Intro

Welcome to Safer States: an information handbook about drugs and nightlife brought to you by Good Night Out Campaign, Release, The Love Tank, and Safe Only.

Drugs are part of nightlife. They always have been, and whether you use them or not, they aren’t going anywhere. It’s high time we got informed.

Safer States is for anyone who uses drugs now, may do so in the future, or cares about those in their community who do. We’ve cut through the noise to bring you the most accurate information, informed by science, evidence and a commitment to respect, autonomy and care.

Reducing harm, increasing choice

Some people take the misguided view that talking about drugs is the same as encouraging people to take them. We know that’s not true. Just like when it comes to sex education, gatekeeping essential knowledge only forces us to make assumptions, rely on harmful myths, or take unnecessary risks.

All drug use carries some health or legal risks, but many people choose to use drugs regardless. The information provided here is all about reducing harm by giving anyone who chooses to use drugs more information on doing so safely.

The drugs we cover here are regulated differently across the world. In the UK, for example, drugs are criminalised, and there are legal penalties for taking, carrying, distributing or producing them. Check your local drug laws before acquiring or consuming anything.

This work builds on the pioneering efforts of harm reduction organisations that have fought for a different approach to drugs for decades.

We produced Safer States in partnership with:

  • Release
    The UK’s national centre of expertise on drugs and drug law
  • The Love Tank
    A not-for-profit community interest company which provides education and research in health and wellbeing for underserved communities
  • Safe Only
    A peer-led queer welfare, security and harm reduction provider

We also consulted grassroots harm reductionists and people who use drugs.

When we develop safer use practices for our friendship groups and communities, we can reduce the risks of drug use and save lives. If you find something useful or learn something new, share this toolkit with a friend or five!

Let’s change the party and change the world.

Before we begin

Here are some important things to understand before we begin, which will help you get the most out of Safer States.

Interactions

Using more than one drug on a night out is very common – so much so that we don’t think of some drug combinations in those terms at all, like smoking nicotine and drinking alcohol, or using some prescription medications alongside other drugs. This is sometimes referred to as poly-drug use. When we use more than one type of drug, they can interact to create different effects in our minds and bodies.

People often mix drugs intentionally for certain effects – usually to intensify or numb an experience. It can also be done accidentally. Either way, understanding interactions is a core part of safer use.

Duration

Drugs have wildly different duration and after effects. Knowing how long a drug experience will last is key to planning your life around it. This can also help you recognise when to seek support for yourself or offer help to a friend, as well as when to alert venue or welfare staff, or seek medical help.

Set and Setting

There are two key things that impact your drug experience, influencing the amount of drugs you need to feel effects. These are your set (meaning the mindset you’re in when you use drugs), and setting (your physical and social environment).

Set

  • Have you eaten well today?
  • Do you feel rested?
  • Are you stressed?
  • Where’s your head at?
  • What do you want to get out of the experience?

Setting

  • Who will you be with?
  • Is the space you’re in familiar to you?
  • Do you feel safe where you are using drugs?
  • Can you control your environment (e.g. can you leave, change the temperature, lay down or move around freely)?

How people take drugs

Methods

Drugs can be consumed in various ways, with varying degrees of blood absorption depending on the route chosen. The more something is absorbed, the stronger the psychoactive effects. The different methods we use to take drugs are called ‘routes of administration’ and they have different pros and cons depending on the drug and your own body, so they are worth looking into!

In this guide, we have generally referred to the most common routes of administration for each drug. While cocaine and ketamine are usually snorted, MDMA is often swallowed in pill or powder form. NOS is usually inhaled from a canister or via a balloon.

Dosage & Purity

Dosage refers to the amount of a drug you choose to take. The amount you need to feel an effect will always be dependent on the substance itself, the purity, and what else is going on in your body.

Unless you got your drugs through a medical prescription, it’s fair to assume they’re cut with some other substance ranging from caffeine, paracetamol or stronger things like lidocaine which numbs your mouth. Purity refers to the actual proportion of the drug (e.g. cocaine) in the batch.

Dosing at home

Careful dosage is an essential part of a drug experience. Using a milligram scale is the best way to accurately measure the weight of what you are taking. A good way to stay safe, especially with a new drug of unknown quality, is to start with a small amount, wait 90 minutes, and decide if you want to redose after that.

