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Drugs: The Good, the Bad and the Ugly

THE CHANCES ARE THAT at some point someone, probably some shady-looking guy in a nightclub on a night out, will offer you drugs. People tend to become involved with drugs, if at all, during their teens, but it’s by no means confined to that time. During my teens, I experimented with drugs – this chapter is not intended to steer you either away from or towards recreational drug use. That isn’t to say I don’t have my own opinions on the subject. People with Asperger’s have an environmental proclivity towards depression, born of a feeling of ‘living on the outside’. As I’ve struggled with these issues myself, and being diagnosed with bipolar disorder, I make a marked point of avoiding anything that may inadvertently affect my already somewhat disordered neurochemistry. However, having looked around at some research on the subject, there isn’t all that much from a personal point of view. Just because a drug is included in here, it doesn’t mean that I’ve tried it. I’m very careful with

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Al l ri gh ts r es er ve d. M ay n ot b e re pr od uc ed i n an y fo rm w it ho ut p er mi ss io n fr om t he p ub li sh er , ex ce pt f ai r us es p er mi tt ed u nd er U .S . or a pp li ca bl e co py ri gh t la w.

EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 11/26/2019 1:38 PM via COLUMBIA SOUTHERN EDUCATION GROUP AN: 1160121 ; Jackson, Luke, Attwood, Tony.; Sex, Drugs and Asperger's Syndrome (ASD) : A User Guide to Adulthood Account: s3921192.main.eds

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what I put into my body – when I was younger, I had some strange reactions to various pharmaceutical drugs and so I felt that when taking drugs for recreational reasons I’d have similar unusual effects.

Personal opinions aside, one of the most glaring reasons to give all due care and attention when it comes to recreational drugs is the inherent lack of regulation. As recreational drugs such as MDMA are Class A illegal drugs, ones that are shipped into or made in the UK are made safe only at the makers’ discretion. That means you’re never completely sure (and contrary to popular belief, neither is the person you get it from) whether what you’re getting is actually active and pure, or whether it’s safe or not – and sometimes it isn’t. I’ve known a couple of people who died from badly made or poorly manufactured MDMA and it was more than enough to dissuade me from becoming involved in that scene.

I have heard so many arguments for and against drugs, but the fact is that anything, even if it’s not physiologically addictive, can be addictive on a personal, psychological level. Humans can grow to crave something that makes them feel a certain way and this can quickly turn into a habit, which can turn into a full-blown addiction, especially if somebody already has a predisposition towards escapism in the first place. It can become a crutch, something that takes away the edge at times of difficulty, and when this happens, you’re in trouble. There are too many variables, and each time you take something it is different to the last time. It depends on whether and what you’ve eaten, if you’ve had a drink, how much you’ve drunk, whether you’re happy, sad, angry, bewildered or stressed, and that’s just personal variables. It also depends on who you’re with, where you are and what the music’s like. Add to this the body’s natural ability, or tendency, to develop an immunity to certain drugs, and you have yourself a crutch made of sticks and straw.

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Drugs are generally split into two categories: ‘hard’ drugs and ‘soft’ drugs. They’re split in terms of harmfulness to the users, judged by both toxicity and addictiveness. Soft drugs include cannabis, LSD and ecstasy, while hard drugs are things like cocaine and heroin. One of the biggest things to remember is that just because something is legal, it doesn’t mean that it’s safe. Some drugs, such as tobacco and alcohol, come between hard and soft drugs. Both are highly addictive and highly dangerous. Caffeine is also highly addictive, but its stigma has been all but removed because of its legality.

The world of drugs is a strange one. In an effort to make sense of this weird drug-based landscape, we’re going to call on an old friend, the bulleted list. The list that follows is a rundown of the more common street drugs that are around, their synonyms, effects and risks. Some of it is based on my own experience, in one way or another, some of it on other people’s experience, and some of it on research. As there are a great many resources online about the good and bad points of recreational drug use, I’m going to try to describe the various street drugs, specifically the five main drugs you’re most likely to be offered when you’re out – ecstasy, ketamine, speed, cannabis and cocaine – with relation to their effects on an autistic individual. Anyway, down the rabbit hole we go.

