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Recreational Drugs and Alcohol
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.
What are recreational drugs and alcohol?
Recreational drugs are substances people may take:
- to give themselves a pleasurable experience
- to help them feel better if they are having a bad time
- because their friends are using them
- to see what it feels like.
They include alcohol, tobacco (nicotine), substances such as cannabis, heroin, cocaine and ecstasy, and some prescribed medicines.
“All my experiences with recreational drug use started due to social influences, of wanting to ‘fit in’.”
Recreational drugs may be:
- legal – such as nicotine and alcohol
- illegal – this means it is against the law to have them or supply them to other people; most recreational drugs are illegal
- controlled – these are drugs used in medicine, such as benzodiazepines; it is legal to take controlled drugs if a doctor has given you a prescription for them but it is illegal to have them if not; it is also illegal to give or sell controlled drugs to anyone else.
A number of substances previously known as ‘legal highs’ are now illegal – for example, mephedrone (‘meow meow’).
Drugs and the law
Possession and supply
Most drugs come under the Misuse of Drugs Act 1971, which makes it illegal to possess certain drugs and to supply them to others. They are classified as class A, B or C, depending on the presumed risk of harm they may cause.
New synthetic versions of existing drugs (previously called ‘legal highs’) come under the Psychoactive Substances Act 2016. These are chemicals made to mimic the effects of existing illegal drugs, for example cannabis or cocaine. The Psychoactive Substances Act, which came into effect in May 2016, makes it illegal to produce or supply these types of substances, or to possess them with the intention of supplying them.
The way street drugs are legally classified does not reflect how harmful they are to your mental health. Legal, illegal and controlled drugs can all have a negative impact on you, whichever Act of Parliament they come under and whatever class they are given.
Driving
- It is illegal to drive if you are not fit to do so because of a drug you have taken, whether it is a legal, illegal or controlled drug.
- It is illegal to drive with an illegal drug in your blood, whether or not it affects your driving.
Medical uses
Some of the substances discussed on these pages have potential medical uses:
- synthetic versions of cannabis are available for use in some branches of medicine
- ketamine, psilocybin (magic mushrooms) and LSD are being researched in the UK for possible use in treating mental health problems
The drugs discussed in these pages are those that are used most commonly. There are many others – information about these can be found on the Frank and Erowid websites.
How can recreational drugs affect mental health?
All 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
- be short-lived or longer-lasting
- be similar to those you experience as part of a mental health problem
- go away once the drug has worn off
- continue once the drug has worn off
For some people, taking drugs can lead to long-term mental health problems, such as depression or schizophrenia.
You may already have a mental health diagnosis, and use illegal drugs to help yourself cope.
Dual diagnosis
If you have mental health problems and also have problems with drug or alcohol use, you will probably be described as having ‘dual diagnosis’.
This may cause a large number of problems, and you may need help with many different parts of your life – see support for dual diagnosis.
There is no standardised treatment for dual diagnosis. Treatment involves both mental health services and drug and alcohol services.
How drugs may affect you
It is difficult to predict how you will react to a drug. You may react differently to the same drug at different times or in different situations.
This 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 it
- how often you take it
- your previous experience of it
- what you want and expect to happen
- your mental state at the time
If you have a history of poor mental health, you may be more likely to experience negative effects with illegal drugs.
If you have previously had no mental health problems, you may still develop symptoms of a mental health problem from using these drugs.
Regular use
If you use 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 problems with:
- money
- education and employment
- relationships
- housing
- low self-esteem
- finding it hard to maintain commitments, including appointments related to your drug use or mental health
- crime – either in possessing an illegal substance or to finance a habit, leading to a criminal record
- imprisonment
If you take drugs, remember:
- you don’t always know what is in them
- it can be difficult to predict how you will react
- they could contain additional harmful substances
- they may not contain any of the substance you are expecting
- even if you have taken something before, it could have different ingredients or be a different dose
This is more likely to be the case with illegal highs.
What types of drug are there?
There are four main groups of drugs, divided according to their major effects, plus a few substances that do not easily fit into any category. The main categories are:
- stimulants (e.g. cocaine)
- depressants (e.g. alcohol)
- opium-related painkillers (e.g. heroin)
- hallucinogens (e.g. LSD)
Visit Frank’s A–Z list of drugs for detailed information about lots of different individual drugs.
Stimulants
These make you feel:
- energetic
- alert
- talkative
- active
- very excited
They can be very dangerous (causing death) at high doses.
Repeated use can cause psychosis and paranoia, which may be diagnosed as schizophrenia. They are also addictive.
Hallucinogens
These vary a lot. The same drug may have different effects at different times.
These may make you feel:
- detached from your surroundings
- mood swings
- altered sense of space and time
- hallucinations, illusions and distortions of reality
- feelings of insight
- mystical or religious experiences
The experience may be powerful and not much fun.
