Drug addiction and abuse

There are 3 common forms of cannabis, depending on what part of the plant is used. These are marijuana, hashish and hash oil.

Cannabis can be smoked:

• as joints
• in a pipe
• in a vaporiser
• using a water pipe or bong
• using knives on a stove element

It can also be eaten in foods. Some people also mix cannabis with tobacco when they smoke it.

Most people who use cannabis do not use it often. They never develop problems in their lives from its use, and do not have withdrawal symptoms.

Driving while high (stoned) is dangerous and illegal. If the police pull you over while driving after taking drugs, you may lose your license or face a criminal conviction.

Mental symptoms

Some people who use cannabis regularly find that they struggle with poor mood or mood swings. They also have poor motivation, irritability, and poor sleep.

Physical symptoms

People who use cannabis can become physically addicted, especially people who use it every day.

These people may develop unpleasant withdrawal symptoms if they have a day without cannabis or try to cut down or quit. Heavy users of cannabis can become paranoid and fearful. This usually settles down when the drug effect wears off.

Hallucinogens or psychedelic drugs can change the way you see the world. They affect your senses, so you might hear or see things that are not there, or feel things differently. This is called tripping.

More than any other drug, the effects of hallucinogens vary from person to person. The effects also depend on your size, your mood and other things in the environment. You cannot know if you will have a good trip or a bad trip. The effects of the drug usually last between 3 and 5 hours, but can last as long as 12 hours.

Long term, you may have flashbacks. These can happen at any time after taking the drug. Taking other drugs can trigger them, as well as fatigue or heavy exercise.

Heavy use of LSD can affect your memory. It may also increase your risk of serious mental disturbance.

Healthcare providers prescribe opioids to treat strong pain. They are most often used:

• in hospitals or hospices
• after operations
• when a person has a terminal illness like cancer.

In these cases, taking opioids is completely appropriate.

People can also use opioids as drugs of abuse because they can give a feeling of pleasure.

Sometimes a person is introduced to opioids in a social situation. Other times they step up to opioids after getting comfortable using a less dangerous drug. They can also get hooked after using opioids for pain relief. However they started, if a person misuses opioids, they are likely to become addicted to them.

Getting opioids

Some people with opioid addictions get opioids from their healthcare provider under false pretences. This is called drug-seeking. Other people get them through a friend or by buying them on the street.

Buying or selling opioids is illegal. So is prescribing opioids for a person who is addicted. 

Types of opioids

There are many different types of opioids. The most common ones are:

• oxycodone
• codeine
• DHC
• heroin
• fentanyl
• pethidine
• morphine
• methadone.

When a person is in pain, these drugs stop them experiencing the pain. They work by blocking the pain message in their brains. When they are not in pain, the opioids give them a feeling of pleasure, or a high.

Taking opioids

Opioids can be swallowed, sniffed (snorted), smoked, injected or applied as patches. Different ways of taking the drugs give different effects. For example, injecting or snorting gives an intense high. Swallowing tablets like morphine give a less intense high.

Opioids are very addictive. If they are not managed carefully, the person taking them rapidly starts to develop a tolerance and to crave more. They find they cannot quit or reduce the amount they are taking and get bad withdrawal symptoms if they try.

People often make increasingly extreme efforts to get the drug. This often results in crime, poverty and physical injury. It also often leads to loss of relationships and loss of employment.

You have a higher risk of having an accident while driving. Driving while high is dangerous and illegal. You could lose your licence or face a criminal conviction.

While high you could be physically or sexually assaulted.

If you inject drugs, you have a high risk of contracting blood-borne diseases like hepatitis B and C, and HIV and AIDS.

Withdrawal

Withdrawing from an opioid is usually extremely unpleasant. People addicted to opioids tend to use the drug to avoid the withdrawal symptoms rather than to get a high. It can be very hard to get control of an opioid addiction.

Stimulant drugs turn the brain on, giving the user a good feeling and intense energy.

A person using stimulants may feel sexier, stronger, more courageous and more capable. They may need less food or sleep. They may be frenetically active for days on end, and do far more than they are normally capable of doing.

