Recreational drugs and alcohol

Explains the mental health effects of recreational drugs, what might happen if you use recreational drugs and also have a mental health problem, and suggestions for where to find support.

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What effect could different drugs have?

The possible mental health effects of the most commonly-used drugs are listed below.

Not everyone will experience all of them.

alcohol ecstasy
(MDMA)
mephedrone
(meow meow)
amphetamines;
methylamphetamine
(crystal meth)
GHB nicotine
(tobacco)
anabolic steroids heroin phencyclidine
(PCP)
benzodiazepines ketamine pregabalin
buprenorphine khat psilocybin/psilocyn
(magic mushrooms)
cannabis LSD solvents
cocaine    

alcohol

Alcohol is legal but it is the most toxic of the commonly-used drugs.

Moderate use is not usually a problem. The long-term effects listed below are associated with drinking a lot over a long period of time. These effects will go away if you stop drinking.

I never drink when feeling even a little low as I think the alcohol enhanced my feelings and led to me feeling even worse.

If you think you may be addicted to alcohol and want to give up:

  • get advice and information
  • seek medical help if possible – it can be dangerous to stop drinking suddenly
Type of drug depressant
Short-term effects
  • feeling relaxed and more sociable
  • feeling subdued, so that you drink more in order to recreate the pleasant effects
  • large amounts – uninhibited behaviour or aggression
Long-term effects
  • memory loss
  • difficulty thinking clearly
  • difficulty problem-solving
  • poor concentration
  • addiction
Dependency and withdrawal symptoms
  • anxiety
  • delirium (confusion, disorientation, hallucinations)

Alcohol is the main culprit for some terrible decision making at university. The overwhelming pressure to go out drinking most nights can and did get the better of many students in my first year.

amphetamines; methylamphetamine (crystal meth)

Amphetamines are a group of drugs which vary in how powerful they are and how they are classified legally.

The effects of crystal meth are similar to crack cocaine but they last longer. If you have experience of a mental health problem, you are more likely to experience negative effects.

Type of drug stimulant
Short-term effects
  • increased attention and alertness
  • reduced tiredness
  • increased energy and confidence
Long-term effects
  • agitation
  • confusion
  • aggression
  • psychosis; paranoia
Withdrawal symptoms
  • anxiety
  • depression
  • tiredness
  • irritability

anabolic steroids

These are taken to increase muscle bulk and enhance sporting performance. They are slow to act, and do not cause an immediate buzz like other stimulants.

They are class C drugs, legally available only from a pharmacist on prescription. Their use is banned by many sporting organisations.

The short- and long-term mental health effects of steroids will disappear if you stop taking them. However, the symptoms of dependency may continue.

Type of drug stimulant
Short- and long-term effects
  • increased energy
  • excitement
  • competitiveness
  • aggression
  • dramatic mood swings
  • confusion
  • sleeping problems
  • depression
  • paranoia
Dependency symptoms
  • extreme tiredness
  • depression

benzodiazepines

These are prescribed for anxiety and as sleeping pills. It is illegal to take them without a prescription written for you.

You might use them:

  • to increase the effects of similar drugs, such as alcohol or opiates
  • to counteract the effects of stimulants, such as ecstasy or amphetamines, or
  • to help with stopping smoking

Benzodiazepines can be very addictive, and coming off them can be very difficult.

Type of drug depressant
Short-term effects

negative effects:

  • agitation
  • aggression
  • hostility

positive effects:

  • reduced tension and anxiety
  • clear thinking
  • feeling calm and relaxed
Dependency symptoms
  • sleeping problems
  • anxiety
  • irritability
  • heightened awareness
For a list of withdrawal symptoms see our full benzodiazepines section.

buprenorphine

Buprenorphine and methadone are both prescription drugs that are used to treat heroin addiction. They are recommended by NICE (the National Institute for Health and Care Excellence).

Buprenorphine (trade name Temgesic) is less sedating than methadone, and so may be preferable if you are working or if you drive.

Type of drug opium-related painkiller
Short- and long-term effects
  • depression
  • loss of libido
  • hallucinations and other psychotic symptoms
  • feelings of detachment

cannabis (marijuana, hemp, hashish, grass, skunk)

People take cannabis as a way of relaxing and getting high. The effects you experience will largely depend on:

  • whether you are used to taking the drug
  • how much you take
  • the type of cannabis you use
  • your genes

If you have experience of anxiety and depression, you are more likely to experience negative side effects.

