Barbiturates are synthetic drugs which used to be regularly prescribed for anxiety, depression and insomnia. However, they are highly dangerous because of the small difference between a normal dose and an overdose and many people were either accidently dying or deliberately using them to commit suicide. Therefore they are only now prescribed for very serious insomnia. A less dangerous type is also used to treat epilepsy.
Barbiturates used to be a regular feature of the UK drugs scene, but because there is very little prescribing and no illicitly made varieties around, fortunately little is seen of them these days.
The law
Barbiturates are Prescription Only drugs under the Medicines Act. This means they can only be sold from a pharmacy in accordance with a doctor's prescription.
Barbiturates are also controlled as class B drugs under the Misuse of Drugs Act. Doctors can still prescribe them and patients take them but unauthorised possession or supply is an offence. The maximum penalty is 5 years imprisonment and a fine for possession and 14 years imprisonment and a fine for supply. If prepared for injection barbiturates are regarded as class A drugs with more severe penalties.
History
A large number of barbiturates have been manufactured for medical use since 1903. They were originally advertised as being completely safe and without any side effects. Despite stories of fatal overdoses, physical dependence and unpleasant effects medical use grew dramatically in the 1950s and 1960s, especially as sleeping tablets. In 1966 there were over 16 million prescriptions for barbiturates in the UK Barbiturates diverted or stolen from medical supplies also became commonly used as street drugs.
Concern about the number of accidental and deliberate overdoses from prescribed barbiturates led to a campaign amongst doctors in 1975 to warn people of their dangers. The campaigning group of doctors estimated that 27,000 people had died using barbiturates between 1959 and 1974. Medical prescribing fell to 5.1 million prescriptions in 1978 and continued downwards in 1996. Doctors switched to prescribing minor tranquillisers instead.
Street use also led to many deaths and problems, especially where barbiturates were injected. Despite this the government did not consider them dangerous enough to control under the Misuse of Drugs Act until 1985. By then street use had begun to decline. Fewer barbiturates were being manufactured as pharmaceutical companies marketed tranquillisers as an alternative and by the mid 1980s greater supplies of another 'downer' drug hit the streets - heroin.
There have been some recent isolated reports of use of barbiturates in clubs possibly by users of amphetamines and ecstasy to bring them down from the high.
Effects/risks
Barbiturates are sedative drugs which slow down the central nervous system in a similar way to alcohol. A small dose will make people feel relaxed, sociable and good humoured. With larger doses hostility and anxiety are common effects and slurred speech, loss of co-ordination and difficulty staying awake may follow. Falling over and accidents become more likely.
There is a high risk of overdose because the lethal dose is quite close to the 'normal' dose level. 10 tablets may be fatal and this risk is greater if barbiturate use is combined with use of other downer drugs such as alcohol, heroin or tranquillisers.
"This friend of mine was always taking barbs. He also drank whisky a lot. Anyway one night he'd had a skinful of both. He was out in the back garden and his flatmate had started a fire to burn a load of garden rubbish. He collapsed and fell into the fire. He just lay there for ages. We found him and his leg was like a burnt piece of lamb. I've played around with all sorts of drugs but barbs no way".
Injected into a vein barbiturates produce an almost immediate feeling of warmth and drowsiness. Besides the usual hazards of injecting (hepatitis, HIV etc.) barbiturate injectors run an increased risk of overdose, gangrene and skin abscesses.
Tolerance and physical dependence develop with regular use. Withdrawal from regular use may result in irritability, anxiety, inability to sleep, faintness and nausea, twitching and occasionally convulsions. After very high doses and regular use, severe withdrawal symptoms are likely including seizures, low blood pressure, delirium and hallucinations. Sudden withdrawal from high doses can be fatal.
Heavy users are also liable to bronchitis and pneumonia (because the cough reflex is suppressed) and hypothermia.