Dosing out & about

It’s common to dose in groups, but remember that what is a standard for one person could be an overdose for another. For example, you’ve used ketamine many times before but your friend has never tried it. The dosage you would use to feel the intended effects could be an overwhelming amount for your friend. Remember that metabolism, mindset, and setting will all influence your experience. We encourage starting off slow as you can’t dose down after using! Don’t pressure anyone into taking more if they don’t seem totally comfortable with it.

Testing

Testing your drugs is the only way you can really know what you’re taking. The most accurate way to do this is to have it tested through a drug checking service where they can tell you the purity and the contents, which can then inform your dosage. This isn’t very widely available in the UK at the moment, but there are a couple of options:

  • The Loop (UK)
    A drugs charity who run drug checking at some festivals, and have funding to develop more around this in city centres
  • Kykeon Analytics
    A drug checking service in Spain that tests mailed-in drugs and posts results online
  • Energy Control
    A drug checking service based in Spain who will receive drug samples from anywhere internationally

To otherwise determine just the contents of a substance, you can send samples to:

  • WEDINOS (UK)
    A free drug testing service who cannot report on purity but can tell you the ‘major’ and ‘minor’ substances found in samples analysed

Finally, reagent testing kits (available via Reagent Tests UK) allow you to test your own drugs at home. Reagents are chemicals that you drop onto a substance which will change colour in the presence of different drugs. This is useful for confirming whether a substance is or is not what you expected, but it cannot help you with purity or dosage.

Safer Snorting

If you are snorting a drug, crush it first on a clean flat surface. If this is your phone screen, you can use hand sanitiser to clean this surface before crushing on it.

Hot tip #1

Try not to share snorting equipment. Hepatitis C and other bloodborne infections are transmitted this way. Unlike HIV, Hepatitis can survive for a long time on surfaces.

Hot tip #2

Don’t use cash. Cash is pretty filthy, and its edges can cut your nose’s membrane. Use your own clean straw instead, or a clean rolled up piece of paper. If using a key, disinfect before using.

Hot tip #3

Put your bank card away. Try to keep a specific card to crush and/or cut your drugs which is not your bank card. Thoroughly clean this card between uses, preferably with disinfectant. Contactless payment devices and the rollers inside ATM machines make contact with millions of other cards a week, which can lead to cross-contamination.

Using this guide

Below you will find some information about some drugs that are commonly used in clubs, bars and other nightlife settings. Each section contains a table of information on the relevant drug about dosage. It is important for us to note again that how you react to something is very dependent on what else is going on in your body.

  • Threshold is the lowest amount of a substance you’d take to have any effect in the body, though it is unlikely to bring out any of the sought effects.
  • A light dose is likely to create a mild but noticeable level of the sought effects.
  • A common dose refers to a standard amount used by the average person.
  • A strong dose is likely to have very noticeable effects, generally taken by users with more experience and/or a higher tolerance. Could present undesirable effects.
  • A heavy dose is very likely to give you undesirable effects.
  • Onset is the time it takes for the effects of a substance to kick in.
  • The duration is how long the key sought effects last for.
  • The after-effect duration refers to how long you’ll still experience secondary effects for once you’re no longer high and the sought effects have faded.

Support

Supporting others on the night

Sudden changes in behaviour, appearing hot and sweaty, as well as fainting and nausea can be a sign someone has had too much alcohol or another drug.
 Remember that they need our support, care and attention, not judgement.
 Ask the person what they might need and seek the support of those around you.
 You can take these further key steps if you encounter someone who is unwell:

Are they responsive/conscious?

  • If yes, talk with them to see what they need
  • If no, gently try to alert them, and check if they are breathing
    • To gently try and wake someone up, you can say their name if you know it. Try speaking to them on each side of their head (in case they are deaf in one ear), and gently tap their collar bone
    • A healthy adult usually breathes 12 to 20 breaths in a minute – if you can’t comfortably breathe in sync with the unconscious person then it’s likely that they are not breathing enough
    • Their breathing should be rhythmic or even and without a gurgling sound. If the person’s breathing is not rhythmic or it sounds like sharp gurgling or gasping, this is known as ‘agonal breathing’ and may mean that the person isn’t getting enough oxygen


Are they unconscious but breathing?