When a drug experience goes bad, a person using stimulants may collapse in exhaustion. They may also become aggressive, agitated or even psychotic.

Driving while high is dangerous and illegal. If the police pull you over while driving and you are high on a stimulant, you may lose your licence or face a criminal conviction.

Types of stimulants

Common stimulants are those based on amphetamines like methamphetamine (ice, crystal meth, P). These are very different from the prescribed amphetamine Ritalin, which healthcare providers use to treat ADHD.

Other stimulants that people can abuse are cocaine and ecstasy (MDMA). These work differently from amphetamines.

Stimulant drugs come in many different forms and people can take them in different ways. They can be swallowed as tablets, sniffed as powder (snorted), injected or smoked in a pipe. Most stimulants are highly addictive.

People who are addicted to stimulants may lose their jobs, or lose their families. They can damage their health and reputation. They may start committing crimes to get access to more drugs.

Synthetic drugs are made in a laboratory. They are designed to give similar effects to other chemicals that give highs.

Synthetic cannabinoids are made to be like cannabis and give similar effects.

Synthetic stimulants are similar to amphetamines. They try to give effects similar to drugs like methamphetamine (P) or cocaine.

The effect that these drugs give depends on the particular batch. It also depends on:

• what drug they are based on
• the amount of the drug taken
• how pure the drug is.

The drugs can come in different forms, including:

• tablets or capsules
• powder
• crystal
• liquid.

They have many different brand names, or street names.

While it was once possible to buy them in shops, synthetic drugs are now illegal due to the harm they can cause. Many people were becoming very sick and even dying, after using these drugs.

Synthetic drugs are very addictive. They cause a lot of problems for people in Aotearoa New Zealand.

A tranquilliser makes a person feel calm and relaxed. If it is used in higher doses, it makes them fall asleep.

A healthcare provider may prescribe a tranquilliser to help someone with certain difficulties, including:

• going through a very stressful time
• getting panic attacks
• feeling tense
• struggling with sleep.

Tranquillisers are only meant to be used for a short time. But for some people, they can become a daily habit and they can get hooked.

The most commonly abused tranquillisers are benzodiazepines and sleeping tablets. People can abuse them deliberately, or accidentally. They might be prescribed them by a healthcare provider, buy them off the street or get them from a friend.

Signs of addiction

Long term use and doses gradually increasing are signs of addiction. If you cannot easily stop taking the drug, or get withdrawal symptoms when you stop, this could also indicate addiction.

People who abuse these drugs do not always realise that their drug use is harmful. They may feel that they simply cannot sleep or manage their worries without these tablets. They may think they have no choice about taking them. But using drugs to make problems go away does not solve the problems in the long term. Drug taking brings with it a new set of problems.

• difficulty with work performance leading to losing your job
• difficulty operating machinery resulting in an accident
• difficulty driving resulting in an accident or losing your licence
• difficulty managing household and parenting duties.

If you use the drugs while pregnant or while breastfeeding, they can harm your pēpi (baby).

Getting tranquillisers

It is illegal to buy or sell these drugs, and to get them from a healthcare provider under false pretences. It is also illegal for a healthcare provider to prescribe these drugs to an addicted person. If your healthcare provider suspects that your tranquilliser use is harmful, they may refuse to give you further prescriptions. They may also try to support you to withdraw from taking them.

Withdrawal

Withdrawing from a tranquilliser usually happens slowly. It is likely to need medical and nursing support and intensive therapy.