Type of drug stimulant, depressant and hallucinogen
Short-term effects
  • feeling relaxed

  • talkative

  • finding things very funny and laughing a lot

  • feeling excited by the things you see, hear and feel

  • hunger

High doses may cause:

  • distorted perceptions

  • forgetfulness

  • distress and confusion

  • psychotic experiences (hallucinations or other unshared perceptions)

Long-term effects
  • long-lasting symptoms of psychosis, that may be diagnosed as schizophrenia

  • depression in later life, if you use it a lot as a teenager

Cannabis psychosis

Whether or not you get psychotic effects when using cannabis depends on a gene which codes for a chemical called COMT (catechol-O-methyltransferase, a brain enzyme). There are two versions of this gene, one of which is associated with a much greater chance of getting psychotic effects than the other.

You are more likely to have psychotic experiences if:

  • you use cannabis such as skunk, which has a high level of tetrahydrocannabinol (THC, the component of cannabis that is hallucinogenic)
  • you have two copies of the version of the COMT gene, which makes you more susceptible to psychotic experiences

cocaine, crack cocaine

Cocaine comes in two forms:

  • cocaine powder, which is snorted
  • crack cocaine, which is smoked

Both forms may be injected. Cocaine is notoriously impure, and often contains other substances.

Type of drug stimulant
Short-term effects
  • feeling wide awake
  • full of energy
  • feeling confident

High doses may cause:

  • hallucinations and delusions
  • depression
  • suicidal thoughts
Long-term effects
  • depression
  • anxiety
  • panic attacks
  • paranoia
  • irreversible brain damage
  • worsening of pre-existing mental health problems
  • repetitive movements
Dependency and withdrawal symptoms
  • loss of energy
  • psychosis
  • depression
  • akathisia (a feeling of intense restlessness)

Cocaine – from a perceived non-addiction I realised that my intermittent use is addiction and is most prevalent in social situations.

Cocaine is extremely addictive, and it is very difficult to stop taking it.

If you have a mental health problem, cocaine can make this worse.

ecstasy (MDMA)

Ecstasy tablets are notoriously impure, and often contain substances other than MDMA.

Although ecstasy is a stimulant, it has different effects from other stimulants (such as amphetamines) as it causes feelings of empathy rather than euphoria.

It is very dangerous to take ecstasy at the same time as MAOI antidepressants.

Type of drug stimulant
Short-term effects
  • feeling happy and relaxed
  • feelings of empathy, openness and caring
 
Long-term effects
  • depression, which does not respond to antidepressants
  • loss of confidence
  • anxiety
  • confusion
  • agitation and teeth clenching
  • panic attacks after repeated use
  • hallucinations and paranoia after repeated high doses

GHB – gammahydroxybutyrate (GBH)

GHB is an anaesthetic liquid, which may be mixed with solvents or caustic soda. As it is very sedating, it has been associated with sexual assaults.

It is dangerous, potentially causing seizures, coma and death.

It is very dangerous to take GHB with alcohol.

Type of drug depressant
Short-term effects
  • loss of inhibitions
  • calmness
  • sedation
  • confusion
Long-term effects
  • the above effects can last for up to seven hours

heroin (diamorphine)

Heroin is a painkiller, prescribed as diamorphine. The main effects are pain relief and euphoria but also depression.

It is very addictive, and leads many people to crime to fund their use of it.

The main problems with heroin arise because it is very addictive. Many drug treatment programmes are geared to helping people who are addicted to heroin and other opioid drugs.

Naltrexone (Nalorex) is a prescribed drug that eliminates the positive experiences associated with opioid use. If you are being treated for heroin addiction, naltrexone may be prescribed to help you stay off it.

Type of drug opium-related painkiller/depressant
Short-term effects
  • rush of pleasure followed by calm, warm, dreamy contentment
  • drowsiness
  • talkativeness
  • loss of appetite
  • insomnia
  • lethargy
Long-term effects
  • loss of appetite
  • apathy
  • neglect of personal safety and hygiene
  • generalised pain when the level of drug in your system drops
Dependency and withdrawal symptoms
  • a craving that can lead to serious social problems including crime
  • severe physical withdrawal symptoms
  • tolerance of the drug, meaning you need to take more of it to achieve the same effect

ketamine (Special K)

Ketamine is an anaesthetic that is mainly used in animals. It is similar to PCP.

It has antidepressant effects and is being researched for use in treatment-resistant depression and PTSD.

Type of drug hallucinogen
Short-term effects
  • poor concentration
  • changed perception of surroundings – things not 'looking right' or 'feeling right'
  • feeling out of touch with reality and your surroundings
  • delusions
  • paranoia
  • dream-like states
  • nightmares
  • feeling you have no thoughts
  • a 'bad trip' may make you violent, suicidal or likely to harm yourself
Long-term effects
  • difficulty thinking clearly
  • depression
  • panic attacks
  • anxiety
Dependency and withdrawal symptoms
  • tiredness
  • depression

khat

Khat is a green, leafy plant that has been chewed in East Africa for thousands of years. The effects are similar to amphetamine but less strong.