Remember
- You will not necessarily experience these effects.
- Someone showing symptoms like this will not necessarily be taking drugs – there may well be other causes.
- All these drugs can also cause physical side effects, some of which can be unpleasant or dangerous.
For more information about physical effects of illegal drugs, see the Frank or Erowid websites.
New psychoactive substances (illegal highs)
These are synthetic substances created to try to mimic the effects of existing drugs in the categories above, to get around the law. They used to be called ‘legal highs’ but all such substances are now illegal.
Most have unknown effects in addition to their intended effect, and trying them is therefore extremely hazardous.
What support is available?
If your drug use is affecting your mental health, you could:
- contact a drug organisation (see Useful contacts)
- see your local NHS drug and alcohol service
- see a GP
They can:
- discuss your drug use and how it is affecting you
- explain your options for treatment
- refer you to a specialist if necessary
You may feel anxious about discussing your use of recreational drugs with your doctor, but your treatment is likely to be more successful if they have all the information about your drug use.
Be honest about how you use drugs. For example, if you have psychotic symptoms, a doctor may be less likely to prescribe antipsychotic medication if they know these may have been caused by a recreational drug.
Before you start any treatment, your doctor should discuss your options with you, and take your opinions into account.
If you are seen by your local drug and alcohol service, you should be given a key worker (a doctor, nurse or drug worker) who will make a care plan with you and see you regularly.
Guidance from NICE (the National Institute for Health and Care Excellence) on the psychological treatment and social help for people with problems related to drug or alcohol abuse recommends:
- all treatment should:
- be person-centred
- take into account your individual needs and preferences
- take into account your cultural background and any special needs
- you should have a good support worker to co-ordinate your care plan and build a good therapeutic relationship with you, discussing your options with you
- you should be offered ‘motivational interviewing’ and ‘contingency management’, which aim to encourage you to stop taking street drugs
- if you are being treated for heroin addiction with methadone, buprenorphine or naltrexone, you should be offered a talking treatment.
Talking treatments
You may be offered psychological therapies, such as cognitive behavioural therapy (CBT) or psychodynamic therapy.
You and your family may be offered behavioural family intervention therapy. If you and your partner both use recreational drugs, you may also be offered behavioural couples therapy.
See talking treatments and cognitive behavioural therapy for further information.
Medication
Medication is unlikely to help with mental health problems that are directly caused by your use of alcohol or recreational drugs. For example:
- antipsychotic medication may not be effective for psychosis caused by an illegal drug
- SSRI (selective serotonin reuptake inhibitor) antidepressants are not effective for treating depression caused by using ecstasy
But if you were already diagnosed with a mental health problem before you started using other substances, you may be prescribed drugs to treat it.
If you are prescribed psychiatric drugs, it’s important to be careful about taking them with recreational drugs. Certain drugs may interact with each other and cause adverse effects.
Heroin addiction
If you are addicted to heroin, you are likely to be offered treatment with methadone, buprenorphine or naltrexone.
What help is available if I have a dual diagnosis?
If you have severe mental health problems and problematic substance misuse, you may be given what is known as a ‘dual diagnosis’ – when both problems are diagnosed.
If you have a dual diagnosis, a range of services can help you:
- mental health and social services
- housing
- self-help groups
- support in the criminal justice system
- drug and alcohol support services
Mental health and social services
Important: if you have a dual diagnosis, mental health services should be responsible for your treatment, rather than drug or alcohol services.
They should be able to refer you for help you with:
- suitable housing
- employment
- benefits
The professionals will need to make a full assessment of your needs, so tell them as much as you can about your circumstances.
You may:
- be referred to your Community Mental Health Team (CMHT)
- be referred to an Assertive Outreach Team (AOT)
- be allocated a care co-ordinator, and
- have a written care plan under the Care Programme Approach (CPA)
If you find it difficult to get the support you need, you may find an advocate helpful.
Support in the criminal justice system
If you have been in contact with the criminal justice system linked to your drug use, this should not make any difference to the type of treatment you are offered.
If you are in prison, you may be offered a ‘therapeutic community’, developed to help people with drug problems in a prison environment.
Drug and alcohol support services
You may be offered help from drug and alcohol support services to encourage you to stop taking drugs or alcohol. This usually means you are allocated a support worker, and receive quite intensive one-to-one support.
The programmes recommended by NICE (the National Institute for Health and Care Excellence) are:
- Motivational interviewing – this aims to help you decide what to do about your drug use, and to follow up the decisions you make. You may be offered one or two sessions.
- Contingency management – under contingency management, you may be offered incentives (such as shopping vouchers) to encourage you to stay off drugs. You will have to agree to urine or saliva testing as part of this.