  • If yes, get them into the recovery position and call an ambulance
    • While waiting for an ambulance you can administer naloxone if it is available. This is the opioid overdose reversal medication
  • If no, a medic or first aider should begin CPR immediately
    • If you or another person has naloxone, this can be administered by someone who is not the CPR responder, between chest compressions

Ensure you have the contact details of the person you are supporting, and the contact details of any of their friends. If you are worried about telling an ambulance worker that you think this person has taken something, remember: name the symptoms, not the substance.

The impact of supporting someone in this moment can be difficult. It’s normal to feel emotional about it. You are not alone.

Seeking support on the night

When you think you know how a substance should feel but your body responds in an unexpected way it can be scary. Being tired, run down, hungry, or having any other kind of substances or medications in your system can easily throw things off balance. If you are feeling ‘off’ on a night out, let a friend or someone you trust know that you need company and find somewhere to take a breather.

It can be unsettling to wake up with gaps in your memory from the night before, especially if you don’t feel quite right in yourself. There is support available which you can call or text anonymously to seek help and talk through things if you need to. Take a look at Good Night Out’s ‘Get Support’ page for suggestions of helplines and web chats we trust: goodnightoutcampaign.org/support

MDMA

What is MDMA?

MDMA is an ‘empathogen’ with stimulant properties, often used in clubs and festivals, known as ‘ecstasy’ in its pressed-pill form and ‘MD/Molly’ in its powdered or crystal form.

What are its effects?

Sought effects

  • ‘empathogen’ = increased empathy
  • emotional connection
  • euphoria
  • feeling of oneness
  • sexual arousal

Side effects

  • dehydration
  • teeth grinding
  • jaw locking
  • eye wiggling
  • trouble peeing

Emergency scenarios

  • seizure
  • severe agitation
  • extreme body temperatures
  • hyponatremia (as too much water)

Usage

Dosage
Threshold 20 mg
Light 20–80 mg
Common 80–120 mg
Strong 120–180 mg
Heavy 180+ mg
Lengths
Onset 20–70 minutes
Duration 3–5 hours
After-effects 1–72 hours

Need to know

  • Certain anti-depressants (MAOIs and SSRIs) should be avoided with MDMA. These can block MDMA’s effects, leading to serotonin accumulation (serotonin syndrome).

  • Combining MDMA with GHB/GBL, alcohol, tramadol, caffeine, or cocaine, can also cause unpredictable and dangerous effects.

  • MDMA raises your body temperature. Take regular dancing breaks and hydrate often (aim to drink one pint of water per hour).

  • Don’t overhydrate! Too much water dilutes essential electrolytes and salts in the blood (hyponatremia) which can be fatal.

  • Don’t redose more than once in a session. This will not make the ‘high’ last longer, can lead to serotonin syndrome, and may worsen the comedown.

  • Comedowns can leave you depressed and anxious; eat a balanced diet, rehydrate, and get some sleep!

  • Take a 2-3 month break between sessions to replenish natural serotonin levels.

Nitrous Oxide

What is Nitrous Oxide?

Nitrous Oxide or NOS is a dissociative anaesthetic gas that produces short-term euphoric feelings. It’s also called laughing gas/whippets/N20.

What are its effects?

Sought effects

  • laughing
  • euphoria
  • visual & auditory distortions
  • calmness

Side effects

  • headache
  • tight chest
  • nausea
  • confusion
  • dizziness

Emergency scenarios

  • B12 deficiency
  • neurological damage

Usage

Dosage
Common 1–3 normal* balloons
Strong 4–9 balloons
Heavy 10+ balloons

*a ‘normal’ balloon = standard 8g canister; ‘doubles’ are also common, meaning 2x the normal dose.

Lengths
Onset Immediate
Duration 1–3 minutes
After-effects n/a

Need to know

  • NOS can trigger pre-existing heart, lung or blood pressure problems.

  • Never inhale NOS directly from the dispenser; the gas is highly pressured and cold, and can severely damage your lungs and mouth.

  • Never put a mask or plastic bag over your head to take NOS. You can easily suffocate.