Khat was made a class C drug in 2014, meaning that it is illegal to possess or supply to others. It is used socially in much of east Africa, in much the same way that alcohol is used in the UK. Like alcohol, it becomes a problem with overuse.

Type of drug stimulant
Short-term effects

• feeling elated and energetic

• not being able to sleep

• loss of appetite

• relaxation

• feeling sociable

• hearing voices (associated with high doses)

• paranoia (associated with high doses)

Dependency and withdrawal symptoms

• tiredness

• depression

• anxiety

• irritability

LSD (lysergic acid diethylamide, acid)

LSD is a synthetic drug that was first made in the 1940s. It causes random and sometimes frightening effects, known as a 'bad trip', which may be delayed.

As LSD causes you to hallucinate and lose touch with your surroundings, it can cause you to do dangerous things (such as attempting to fly, for example). In some cases, people have died due to dangerous behaviour as a result of taking LSD.

Type of drug hallucinogen
Short-term effects
  • detachment from surroundings
  • altered sense of space and time
  • hallucinations
  • feelings of insight, mysticism and spirituality
  • feeling that you can fly
  • anxiety (associated with a bad trip)
  • feeling panicky (associated with a bad trip)
Long-term effects
  • likely to worsen existing symptoms of schizophrenia
  • flashbacks of bad trips, when you feel you are re-living them

mephedrone (meow meow)

Mephedrone is similar to amphetamines, ecstasy and the active ingredients of khat.

Do not confuse mephedrone with methadone.

Type of drug stimulant
Short-term effects
  • alertness, confidence, talkativeness
  • agitation
  • anxiety
  • hallucinations (hearing and seeing things, and strange touch sensations)
  • paranoid delusions (even if taking antipsychotic medication)
  • depression
  • suicidal feelings

The effects of this drug [mephedrone] were at the beginning the most enjoyable. My problem with this became very detrimental to my mental wellbeing, leading to psychosis and becoming a danger to myself.

nicotine (tobacco)

You would not normally experience mental health effects from using nicotine. However, it is extremely addictive, and stopping nicotine can cause negative effects.

If you are taking part in a smoking cessation programme, you may be offered a medication such as bupropion (Zyban), varenicline (Champix) or a benzodiazepine to help cope with the withdrawal effects and reduce dependency.

Type of drug stimulant
Dependency and withdrawal symptoms
  • irritability
  • restlessness
  • depression

phencyclidine (PCP)

PCP is an anaesthetic, mainly used in animals. It is similar to ketamine. The symptoms you experience from taking PCP may be confused with schizophrenia.

PCP can make you feel good but may also make you panicky, paranoid and low. Some people have died as a result of injuries they caused themselves after taking it.

Type of drug hallucinogen
Short-term effects
  • poor concentration
  • changed perception of surroundings – things not 'looking right' or 'feeling right'
  • feeling out of touch with reality and your surroundings
  • hallucinations
  • delusions
  • paranoia
  • dream-like states
  • nightmares
  • feeling that you have no thoughts
  • feeling violent (associated with a 'bad trip')
  • feeling suicidal or wanting to self-harm (associated with a 'bad trip')
  • psychosis
Long-term effects
  • depression
Dependency and withdrawal symptoms
  • depression

pregabalin

Pregabalin is a prescription-only medication used for anxiety, neuropathic pain and epilepsy.

See our full pregabalin listing for further details.

Type of drug depressant
Short-term effects
  • calmness
  • relaxation
  • happiness and excitement
  • sleeping problems
  • hallucinations
  • panic attacks
  • agitation
Dependency and withdrawal symptoms
  • anxiety
  • depression
  • difficulty sleeping
  • nausea
  • pain
  • seizures
  • sweating

psilocybin/psilocyn (magic mushrooms)

The effects of magic mushrooms are similar to LSD.

If you have mental health problems, magic mushrooms may make them worse.

Type of drug hallucinogen
Short-term effects
  • hallucinations, which could be pleasant or frightening
  • feeling disconnected from your surroundings and out of control
Long-term effects
  • flashbacks (if you had a 'bad trip')

solvents

Solvents, glues, gases and aerosols can affect the heartbeat and cause death. Repeated sniffing can cause a hangover effect, making you pale, very tired, forgetful and unable to concentrate.

They are used mainly by (a small percentage of) young people, usually only for a short period.

It is illegal to sell glues and solvents to young people under 18 if you suspect they may be using them to sniff.

Type of drug depressant
Short-term effects
  • feelings similar to getting drunk
  • dizziness
  • feeling unreal
  • euphoria
  • loss of inhibition
  • mood swings
  • pseudo-hallucinations (hallucinations that you know are not real)
  • depression
  • aggression
Dependence
  • rare

This information was published in November 2016. We will revise it in 2019.


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