Regular use of barbiturates in the later stages of pregnancy can result in withdrawal symptoms in new born babies.
Benzodiazepines
Benzos, minor tranquillisers, diazepam (Valium), lorazepam (Ativan), chlordiazepoxide (librium), nitrazepam (Mogadon) flunitrazepam (Rohypnol), temazepam
What are Benzodiazepines?
Benzodiazepines are the most commonly prescribed minor tranquilisers, known as anxiolytics (for daytime anxiety relief) and hypnotics (to promote sleep).
The law
All benzodiazepines are Prescription Only medicines under the Medicines Act. This means they can only be legally supplied by a pharmacist in accordance with a doctors prescription. They are also controlled as a class C drug under the Misuse of Drugs Act. This also makes it illegal to supply them to someone else, the maximum penalty being fourteen years imprisonment and a fine. Until recently, possession was not an arrestable offence if you did not have a prescription, except for Rohypnol and temazepam. Now police can arrest an individual in possession of any minor tranquilliser who cannot show a legitimate prescription for them.
Under the Misuse of Drugs Act possession brings with it a maximum sentence of two years and an unlimited fine or both. Selling them on can bring fourteen years and/or fine for trafficking.
Prevalence
Surveys suggest that one in seven British adults take benzodiazepines at some time during the year, and 1 in 40 take them throughout the year. The proportion of women using prescribed psychotropics is double the proportion of men.
There is no known illicit manufacture of benzodiazepines. The benzodiazepines which circulate on the illicit market are diverted from legitimate clients either by over-prescription, that is to say individuals selling on part, or all, of their legitimately precribed drugs, or by theft from pharmacies, hospitals or retailers.
History
Tranquillisers were first manufactured in the 1960s and seen as safe, non addictive drugs which could be used by doctors to treat anxiety and sleeping pills. They were at first regarded as a hazard free alternative to the prescribing of barbiturates.
Although many people, particularly women, suffered serious side effects and dependence prescribing of tranquillisers continued to grow for over 20 years. It was not until the late 1970s that these problems were openly acknowledged. Prescriptions for tranquillisers fell from just over 30 million in 1979 to less than half that amount in the late 1990s. Despite this fall tranquillisers are still the most commonly prescribed mood altering drugs in the UK
Effects/risks
Tranquillisers are sedative drugs which slow down people's reactions and can make them feel drowsy, lethargic and forgetful. They relieve anxiety and tension and can make people feel more calm and relaxed. Effects begin after 10-15 minutes and can last up to 6 hours without repeating the dose.
"It's like a dream state. It gets you away from it all. It cushions you so you don't worry or care anymore. You don't really know what is going on".
The effect of slowing reactions and making people drowsy can make accidents more likely. It can be dangerous to drive while on tranquillisers. With regular use tolerance can develop quickly so increasing amounts are needed to get the same effect. Dependence can also quickly develop with regular use so that withdrawal can lead to intense anxiety, nausea, insomnia, irritability and headaches. Sudden withdrawal from very high doses can be very dangerous and result in confusion and serious convulsions. Many people find it very difficult to give up and may need a gradually reduced dosage to do so.
"Temazepam took over my life. It creeps up on you and is very addictive. I started using to bring me down from acid trips to make me feel normal. I liked them and started to use more and more. And that's when the problems really started because I couldn't leave them alone".
Regular users often find that after a time tranquillisers become ineffective in giving the desired effect. Continual use may mean they become ineffective as sleeping pills after 2 weeks and ineffective to combat anxiety after 4 months. The temptation is then to increase the dosage. Tranquillisers are only really effective as short term medicines but many people are dependent and have been taking them for several years.
A lot of tranquillisers have to be taken to fatally overdose but there have been many cases where people have died when also drinking alcohol.
Beta-blockers
Beta-adrenoceptor blocking drugs. Oxyprenolol, pindolol, acebutolol, celiprolol, atenolol, celiprolol, nadolol sotalol, labetalol, carvedilol, nevibolol, betaxolol, bisoprolol, metoprolol, timolol, propranolol, esmolol.
