How can street drugs affect your mental health?

All street drugs have some kind of effect on your mental health. They affect the way you see things, your mood and your behaviour.

These effects may be pleasant or unpleasant. They might be short-lived, or last a long time. In some cases, these effects may be similar to symptoms you experience as part of a mental health problem. They may go away once the drug has worn off, or they may not, and you may experience longer-lasting effects.

For some people, taking street drugs can also lead to long-term mental health problems, such as depression or schizophrenia.

It is difficult to predict how you will react to a street drug. You may react differently to the same drug at different times or in different situations. How you will react to a street drug may differ depending on:

• The type of drug
• Whether the drug has been mixed with other substances, and what these other substances are
• The amount you take
• The environment or social situation in which you take the drug
• How often you take the drug
• Your previous experience(s) of the drug
• What you want and expect to happen when you take the drug

If you have a history of poor mental health or mental health problems, you are more likely to experience negative effects if you take street drugs. However, even if you have no existing mental health problems, you may still develop symptoms of a mental health problem from using street drugs.

If you take street drugs a lot, or become dependent on them, this can have a negative impact on your day-to-day life. For example, it could lead to:

• Financial problems
• Problems with education and employment
• Problems with relationships
• Problems with housing
• Low self-esteem
• Finding it hard to maintain commitments, including appointments related to your drug use or mental health
• Crime, either for possessing an illegal substance, or for committing an offense to finance your drug use
• Imprisonment

Dual diagnosis

If you have both mental health problems and problems with drug or alcohol use, you may be described as having a dual diagnosis. There is no standardised treatment for dual diagnosis, because it includes a large number of possible problems, and involves both drug and alcohol services and mental health services. If you have a dual diagnosis, you may need help with many different parts of your life (see ‘Treatments’ and ‘Support services’ for more information).

What are the mental health effects of different drugs?

There are four main groups of street drugs, divided according to their major effects, plus a few substances that do not easily fit into any category.The main categories are:

• Stimulants
• Depressants
• Opium-related painkillers
• Hallucinogens

The mental health effects listed in this section are all possible effects of each drug. This does not mean that you will definitely experience these effects, nor does it mean that someone with the symptoms listed here must be taking drugs.

All of these drugs can also cause physical side effects, some of which can be unpleasant and even dangerous.

If you take street drugs, remember that you do not always know what is in them so it can be difficult to predict how you will react. They may not contain any of the substance you are expecting, and may also contain harmful substances.

Alcohol

Alcohol is the most toxic of the commonly used drugs, but moderate use is not usually a problem. The long-term effects listed are associated with drinking a lot over a long period of time. These effects will go away eventually if you stop drinking. However, if you think you may be addicted to alcohol and want to give up alcohol and become sober, it is important to get all the advice and information you need and to seek medical help if possible, as it can be dangerous to stop drinking suddenly.

Type of drug: Depressant

Short-term effects:

• Feeling relaxed and more sociable to begin with
• As the depressant effect sets in, you may need to drink more in order to recreate or maintain these pleasant effects
• Large amounts can cause uninhibited behaviour, such as aggression

Long-term effects:

• Short-term memory loss
• Difficulty thinking clearly
• Difficulty with problem-solving
• Poor concentration
• Addiction
• Dependency
• Withdrawal symptoms
• Anxiety
• Delirium, which may include confusion, disorientation and hallucinations

Amphetamines and methylamphetamine (crystal meth)

The effects of crystal meth are similar to cocaine, but they last longer. For more information, see ‘Cocaine’.

If you have history of or experienced a mental health problem, you are more likely to experience negative effects when using amphetamines or methamphetamine.

Type of drug: Stimulant

Short-term effects:

• Increased attention and alertness
• Reduced tiredness
• Increased energy and confidence

Long-term effects:

• Agitation
• Confusion
• Aggression
• Symptoms of psychosis, such as paranoia or hallucinations
• Withdrawal symptoms
• Anxiety
• Depression
• Tiredness
• Irritability

Anabolic steroids

Anabolic steroids are taken to increase muscle bulk and enhance sporting performance.The short- and long-term effects of anabolic steroids will disappear if you stop taking them. However, the symptoms of dependency may continue.

Type of drug: Stimulant

Short and long-term effects:

• Aggression
• Dramatic mood swings
• Confusion
• Sleeping problems
• Depression
• Paranoia
• Symptoms of dependency
• Extreme tiredness
• Depression

Benzodiazepines

Benzodiazepines are prescribed for anxiety and sleep problems. People take them illegally to increase the effects of other drugs, such as alcohol or opiates; to counteract the effects of stimulants, such as ecstasy or amphetamines; or to stop smoking. Benzodiazepines can be very addictive, and stopping the use of benzodiazepines can be very difficult.

Type of drug: Depressant

Negative effects:

• Feeling agitated
• Aggression
• Feeling hostile

Positive effects:

• Reduced tension and anxiety
• Lucidity
• Feeling calm and relaxed
• Dependency and withdrawal symptoms
• Sleeping problems
• Anxiety
• Irritability
• Heightened senses

Buprenorphine

Heroin addiction is often treated with buprenorphine or methadone. Buprenorphine is less sedating than methadone, and so may be preferable if you are working, or if you drive.

Type of drug: Opium-related painkiller/depressant

Short- and long-term effects:

• Depression
• Loss of libido
• Symptoms of psychosis, such as paranoia or hallucinations
• Feelings of detachment

Caffeine

Caffeine is present in drinks that most people have every day, such as coffee and tea. It is also present in chocolate, and is added to some manufactured drinks such as colas.You can buy it in tablet form too.

