Drugs – general effects and risks

What are drugs?

Drugs are psychoactive substances – this means that they disrupt chemical messaging in the brain, which in turn alters how someone feels. These changes can be physical (for example, affecting vital functions such as heart rate and body temperature), mental (for example, making someone feel more sleepy or alert than would otherwise be the case), and emotional (for example, causing fluctuations in mood). 

All drugs have risk

It is important to bear in mind that all drugs pose risks, whether that is paracetamol (Calpol) given to a baby, or the heroin someone with long-term, problematic experience of drugs might be taking. With medicines, the risks – such as allergies to ingredients, chance of overdose, potential for side effects and interactions with others medicines, alcohol or drugs – are managed very carefully, through regulations applied and enforced by the government, and adhered to by the pharmaceutical industry and healthcare professionals such as doctors and pharmacists. The measures put in place to ensure people can use medicines safely are both complicated and rigorous, and with good reason: there has to be a balance struck between the therapeutic benefits and the significant potential for risks. 


The risks of illegal drugs

The safety measures applied to medicines simply don’t exist for illegal drugs, so essentially someone who is taking something is using an unknown entity. There are no standards in place in terms of ingredients, quantities, or even how and where illegal drugs are made; the products that reach users will have been made by individuals who lack any form of qualification, and who aren’t subject to any checks in terms of their skills or the processes they are using.  

Distribution and supply channels are often long-winded and carried out by criminals who are motivated by profit, which means that substances are often diluted (cut) with other ingredients in order to try and make more money. Some of these additions are relatively harmless, but others can be incredibly dangerous, both themselves and in terms of complicating the effects and risk of the drug. Without proper chemical analysis, it isn’t possible to know the precise contents and quantities of an illegal drug, as the work of organisations like The Loop illustrates.

As well as issues around purity, strengths of drugs can vary hugely. In recent years, there have been a number of fatalities from incredibly strong and pure drugs – such as ecstasy/MDMA and cocaine – plus many more people have suffered damage to their physical and/or mental health. 

This is why harm reduction advice always centres around a key message: the only way to eliminate drug-related risk is to not take them at all. 

The complexity of risk

There are lots of variable factors that can affect the risk of any substance to an individual, which are often referred to as “the three dimensions of risk”: 


The drug 

  • What substance has been taken?  
  • How pure or strong is it? 
  • Has it been mixed with anything else, for example, another drug, alcohol, medication, additives during the manufacturing process? 
  • How has it been taken – swallowed, smoked, another method?  


The person

  • How is their physical health? 
  • Any medical conditions or allergies? 
  • How is their mental health?
  • How are they feeling? 
  • What are their expectations of the drug? 


The place

  • Are there other people around?
  • What are they doing – are they taking drugs too, or drinking alcohol?
  • Do they know and trust the other people? 
  • What is the environment like – hot, cold, crowded? 
  • What is the vibe – excited, scary? 
  • Are there any potential dangers, such as stairs?

The above are just a few examples of the variables within each dimension of risk, there are many, many more. 

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