• Ecstasy – MDMA, Es, Mitsubishi, XTC, Mandy, Molly, Mum, Dad, pills

Ecstasy is taken in pill form and is an ‘upper’. The pills are often given their names by the image stamped into the front of the pill. It has strong links to dance music because it was used to help people survive the all-night party scene of the late 80s/early 90s. It makes people feel awake, invigorated and refreshed, as if they have the energy to

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do anything. Sounds, smells and everything else are much more finely tuned. Often it has the side-effect of causing feelings of love and adoration for other people. Generally, it takes about 20 minutes or so to ‘come up’ and tends to last about three to six hours.

If the positive effects were the only effects it had, I’m pretty sure everybody would be taking it all the time. Recently there have been trials of MDMA for use in people with post-traumatic stress disorder, with limited results. However, these aren’t the only effects. While I must stress, for the purpose of impartiality, that these effects don’t happen all the time, they sometimes do, which means every time you take a pill, you make a gamble.

One of the short-term effects and one of the most noticeable from an outsider’s perspective is an onset of anxiety. As anxiety is ‘a feeling of worry, nervousness or unease about something with an uncertain outcome’, the chances are high that if you have an ASD, you’ve already had some form of acute anxiety before. Obviously, everyone is anxious at some point, but if you’re more prone to anxiety, adding outside influences such as ecstasy to this can certainly compound the issue. This added anxiety also raises the chance of a panic attack or meltdown, and as the effects of ecstasy can also cause confusion, people often end up less than able to deal with these attacks.

From an outside perspective, to someone sober, the effects of ecstasy aren’t pretty. The drug generally results in a rise or fall in body temperature, causing sweating or the chills, and shaking. This, coupled with occasional involuntary muscle tension, causes gurning – the rolling of the tongue, clenching of the jaw and licking of the lips – to create a not altogether pleasant look. On top of this,

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the tendency to become more conversational and lose any or all sense of personal space means that it’s much, much easier to get into fights.

One of the most notable and most talked about side- effects of ecstasy, however, is the comedown. MDMA acts on serotonin, a neurotransmitter within the brain thought to play an important part in mood. It comes in leaps and bounds and the elevated serotonin levels go towards causing the pleasurable feeling and oneness that are so associated with the drug. Afterwards, people can experience two or three days of depression, often called a comedown. One possible explanation for this is that the brain takes a while to regulate after being bombarded with serotonin, which could be what causes what is often known as the ‘midweek blues’, due to people’s tendency to take ecstasy at the weekends. Restoration of proper serotonin levels can take 48 hours or even a week, depending on the person. Ecstasy has been linked to long-term depression in past studies and it could be down to some people’s inability to reach homeostasis, or proper balance. If there are already pre-existing depressive tendencies in users prior to taking it, then usage could compound these.

The most important thing to remember with ecstasy, as with anything, is not to take it lightly and to be aware of the risks involved when doing so. There are a notable number of deaths each year from ecstasy. This is partly because when you take a pill, you never really know what’s in it. You’ll hear people talking about a certain type, such as ‘sharks’ or ‘love hearts’, but at the end of the day, the only discernable difference between one pill and another is the colour and the stamp. If you do take it, make sure you have eaten and slept properly beforehand. Both of these affect serotonin production and will help speed up

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and improve recovery. On top of this, make sure you don’t mix the drug with alcohol.

As ecstasy causes dehydration, it’s important to make sure you drink enough water, but don’t drink too much. An excess of water can cause death by dilutional hyponatremia, or low sodium concentration in the blood caused by water intoxication. In short, if you’re not careful, you can end up drinking yourself to death. Obviously, the amount of water varies on the situation and ambient temperature, but a good ballpark figure is around a litre of water every couple hours. If you drink isotonic drinks, they will help replace some of the electrolytes lost when sweating. Make sure you sip drinks and don’t just gulp them down.

• Ketamine – special K, donkey dust, K, vit. K, super K, ket

Ketamine was first developed as a veterinary anaesthetic in the 1960s, and moved into human use as it had fewer side- effects than its common predecessor, PCP. It anaesthetises the body without affecting the respiratory system, and is therefore used in a number of minor operations and was deployed as a field anaesthetic during the Vietnam War. Interest grew in its use as a recreational drug and there has been a resurgence of people taking it in recent years. It’s sometimes added to MDMA to change its effects and can be taken in powder form, or more rarely pill or even liquid form, which is injected. It’s very commonly snorted, in lines or off a key.