• No use is the safest choice.
• Eat well beforehand for energy reserves.
• Drink plenty of water (600ml per hour) especially if dancing.
• Avoid alcohol and caffeinated drinks which further dehydrate you. Catch up on fluids, food and sleep the next day to aid recovery.
• Combining ATS with alcohol or other drugs overworks the system — especially the liver — and the effects are unpredictable.
• Avoid using ATS when taking medication like antidepressants.
• If snorting, make sure it is finely chopped with a razor or knife and use alternate nostrils.
• Taking ATS orally is generally safer than smoking, injecting, or snorting because the stomach can handle acidic substances better than your lungs, veins, or nose.
• Putting ATS in empty pill capsules or wrapped in cigarette papers and drinking plenty of water reduces the damage if swallowing.
• IV use carries increased risks of HIV and hepatitis if needles and other equipment are shared, plus potential damage to veins.
• Avoid IV Ritalin use completely as it can cause serious blood vessel damage.
• Sex on ATS can be rough and long with sore bits, broken condoms and a greater chance of sexually transmitted infections (STIs). Using lube with condoms is safest.
• ATS and medications used to treat HIV or AIDS do not go well together. Contact your local New Zealand Aids Foundation branch. If in Auckland visit Body Positive or the Burnett Centre for more information and support.
• Brush and floss teeth regularly and sip water. When using ATS the blood flow to the gums is reduced and the mouth becomes dry. Also chewing gum is a good idea if you grind your teeth when speeding.

• No use is the safest choice.
• Eat well beforehand for energy reserves.
• Drink plenty of water (600ml per hour) especially if dancing.
• Avoid alcohol and caffeinated drinks which further dehydrate you. Catch up on fluids, food and sleep the next day to aid recovery.
• Combining ATS with alcohol or other drugs overworks the system — especially the liver — and the effects are unpredictable.
• Avoid using ATS when taking medication like antidepressants.
• If snorting, make sure it is finely chopped with a razor or knife and use alternate nostrils.
• Taking ATS orally is generally safer than smoking, injecting, or snorting because the stomach can handle acidic substances better than your lungs, veins, or nose.
• Putting ATS in empty pill capsules or wrapped in cigarette papers and drinking plenty of water reduces the damage if swallowing.
• IV use carries increased risks of HIV and hepatitis if needles and other equipment are shared, plus potential damage to veins.
• Avoid IV Ritalin use completely as it can cause serious blood vessel damage.
• Sex on ATS can be rough and long with sore bits, broken condoms and a greater chance of sexually transmitted infections (STIs). Using lube with condoms is safest.
• ATS and medications used to treat HIV or AIDS do not go well together. Contact your local New Zealand Aids Foundation branch. If in Auckland visit Body Positive or the Burnett Centre for more information and support.
• Brush and floss teeth regularly and sip water. When using ATS the blood flow to the gums is reduced and the mouth becomes dry. Also chewing gum is a good idea if you grind your teeth when speeding.

• Unless prescribed no use is the safest choice.
• Take only as prescribed because the risk of physical dependence increases if benzodiazepines are taken regularly.
• We strongly advise not taking benzos long term as, over the long term, benzo use can result in a person experiencing the very problems for which they sought help in the first place for example, sleep disturbances, depression, anxiety and irritability.
• People who do become dependent or who use benzos for more than a few months should not stop taking them without medical advice and support because they are likely to experience serious withdrawal symptoms. Seek advice from your GP or call CADS.
• Avoid taking benzos with other depressants like alcohol, opioids, other sedatives, barbiturates and antihistamines (such as anti-allergy medications) as this can lead to coma and death.
• Benzos slow reaction times, impair concentration and reduce alertness so do not drive or operate equipment or machinery.
• Avoid injecting crushed tablets or melted down gel capsules — this is extremely dangerous and sometimes fatal. The chalk in tablets causes collapsed veins and can lead to infection and abscess. Injecting gel capsules can also be fatal when the gel solidifies inside the blood vessels.
• Avoid benzos during pregnancy as they may increase the risks of the birth defects. Just as adults taking benzos may experience side effects so too may the unborn baby for example, sedation, decreased muscle tone (floppiness), and breathing problems.
• There are also some reports of benzodiazepine withdrawal occurring in newborns exposed to benzodiazepines in utero. Symptoms of benzodiazepine withdrawal include irritability and sleep disruption.
• Benzos can pass from mother to baby through breast milk which may cause drowsiness and slow response times. When the mother stops using the benzo the baby may also experience withdrawal symptoms.
• The decision to take benzos during pregnancy should be discussed with your prescriber ideally before attempts to conceive.