Type of drug: Stimulant

Short- and long-term effects:

• Agitation
• Finding it difficult to relax

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

People take cannabis as a way of relaxing. The effects you experience when taking cannabis will largely depend on whether you are used to taking the drug, how much you take and the type of cannabis you use. If you have a history of or currently experience anxiety and depression, you are more likely to experience negative side effects of cannabis.

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
• Symptoms of psychosis, such as paranoia or hallucinations

Long-term effects:

• Long-lasting symptoms of psychosis that may be diagnosed as schizophrenia
• May cause depression in later life if you use it a lot as a teenager

Cocaine, crack cocaine

Cocaine comes in two forms: cocaine powder, which is snorted, and crack cocaine, which is smoked. Both forms of cocaine may be injected. Cocaine is notoriously impure, and often contains other substances. Cocaine is extremely addictive, and it is very difficult to stop taking it. If you have a mental health problem, cocaine can make it worse.

Type of drug: Stimulant

Short-term effects:

• Feeling wide awake
• Feeling full of energy
• Feeling confident

High doses may cause:

• Hallucinations
• Delusions
• Depression
• Suicidal thoughts

Long-term effects:

• Anxiety
• Depression
• Panic attacks
• Paranoia
• Irreversible brain damage
• A worsening of pre-existing mental health problems
• Dependency and withdrawal symptoms
• Loss of energy
• Psychosis
• Depression
• Akathisia (a feeling of intense restlessness)

Ecstasy (MDMA)

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

Type of drug: Stimulant

Short-term effects:

• Feeling happy and relaxed
• Feelings of empathy, openness, and emotional closeness to others

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 after repeated high doses
• Paranoia after repeated high doses

Heroin (diamorphine)

Heroin is a painkiller, prescribed as diamorphine, that relieves pain and causes feelings of euphoria.

Many drug treatment programmes are geared towards helping people who are addicted to heroin and other opioid drugs. Naltrexone 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. Many problems arise with the treatment of heroin addiction because heroin is very addictive.

Type of drug: Opium related painkiller/depressant

Short-term effects:

• A rush of pleasure, followed by a 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 heroin in your system drops
• Dependency
• Withdrawal symptoms
• A craving that leads to serious social problems, such as crime
• Severe physical withdrawal symptoms
• Tolerance, which means you need to take more of it to achieve the same effect

Ketamine

Ketamine is an anaesthetic mainly used for animals. It is similar to phencyclidine (PCP).

Type of drug: Hallucinogen

Short-term effects

• Poor concentration
• Changed perception of surroundings, such as things not looking right or not feeling right
• Feeling out of touch with reality and with your surroundings
• Delusions
• Paranoia
• Dream-like states
• Nightmares
• Feeling you have no thoughts
• A ‘bad trip’ may make you violent or suicidal

Long-term effects:

• Difficulty thinking clearly
• Depression
• Panic attacks
• Anxiety
• Dependence and withdrawal symptoms
• Tiredness
• Depression

Khat

Khat is a green, leafy plant that has been chewed in East Africa for thousands of years. Khat is illegal in some parts of the world.

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)
• Dependence and withdrawal symptoms
• Tiredness
• Depression
• Anxiety
• Irritability

LSD (lysergic acid diethylamide)

LSD is a synthetic drug that was first made in the 1940s. It causes random and sometimes frightening effects which may be delayed. As LSD causes you to hallucinate and lose touch with your surroundings, and it can cause people to do dangerous things. 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 andspirituality
• Feeling as if you can fly
• Anxiety (associated with a ‘bad trip’)
• Feeling panicky (associated with a ‘bad trip’)

Long-term effects:

• Likely to make existing symptoms of schizophrenia worse
• Flashbacks of bad trips, when you feel you are reliving them again

Mephedrone (do not confuse with methadone)

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

Type of drug: Stimulant

Short-term effects

• Agitation
• Hallucinations
• Paranoid delusions (even if you are taking antipsychotic medication)
• Depression
• Suicidal feelings

Methadone

Heroin addiction is often treated with methadone or buprenorphine, which are both prescribed as heroin substitutes.

Methadone has similar effects to heroin, but they are milder and longer lasting, so it stops you going through withdrawal, and doesn’t give you the initial high.

Type of drug: Opium-related drug/depressant

Side effects:

• Mood changes
• Hallucinations
• Restlessness

Nicotine

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

Type of drug: Stimulant

Dependence and withdrawal symptoms:

• Irritability
• Restlessness
• Depression

Phencyclidine (PCP)

PCP is an anaesthetic, mainly used in animals. It is similar to ketamine (see p.15).The symptoms you experience from taking PCP may be confused with schizophrenia.

Type of drug: Hallucinogen

Short-term effects:

• Poor concentration
• Changed perception of surroundings i.e. things not looking or feeling right
• Feeling out of touch with reality and with your surroundings
• Delusions
• Paranoia
• Dream-like states
• Nightmares
• Feeling you have no thoughts
• Feeling violent (associated with a bad trip)
• Feeling suicidal or wanting to self-harm (associated with a ‘bad trip’)

Long-term effects:

• Depression
• Long-lasting psychosis
• Dependence and withdrawal symptoms

Psilocybin/psilocyn (magic mushrooms)

The effects of magic mushrooms are similar to LSD.

Type of drug: Hallucinogen

Short-term effects:

• Hallucinations

Solvents

Solvents, such as glues, gases and aerosols, are used mainly by a small percentage of young people, usually only for a short period.

Type of drug: Depressant

Short-term effects:

• Feelings similar to getting drunk
• Dizziness
• Feeling unreal
• Euphoria
• Loss of inhibition
• Pseudo-hallucinations i.e. hallucinations that you know are not real
• Repeated sniffing can cause a hangover effect, making you pale, very tired, forgetful and unable to concentrate