First of all, let’s talk about the effects of ketamine. As a general anaesthetic, it has the effect of anaesthetising one to the outside world, creating a disconnection between body and mind, an effect that can last from around 20 minutes to an hour. It can leave you feeling completely relaxed and at peace. On top of this, ketamine can have

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hallucinogenic effects which can last from half an hour to several hours and can change the way you see and hear the world in the period the effects are active. People can often become completely immobile and enter a ‘k-hole’, frequently likened to a near-death experience.

There are a number of risks associated with taking ketamine. First and foremost, as ketamine was originally developed as an anaesthetic, the drug leaves the body vulnerable. A dulled pain response coupled with reduced motor coordination skills and disinhibition can leave you open to being hurt and not even realising it. As ketamine can leave a person completely incapacitated, it is also commonly used as a date-rape drug. You are leaving yourself completely open, and thus need to be immensely careful where and when you take it. As with many drugs, especially tranquilisers, it can also leave you confused and disoriented, and there is no ‘off ’ switch you can use if you need to respond quickly, such as if you find yourself in danger.

At the time of writing, more and more research is coming to light about the effect of ketamine on the bladder and liver. In particular, when taking the drug, people feel the need to urinate frequently and urgently. If the urine contains blood or tissue, it can be an indication that the bladder wall is badly damaged and a bladder transplant may even be needed, or the urinary tract is affected and incontinence can occur. Before the research, however, there were long-term users hospitalised with abdominal pains referred to as ‘k-pains’ or ‘k-cramps’, and these people would often take ketamine to lessen the pain, compounding the problem.

Ketamine is a physiologically addictive substance and has the propensity to be psychologically addictive too.

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When someone is physiologically addicted to something like ketamine, however, they can often fool themselves into thinking that they just like it and the feeling it gives. The kicker is that, even though this may be true, there is no way to tell, and very often the body builds up a tolerance, so people need to take more and more to reach the same high. When people continue using something that is damaging their health and starting to encroach on the times when they aren’t using it, this is when they need help the most.

• Cannabis – weed, green, Mary Jane, marijuana, pot, grass, bud, draw, herb, skank, ganja

Cannabis is a drug derived from the cannabis plant, with different types of cannabis often pertaining to different parts of the plant. The active ingredient is THC, or tetrahydrocannabinol. There has been massive debate in the UK in recent years as to the question of its legality and it’s been recently legalised in many parts of America. Part of the argument for its legalisation stems from its effective use as pain and nausea relief in the treatment of advanced stages of some cancers, AIDS and multiple sclerosis, to name a few. It is taken in a number of ways and is often smoked with tobacco, a point which is frequently used in the arguments against its decriminalisation. It can be smoked in a joint with or without tobacco, filtered through water in a bong or cooked in or sprinkled onto food. When smoked, the effects are nigh on instant, whereas cannabis when ingested takes a little longer to kick in.

Cannabis has a number of effects, ranging from relaxation through to mild hallucinations (which are much less common). It can make you feel extremely relaxed and laid back. Stronger strains can have you laughing at

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nothing, confabulating about the most random of subjects and perceiving colours and music differently. The effects vary wildly from person to person and depend heavily on the type of cannabis and the way it is taken. After-effects of strong cannabis include a dry mouth, bloodshot eyes and a distorted perception of time, along with a huge reduction in reflexes. On top of this, cannabis tricks the brain into thinking you’re hungry, which results in ‘the munchies’. Be prepared to eat yourself out of house and home.

In recent years, cannabis has changed a little. When I was growing up, resin, also known as hash, was very common: a brown or black lump that is generally heated and crumbled into joints, bongs or brownies. Nowadays, green or skunk, dried buds and leaves of the cannabis plant, are much more commonplace and are stronger than they were in the past. It affects different people in different ways – for some people, having a smoke is an incredibly normal event, simply a way to chill out after a heavy day. The chances are these people have been smoking for a while and their bodies are more accustomed to the hit. Other people will become slow and lazy and the habit can consume them. Weed is less addictive than other drugs, but it can become psychologically addictive. I’ve seen it rule people’s lives and become their only hobby, almost their entire raison d ’être.