• No use is the safest choice. If you choose to use cannabis then moderate, occasional use is safer than continual use.
• Taking deep tokes and holding smoke down for a long time is very harmful to the lungs and is not necessary to get the full effects.
• If a friend is spinning out, reassure them and get them to focus on relaxed breathing (refer to safer partying section).
• Avoid using cannabis to deal with bad trips as this often intensifies the unpleasant experience.
• Be aware that mixing cannabis and another depressant like alcohol makes the effect much stronger.
• Avoid mixing tobacco with pot as it increases lung damage and risk of nicotine dependency.
• Cannabis strength varies. Try a small quantity of any new smoke first. Although uncommon, cannabis can trigger psychosis in some individuals. If having delusional thoughts or other distorted sensory experiences when not stoned see your GP or local CADS service.
• Cannabis burns at a much higher temperature than tobacco — ‘spotting’ can be especially harsh. It is safer to use a bong or pipe with cold or iced water to reduce damage from hot unfiltered smoke. Ensure that droplets of water are not inhaled — this is not good for your lungs. Avoid inhaling deeply and holding the smoke in your lungs.
• Replace bong water each time to avoid bugs and bacteria. Adding an antibacterial tablet (available at chemists) helps sterilise bongs. Plastic or rubber equipment can give off toxic fumes — glass is best. A pipe for sucking in smoke is less damaging than a wide opening. A long glass or stainless steel pipe kept cold (in a plastic bag in the freezer) will cool smoke effectively.
• The least harmful way to smoke cannabis is with a vaporiser.

• No use is the safest choice.
• Using a water nasal spray or sniffing up water immediately after snorting dissolves the residual coke and will significantly reduce the potential damage to your nose.
• Injecting coke numbs the injection site so any damage is not felt immediately. Avoid using the same injection site when having several blasts in the same night to reduce vein damage. Getting advice and filters (to remove impurities) from your local needle exchange is also advisable.
• If you use other stimulants then reduce your usual dose of each substance by at least half because the combined effects of coke with other drugs become more unpredictable and can increase health risks. Speedballs (IV coke and opiates) can increase the chance of an overdose.
• Drinking alcohol when using coke can be more dangerous than using either on their own due to effects on the liver.
• Trying to prevent the crash by continually using makes the eventual comedown worse.
• Heavy use increases the chances of psychotic episodes.
• Use lube during sex. Coke can cause shrinkage guys and makes it harder to cum. Also, putting coke on genitals is not good for anyone's bits.
• If you have a sensitivity to other stimulants avoid using coke at all.

• No use is the safe choice.
• If you can, get your pills checked.
• Over an hour — every hour — sip, not gulp, up to 600ml of water especially if you are sweating. You will not need this much fluid if you are not sweating.
• Avoid alcohol, caffeine and sugary drinks which increase dehydration.
• Avoid isotonic sports drinks as the potassium they contain can increase blood pressure to unsafe levels. 
• Remember basic safety issues including safe sex.
• Avoid E if you have heart, liver or kidney problems, epilepsy or asthma.
• Avoid combining with alcohol or mixing drugs because this produces unpredictable effects and is a greater health risk, putting a huge strain on the heart and liver.
• Avoid taking E if you are taking medication such as beta blockers. Consult your doctor about taking E with medication.
• If you are diabetic, insulin levels can be affected and you may need to monitor blood sugar levels more regularly.
• E can cause a bad reaction if you have an anxiety or psychotic disorder or suffer panic attacks.
• Taking a break from E use can help you regain your emotional and physical well-being. using E regularly (such as every weekend) can result in becoming emotionally and physically run down and as your natural immunity weakens you become susceptible to infections like colds and flu.
• For more info on what specific pills may contain go to the DrugsData website.
  DrugsDataexternal link

• No use is safest.
• Avoid if you have heart or breathing problems, epilepsy, sensitivity to other central nervous system depressants, or general poor health.
• Avoid using drugs that also have a sedative effect, for example benzos, opiates, alcohol or ketamine, with GHB because this significantly increases the chance of an overdose.
• Avoid taking it alone. Be with friends who know what you are using in case medical attention is urgently required.
• If purchasing G, check if it is GHB or GBL, as GBL is usually 2 to 3 times stronger. However individual batches of these drugs will also vary, and caution is advised if acquiring G from new sources.
• Avoid accepting GHB or similar drugs from people you do not fully trust due to the possibility risk of rape, robbery or being left alone if you are too out of it or unconscious.
• Phone an ambulance if anyone falls unconscious after taking GHB or similar drugs.