  • Don’t huff back into a balloon when using NOS; just take it in and hold. Breathe fresh air between balloons.

  • In high doses, NOS inactivates vitamin B12 in your body; chronic heavy use can cause B12 deficiency, which can lead to severe neurological and psychological problems. If you consume heavily, have your B12 levels checked and take extra supplements.

  • NOS canisters are made from steel and are classified as scrap metal. They are recyclable, but not via your usual household recycling as they can explode when crushed. Take the canisters to a scrap metal yard if your local council won’t accept them for recycling. Do not litter!

Cocaine

What is Cocaine?

Cocaine is a central nervous system stimulant synthesised from the coca plant. In powder form, it is usually snorted, but it can also be swallowed, boofed, or injected. The smokable, free-base form is crack cocaine.

What are its effects?

Sought effects

  • alertness
  • increased energy
  • confidence
  • talkativeness
  • sexual arousal

Side effects

  • restlessness
  • shaking
  • increased heart rate & blood pressure
  • nausea
  • moodiness
  • sweating
  • anxiety
  • paranoia
  • irregular heartbeat

Emergency scenarios

  • overamping
  • chronic nasal problems
  • nosebleeds
  • cardiac complications

Usage

Dosage
Threshold 5 mg
Light 10–30 mg
Common 30–60 mg
Strong 60–90 mg
Heavy 90+ mg
Lengths
Onset 5–30 minutes
Duration 30–60 minutes
After-effects up to 24 hours

Need to know

  • Cocaine combined with alcohol turns into cocaethylene in your liver which is more cardiotoxic than cocaine. This masks the effects of alcohol which encourages more consumption and puts additional pressure on your heart and liver.

  • Using cocaine with psychedelics (e.g. 2CB, LSD, mushrooms) can induce severe anxiety.

  • ‘Overamping’ refers to psychologically distressing and overwhelming effects of stimulants. It can happen from taking too much, or from lower doses if you’ve not slept much or have been ill. Mentally, you may experience restlessness, panic, extreme paranoia and agitation, hypervigilance, or hyper-aggressiveness. Physically, you may experience muscle jerking, racing heartbeat, chest pain, high body temperature, or irregular breathing.

  • It is easy to build a tolerance to cocaine in both the short-term (over a session) and the long-term (chronic use). Try to space out sessions as much as you can.

Ketamine

What is Ketamine?

Ketamine is a dissociative anaesthetic with hallucinogenic properties. At lower doses, ketamine can provide a trance-like warmness. At higher doses, it can induce hallucinations and dissociation, sometimes leading to what some call a ‘K-hole’, where you may feel disconnected from your body.

What are its effects?

Sought effects

  • distorted perception
  • out-of-body feeling
  • euphoria
  • calmness
  • serenity
  • numbness
  • bodily heaviness

Side effects

  • confusion
  • memory impairment
  • increased heart rate
  • double vision

Emergency scenarios

  • bladder crystals
  • trouble peeing
  • psychological distress
  • long-term depersonalisation

Usage

Dosage
Threshold 10 mg
Light 10–30 mg
Common 30–75 mg
Strong 75–150 mg
Heavy 150+ mg
Lengths
Onset 10–20 minutes
Duration 30–90 minutes
After-effects 2–12 hours

Need to know

  • Combining ketamine with other ‘downers’ depresses the central nervous system and can cause vomiting, loss of consciousness, and death. Examples of these are alcohol, GHB/GBL, opioids, tramadol, or benzodiazepines.

  • It’s easy to injure yourself on ketamine without realising, due to its anaesthetic properties. Stay in one place on higher doses and never drive or cycle.

  • While some seek out a K-hole for the dissociative experience, it can also happen accidentally. If you enter a K-hole, do not panic. It will pass.

  • Chronic heavy use of ketamine (2+ sessions/ week) can cause bladder crystals and trouble peeing.

  • If you use ketamine regularly, you can build a tolerance. Be careful if someone asks you to measure out a dose for them and remember that your tolerance may differ quite a lot. Start low and wait to see the effects. You can always redose again later.

Resources

If you would like to speak to someone about your (or someone else’s) substance use, get more harm reduction materials and kit, or otherwise stay up to date, here are some organisations and other useful apps and maps you should know about.