Weed carries its own set of negative effects. It can cause paranoia and exacerbate pre-existing anxiety. How the drug affects you depends on a whole plethora of variables, such as who you’re with, how you’re feeling at the time and what you’ve eaten. There are some studies that have linked cannabis to mental illness, and some that

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have undermined that link. If you’re going to take it, then use your best judgement, educate yourself on the subject and keep in mind genetic predisposition when it comes to mental illness. If you have mental illness in your family, then it would be prudent at least to be wary when it comes to using the drug. In addition to these effects, cannabis does have a negative effect on memory retention and cognition. It doesn’t help you when it comes to learning, so if you do smoke it, leave it until after work, college or university – you wouldn’t come into work or college drunk, so for goodness sake, don’t come in stoned either.

People have different tolerance levels when it comes to cannabis, and if you’ve been around anyone who smokes it at all, you’ll hear the word ‘whitey’ thrown around a lot. To ‘whitey’ is basically to breach your tolerance for smoking weed. It can cause massive anxiety, paranoia, nausea and a feeling of being generally unwell – and feel unwell you will. Seriously, the colour will disappear from your face, hence the term, ‘whitey’ or ‘white-out’. A very extreme ‘white- out’ culminates in vomiting, though often this is down to inhalation of too much tobacco very fast, for example when mixed in with weed in a bong. People will go ‘past the point of no return’ for a number of reasons. Sometimes it can be lack of knowledge of the various types and ways of taking it – some strains are much stronger than others and you’ll get a much stronger hit from a bong than a joint, for example. Other times it’s peer pressure – people will feel as if they have to ‘catch up’, in a similar manner to drinking alcohol with friends on a night out. Some people suggest sugary foods to remedy the onset of a whitey, but how effective this is isn’t known, and there aren’t likely to be any studies on this in the near future. Remember, less is

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more – if you feel as if you’ve had enough, don’t let anyone push you past that. Once you’re up, you can’t just come down straight away, you have to ride out the effects.

A lot of the current literature on cannabis is somewhat one-sided. In recent years, it has seen publicity as both Disney villain and hero. Cannabis is not a wonder-drug that will enrich your life and cure cancer (though it has seen some recent success in certain trials). Neither is it an evil poison that will completely remove your will and status as a human being. If you smoke cannabis, it should be as a recreational habit, don’t make it your life. If you start to feel as if you ‘need’ a joint and get cranky and irritable without it, the chances are you’re developing an addiction. The same applies if you feel as if it isn’t doing anything for you, but still take it, and then find you’re having to take more and more – self-awareness is key. Exercise caution and educate yourself.

One last note – do remember that tobacco is an addictive substance. There have been no recorded deaths with cannabis as the sole cause, but there are around 100,000 smoking-related deaths in the UK each year. If you don’t smoke cigarettes, but mix cannabis with tobacco, and you find yourself craving a joint throughout the day, there is a fairly substantial chance that it’s the tobacco you’re craving, but your brain hasn’t made that link.

• Cocaine – coke, Charlie, toot, blow, snout, sniff, rocks, C

Cocaine, or coke, has long been glamourised and featured in Hollywood films as the drug of choice for the rich and famous. In recent years, prices have dropped and Joe Public, i.e. the general populace, has begun taking it, with increased imports coming in as demand increases. Coke creates a rush, a feeling of euphoria that is short-lived but

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highly potent. As the hit only lasts around 20–30 minutes, people need a lot to keep on top of their high. At around £30–60 for a gram, this can impact on your bank balance as much as anything else. The drug makes the dullest of events seem life changing, and your confidence soars. You’ll become chatty and alert, the life and soul of the party. The thing is, everything is relative, and although you feel confident and alert, there’s every chance you’ll come across as loud, brash, arrogant and, well, a bit of an asshole.