If stopping alcohol, you are likely to be admitted to hospital because stopping suddenly after a long period of heavy drinking is dangerous. You may also be given medication to treat withdrawal symptoms – this may be an antipsychotic, a benzodiazepine or a combination.
Bipolar and alcohol
Watch Jonny’s vlog on how he has coped with biploar and alcoholism.
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How can friends and family help?
This section is for friends and family members who want to help:
- someone with a mental health problem who also uses recreational drugs or alcohol
- someone who is experiencing mental health problems as a result of taking recreational drugs
It can be very difficult to know how to help people who take drugs, especially if they are addicted.
If they have severe problems, the reality may be that there is a limit to the amount of support you can give them and how much you can get them to change.
However, there are some things you can do that might be helpful.
Encourage them to seek help
This can be difficult, particularly if they are seeking help for the first time.
They may be worried about being judged for their drug use, or concerned about what will happen if the drugs they use are illegal.
You can:
- reassure them that it is OK to seek help
- help them decide where to go for support
Support them to use services
You can:
- help them find out what services are available locally
- go with them if they would like you to (especially for a first visit)
- support them to make the most of the services they are using
If the support offered is not helpful, or they are reluctant to attend, you may be asked to attend meetings with their support workers and doctors to help both you and them provide the most suitable care.
NICE (the National Institute for Health and Care Excellence) guidelines suggest that if you are involved in your friend or relative’s care in this way, they should be shown a copy of the record of the meetings and what you have said.
Encourage them to carry on with treatment
If your friend or relative is taking part in a drug treatment programme or receiving a talking treatment, you may be able to encourage them to:
- stick to their treatment plan
- go to appointments
- meet their targets
Spend positive time with them
It can greatly help your friend or relative if you:
- be there for them
- be honest with them
- listen to them if they want to talk
- spend time together, perhaps joining in with activities they enjoy
Help in an emergency
If your friend or relative doesn’t seek help, and you think they are putting themselves or others at risk, their ‘nearest relative’ (as defined under the Mental Health Act (MHA)) can ask for a mental health assessment to be carried out.
Under the MHA, they can be compulsorily detained in hospital for further assessment and treatment if necessary. You may wish to discuss the consequences of taking this action with other friends or family members first. For more information, see Mental Health Act and Sectioning.
Look after yourself
It can be very difficult to try to support someone whose problems are associated with their use of recreational drugs or alcohol.
You may find it helpful to discuss your feelings and concerns with someone else, such as a counsellor, or to join a support group, such as those provided by your local Adfam or Families Anonymous.
Useful contacts
Mind’s services
- Mind’s helplines provide information and support by phone and email.
- Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
- Side by Side is our supportive online community for anyone experiencing a mental health problem.
Other organisations
Adfam
adfam.org.uk
Information and support for friends and family of people with drug or alcohol problems.
Alcoholics Anonymous (AA)
0800 9177 650
help@aamail.org (email helpline)
alcoholics-anonymous.org.uk
Help and support for anyone with alcohol problems.
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
babcp.com
Information about cognitive behavioural therapy and related treatments, including details of accredited therapists.
Club Drug Clinic
020 3317 3000
clubdrugclinic.cnwl.nhs.uk
Information and support for people worried about their use of recreational drugs. The clinic offers help in the London boroughs of Kensington & Chelsea, Hammersmith & Fulham and Westminster.
Cocaine Anonymous UK
0800 612 0225
helpline@cauk.org.uk
cauk.org.uk
Help and support for anyone who wants to stop using cocaine.
DrugWise
drugwise.org.uk
Information about drugs, alcohol and tobacco.
Erowid
erowid.org
Information about psychoactive substances, including prescribed drugs.
Families Anonymous
0207 4984 680
famanon.org.uk
Support for friends and family of people with drug problems.
FRANK
0300 123 6600
talktofrank.com
Confidential advice and information about drugs, their effects and the law.
GOV.UK
gov.uk
Lists government services and information.
Marijuana Anonymous
0300 124 0373
helpline@marijuana-anonymous.org.uk
marijuana-anonymous.co.uk
Help for anyone worried about cannabis use.
Narcotics Anonymous
0300 999 1212
ukna.org
Support for anyone who wants to stop using drugs.
National Institute for Health and Care Excellence (NICE)
nice.org.uk
Produces guidelines on best practice in healthcare.
NHS UK
nhs.uk
Information about health problems and treatments, including details of local NHS services in England.
Progress – National Consortium of Consultant Nurses in Dual Diagnosis and Substance Use
dualdiagnosis.co.uk
Website for nurses, which includes information for people with dual diagnosis.
Turning Point
turning-point.co.uk
Health and social care services in England for people with a learning disability. Also supports people with mental health problems, drug and alcohol abuse or unemployment.
We Are With You
wearewithyou.org.uk
Supports people with drug, alcohol or mental health problems, and their friends and family.