Beta-blockers are used to treat a range of ailments associated with anxiety and tension, such as high blood pressure, angina, irregular heart rhythms, migraines, prevention of a second heart attack, tremors, alcohol withdrawal, anxiety and glaucoma. In 2000, over 18 million prescriptions of the drugs were made.
They work by blocking the receptors for the fight or flight response. Beta-receptors are found in a number of places in the body, such as the heart, lung, arteries, brain and uterus. Different beta-blockers tend to affect different areas, with some more appropriate for treating blood pressure and others anxiety, without necessarily affecting performance.
Their ability to relieve anxiety led to their non-medical use. Students when cramming for exams and performers before going on stage are known to use them for their ability to relieve anxiety. Competitors in sports that require a steady arm such as snooker and darts have also been linked to its use, culminating in threats of competitive drug testing.
Tolerance can develop with regular use to the extent that stopping them can cause problems - exaggerating the original symptoms, which in the case of high blood pressure can prove fatal. Those with asthma and low blood pressure in particular should avoid beta-blockers.
Betel nut
The most widely used stimulant in the world
The nut of the Betel or Areca catechu tree contains arecoline, a mild central nervous system stimulant.
Its widespread use and availability across India, Thailand, Indonesia and other Asian cultures, makes the betel nut the most widely used stimulant in the world. Arecoline can improve learning and memory as well as counteracting intestinal parasites.
The betel nut is used widely in Asia
Regular use stains the mouth, gums and teeth a deep red. Excessive use can cause inebriation and dizziness. Long-term use may damage the teeth and soft tissue of the mouth. The nut can be bought legally in the UK.
BZP (Benzylpiperazine)
BZP, benzylpiperazine, piperazines, PEP pills, Part-E pills, ‘legal ecstasy’, Frenzy, Smileys.
What are BZP pills?
BZP (Benzylpiperazine) is a synthetic stimulant derived from piperazine, often seen as an alternative to ecstasy or amphetamine, although usually considered to be less potent than these drugs. It is sold as a tablet, capsule or as an off-white powder. BZP pills are marketed under a huge variety of names and the tablets come in many different shapes.
Prevalence
It is not known how many people in the UK use BZP pills. Before BZP and related piperazines were brought under the Misuse of Drugs Act in December 2009, most sales were conducted on the internet. The number of UK websites that sold the drug or websites based abroad that shipped to the UK suggested that there was a fairly significant number of users in this country.
The law
BZP and related piperazines are Class C drugs.
BZP and related piperazines were brought under the control of the Misuse of Drugs Act 1971 as Class C drugs on 23 December 2009. It is as yet unknown what the effect of the new legislation will be on sales or prevalence of the drug. Prior to its control under the Misuse of Drugs Act, the drug was sold online, with vendors labelling the drugs as plant feed or ‘not for human consumption’ to attempt to evade prosecution under the Medicines Act.
Effects/risks
The use of BZP has similar effects to other synthetic stimulants such as ecstasy or amphetamines. Users report a sense of euphoria and increased alertness, enhanced senses and a raised heart rate. Depending on the dose taken, the effects of the drug can last for up to 6 – 8 hours.
It is not clear exactly what the risks are to health as large scale studies have not been carried out, but users report a number of adverse side effects. These include vomiting and nausea, headache, palpitations, anxiety, strange thoughts, mood swings, confusion and tremors. Some of these effects occurred in the comedown period while some were experienced for up to 24 hours after use. There are reports of users not being able to sleep for up to ten hours after taking BZP pills.
More severe adverse effects may include fits and potentially life-threatening seizures. The National Programme on Substance Abuse Deaths reports that piperazines were implicated in (i.e. considered to be connected to, alongside other substances) 16 deaths between 2006 and 2008.