Like a lot of stimulants, coke is an appetite suppressant and so regular users can become malnourished as the drug cuts out any sense of hunger. As a stimulant, it puts strain on the heart, so shouldn’t be mixed with any other stimulants. Smoking cocaine’s other form, crack cocaine – mixed from baking soda, coke and water – can cause damage to the lungs, bronchitis and chest pains. In addition to the bodily health concerns, long-term use can affect mental health, resulting in depression and, in extreme cases, drug-induced psychosis, a condition with symptoms similar to schizoid disorders.

• Speed – whizz, phet, paste, base, sulph, billy, dexys

Speed is a type of amphetamine, an addictive ‘upper’ that makes people awake and alert, at a cost. It turns the most introverted introvert into a chatty, extroverted partygoer. Often, people will take speed to stay awake when partying for days on end; after taking it, you’ll feel as if you can dance forever and you’ll be confident and bursting with energy.

Speed makes you do things with a quickness and can evade fatigue in a way that nothing else seems to. Speed tends to come in wraps, little balls of powder for around £10, and is taken in a number of different ways. It can

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either be rubbed onto the gums, snorted or even heated up and injected. Sometimes people ‘bomb’ it – roll it into a paper and swallow it. The effects last up to around six hours, but different ways of taking it often provide a different kind of high; if you bomb it, the effect will be pronounced but won’t last as long. Snorting it will mean the body absorbs it much faster and the effects kick in much quicker.

There are a couple of side-effects to this sudden energy boost. You won’t exactly find yourself wanting food, for example; speed kills the appetite, so much so that it was a chief ingredient in early diet pills, and some diet pills still contain legal variants of speed. You can become disinhibited, and if you mix speed and alcohol, anything can happen – rather than passing out, you may find yourself carrying on indefinitely and wake up the next day (or more likely, the night after, having stayed awake all night and slept the day through) in all manner of states. This disinhibition, alongside the new-found confidence, can turn you into everyone’s best friend. The problem is, this isn’t always reciprocated. People on speed can wax lyrical about anything that comes to mind, however horrendously dull. After about half an hour, they’ve recounted a good portion of their childhood in the most tedious of manners, all the while telling the nearest person they are just ‘the best guy ever’, even if they’ve only met them that night.

A couple of other side-effects have a little more of a physical manifestation. Shortly after taking it, people’s mouths become incredibly dry, and no amount of liquid will moisten the Sahara Desert that has become their tongue. In addition, they may grind their teeth, causing long-term

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users to develop dental problems. As with MDMA, this can cause users to pull faces like contestants in a gurning competition. If you do decide to take this, be aware of this fact; speed is pretty far from a discreet drug and if you’re in a place that’s subject to random police searches, you’re pretty much a grimacing neon ‘search me’ sign. Alongside this, people build up tolerance to speed pretty fast, so if you’re not careful, you could end up with enough on you to be slapped with a ‘possession with intent to supply’ charge. The more you take, the more you need to take to get the same hit. On top of this, street speed is incredibly impure, with an average purity of just 5–10 per cent. You have no idea when you’re taking it what the other 90-odd per cent is and, more importantly, how harmful or addictive it is. Some of the ‘fillers’ may be completely inactive, some may be addictive and some may be harmful.

While I said I’d try my best to stay impartial for the duration of this chapter, what I will say is that if you have heart problems, then avoiding speed may be for the better. Speed puts quite a strain on your heart and raises your blood pressure, so long-term use, especially with pre- existing heart complaints, can and likely will be dangerous. Some types of speed are stronger than others; in particular ‘base’, which produces a stronger hit and more intense symptoms, can place a great amount of strain on the heart. If you mix it with other stimulants, it can put extra stress on the body. Avoid other uppers like coke, MDMA or poppers, as these could bring on Serotonin Syndrome, a potentially fatal overload of serotonin within the brain.

The comedown from speed is not an enviable experience. Take a little lethargy, add some general feelings of being unwell and a dash of depression and possible paranoia and

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you’ve got a recipe for a pretty bad speed hangover. The symptoms that show depend on how much you’ve taken and for how long. As with alcohol, prevention is better than cure; make sure you stock up on vitamins and that you eat well both before taking it and afterwards. Like alcohol, however, there is no way to completely negate its effects – be very careful and do your research if you must take it.

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