• No use is the safest option. Low doses work best and are safer.
• Avoid mixing drugs as the combined effects become more unpredictable and often increase risks.
• Especially avoid using other depressant drugs, such as benzos, opiates, alcohol, as the combined sedative effect increases the risk of overdose, choking or losing consciousness.
• Combining with speed or other stimulants puts extra strain on your system or heart and increases the risk of psychotic reactions similar to PCP.
• If you have freaked out on acid (LSD) or other hallucinogens, it would be safest to avoid K.
• Watch out for each other as it is easy to injure yourself if you are numb, uncoordinated and 'off the planet'. The chill room (if you can find one) can be a good place to blob out for a while. Or stay home.
• Avoid K if you have heart or breathing problems or are feeling emotionally fragile.
• IV use is very dangerous and likely to produce unconsciousness. It is safest to avoid injecting K completely but if you are going to inject, do it intramuscularly not intravenously.
• Do not share straws or other snorting devices as these may have traces of blood on them and put you at risk of contracting HIV or hepatitis.
• You should avoid food for at least 1.5 hours before taking ketamine. Nausea and vomiting can occur when it is coming on. Staying still can help with this feeling.
• It is not advisable to use alone. Tell friends if you are taking K and keep an eye on friends who are.
• It is very important to avoid driving while on ketamine.

• No use is the safest choice. People with heart problems should never use LSD.
• It is best to trip only if you are in a positive mood and with friends.
• First time users — take less than a whole trip and make sure you are in a safe environment with people you trust including an experienced tripper or tripsitter.
• The strength tends to vary between tabs so it is advisable to take a small amount at first each time you go tripping.
• Mixing with drugs and alcohol can increase health risks. Mixing LSD with stimulants, such as speed, increases the chance of a bad trip — sensory overload can lead to panic.
• Combining LSD with Ketamine can be extremely disorientating and should be avoided.
• Taking large doses of LSD can bring back suppressed memories.
• If you are having a bad trip use your supports or change the scene or music. Avoid dwelling on personal problems. If you start to panic, reduce breathing to a steady rate and rationalise things. And remember — you will eventually come down.

• No use is the safest choice.
• It is best to take mushies if you are in a positive mood and with friends in a safe environment.
• If you are new to it start slow — take 3 to 5 mushies only.
• Dropping a shroom trip while out clubbing could end up in disaster. Wait until the effects have peaked before deciding if you can deal with going out.
• It is best to go mushroom hunting with someone who knows what they are doing. Do not pick anything you cannot positively identify. There are very poisonous mushrooms that may be mistaken for psilocybin shrooms.
• The strength of magic mushrooms varies considerably depending on the type, age, recent rain and soil conditions. Mushrooms from the same batch vary and some are toxic. It is safer to take a small dose and wait 2 hours before having more (if required).
• Many people eat magic mushrooms in the forest as they find them. It is safest to stay in a group and plan to have water and other essentials available including a straight driver to get you home.
• Avoid binging during the shroom season as this could put your mental health at risk.
• Driving on mushies is not recommended.

No use is safest, especially if you are around pēpi and tamariki. If using, make arrangements for tamariki to be cared for by someone who is not using.

• Keep all drugs and equipment including pain relief medications (prescribed or purchased over-the-counter from a pharmacy) away from tamariki.
• Avoid using opioids with alcohol and other sedatives (downers) such as benzos, tranquilisers, barbiturates. They all depress the central nervous system and together significantly increase the risk of sedation and overdose.
• Always use clean equipment if injecting.
• Take note of the dosage instructions on any pain relief medications and do not exceed the recommended dose.
• Unless it has been prescribed for you avoid using fentanyl. It is incredibly strong meaning it is very easy to accidentally overdose.