An overview of drugs - Fact Sheet

There is barely a culture in the world that has not sought and used mind-altering substances of one kind or another. Adults who choose to use drugs do so for many reasons and accept varying degrees of risk in doing so. Recreational drug used by a person with an acquired brain injury, however, carries a significantly greater risk.

Three main categories

Psychoactive drugs can be divided into three general categories according to how they affect the central nervous system:

Stimulants include several groups of drugs that tend to stimulate the central nervous system, increasing alertness and physical activity. Legal drugs in this area include nicotine from cigarettes and caffeine in coffee or cola drinks.

Common illicit drugs in this area include amphetamines (street names include speed, crystal, ice, go-ee, whizz and fast), and designer drugs such as ecstasy (usually called ‘E’).

Depressants depress the central nervous system. In a normal dose, they will lead to euphoria, relaxation and reduced coordination, inhibition and concentration. Larger doses may lead to nausea, unconsciousness and death.

The most popular depressant is alcohol. Cannabis is the most popular illegal depressant (also called marijuana, grass, pot or dope). Benzodiazepines are prescription medications that are often used for their depressant effects.

The opiate family of drugs includes heroin, morphine, codeine and pethidine. Street names for heroin include ‘H’, smack, and horse.

Inhalants are a range of chemical products that are inhaled to produce a high feeling. Many of these have a depressant effect and can be obtained from a variety of household products such as glue, aerosols and petrol.

Hallucinogens affect a person’s perceptions, sensations, thinking and emotions. Examples include LSD, mescaline and psilocybin. People who have taken them may see or hear things that aren’t really there. There is currently little use of hallucinogens in Australia. Psilocybin is found in certain mushrooms that are known as “magic mushrooms” or “gold tops”. Cannabis is generally classified as a depressant but is viewed as a hallucinogen as well, as high doses can lead to hallucinations. Ecstasy also tends to fall across two classifications as it is a stimulant, but high doses can cause hallucinations.

Common recreational drugs

Heroin

The biggest problem with heroin is overdose, especially when injected. Many deaths have happened when heroin has been used with other central nervous system depressants, like alcohol or benzodiazepines.

Injection can also cause a variety of problems with viruses such as hepatitis C and HIV/AIDS, vein infections and vein damage.

Heroin can lead to high levels of dependency. Heavy users are often less likely to eat and health problems can arise from malnutrition and lower personal hygiene. Heroin may also interact with prescribed anticonvulsant medication and antidepressants, increasing the risk of overdose significantly.

Trying heroin once does not create an addiction. Some regular users of heroin can stick to a reduced level that avoids physical addiction. People with a pre-existing brain injury may also find that heroin causes serious seizures or that dirty injecting equipment causes meningitis.

Detoxification (‘detox’) from heroin usually takes about a week, and symptoms include muscle and stomach cramps, nausea, physical and nervous tension, vomiting, insomnia, anxiety, yawning, tears, runny nose, irritability, depression, diarrhoea, headaches, sweating and hot and cold flushes. Detox may also lower a person’s seizure threshold, leading to an increase in seizures.

There is a wide range of options for people wanting to detox off heroin. You can have a supervised detox at home or in a residential facility. New medications can be used to detox quickly, often with less adverse effects. Maintenance drugs such as methadone can be used to act as a substitute for heroin, letting you get your life together without having to go through detox. It is however vitally important that you inform the staff providing detox of any pre-existing brain injury.

Ecstasy

The pharmacological name for ecstasy is Methylenedioxymethamphetamine (MDMA). The ingredients of MDMA are often difficult to obtain, therefore manufacturers may substitute other substances, creating a drug which is not quite MDMA and will have unpredictable affects. These can range from caffeine, glucose (simple sugar) and ketamine (a veterinary anaesthetic sometimes used as a date rape drug), to speed and other amphetamine-type substances.

The effects of ecstasy depend on what substances are in the pill (the drug), your mood and expectations (the environment), and your body weight and general health (this is especially true for people with an acquired brain injury). Common immediate effects of ecstasy include an increase of heart rate, blood pressure and body temperature, jaw clenching, teeth grinding, talkativeness, feelings of well-being and a closeness to others, loss of appetite, lowering of the seizure threshold and sometimes nausea.

These effects usually start 30 to 60 minutes after an ecstasy pill has been swallowed, and can last anywhere from three to eight hours depending on the contents of the pill. During the comedown, a person can feel physically exhausted (especially after dancing all night), depressed, irritable, and have difficulty sleeping and concentrating. These effects can last for several days. Long term effects of ecstasy include confusion, depression, insomnia, anxiety, memory disturbance and paranoia.

Many drugs commonly used in the treatment of brain injury can cause serious illness or death when mixed with ecstasy. For example anti-depressant drugs, such as Prozac, Aropax, Zoloft, Nardil, Parnate and Marplan, can interact dangerously with ecstasy.

Cannabis

At present there is little evidence that the occasional use of small amounts of cannabis leads to long-term health problems, but there is evidence that regular or heavy use of cannabis can lead to major health problems. There are some people who should be extra careful when thinking about using cannabis:

Research has shown there can be more serious effects if cannabis is used regularly for a long time. These include:

Chronic cannabis use can exacerbate many of the problems experienced by people with an acquired brain injury and delay or prevent relearning lost skills.

Benzodiazepines

Benzodiazepines are a very commonly prescribed sedative. There are many different brands, including Valium, Ducene, Alepam, Murelax, Serepax, Alodorm, Mogadon, Normison, Euhypnos and Temaze.

Used medically, benzodiazepines can effectively reduce anxiety and sleeping problems for a short period of time until the body develops a tolerance to the drug. Many people do not realise these drugs are highly addictive, with withdrawals similar to that of heroin, but lasting much longer and potentially fatal if going cold turkey.

If you have been prescribed benzodiazepines by your doctor, make sure you discuss the time period you will be using the drug for, to avoid becoming dependent and facing withdrawal symptoms when stopping. As they are short-term drugs, benzodiazepines will never solve the anxiety or sleeping problems you are facing, so if these problems are ongoing, seek counselling or support to address the underlying issues.

It is important to be aware that no prescription medication should be stopped without consulting the prescribing doctor.

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