A brief guide to the eects of alcohol and party drugs
And what to do if you think someone is having a bad reaction
What is SX Scotland?
What is this booklet?
SX is about improving the sex, health and wellbeing of gay and bisexual men, and all men who have sex with men, living in Scotland.
For many men who have sex with men, drinking alcohol or taking drugs can be a big part of our culture.
Our ethos at SX is to be sex positive and we strive to improve the physical, sexual and mental health and wellbeing of all men who have sex with men. SX works with cis and trans men, and many other allies across Scotland. Through listening to the people in our community, and empowering them to have their voices heard, we provide support to those we work with, encouraging them to have consensual and pleasurable sex with the least harm. SX is provided by Waverley Care. Waverley Care is positive about HIV, hepatitis C and sexual health in Scotland. By being part of Waverley Care we have benefited from over 30 years of learning and expertise working to reduce new infections, increasing access to testing and challenging the stigma experienced by our communities.
Heading out for a drink offers the possibility to socialise, meet up with friends and potentially hook up with new guys for sex. Alcohol lowers our inhibitions, making us feel more relaxed, which can contribute to a fun night out. Of course, sometimes it can go too far – it can affect our judgement and lead us to making choices we can later regret. Recently, an increasing number of men have started using certain drugs, as well as alcohol, to enhance the sex they have. Drugs can make you feel less inhibited, more aroused and last longer during sex. In recent years we have started to refer to this as ChemSex. In this booklet you will find information on the effects of alcohol and the most common drugs used by men who have sex with men. You will also find information on the complications of mixing drugs and alcohol as well as important first aid information on what to do if something goes wrong.
Alcohol
booze / bevvy / vino / drink What is it? Alcohol is a legal drug sold as beer, wine or spirits. The potency of alcohol is stated on the packaging as a percentage of the liquid. It can range from 4 to 5% in beer, 11 to 14% in wine, to 35 to 55%+ in spirits. The law Alcohol can be consumed legally by people over the age of 18. Guidance UK Government medical guidance suggests you should not drink more than 14 units of alcohol a week and no more than 3 to 4 units in one sitting. This is approximately 14 shots of spirits, 7 pints of regular lager or 7 average size glasses of wine. The effects The right amount of alcohol may help reduce feelings of anxiety and inhibitions and make you feel sociable, chatty and confident. The downsides Too much alcohol can cause hangovers, nausea, headaches and sweats. Excessive consumption can cause black-outs, accidental injury, unconsciousness, coma and even death. Long term excess
drinking can cause liver damage, high blood pressure, strokes and cancer. Alcohol can also lower your inhibitions which can lead to risk taking, such as unprotected sex. It can also allow you to be taken advantage of, or being hurt by others. Regular alcohol consumption can lead to addiction. Mixing it Taking alcohol with cocaine can be particularly dangerous. Once they mix together in the body they produce a toxic chemical which stays in the body much longer than cocaine or alcohol alone. This effect increases the damage done to the heart and liver. For information on mixing alcohol with other drugs, please see the other drug pages in this booklet. Alcohol will not effect your HIV medication. However, many men may forget to take their meds when consuming large amounts of alcohol. Therefore, it might be worth setting a reminder on your phone to take your meds.
Understanding your drinking Units of alcohol in drinks
We want to help you to understand how to use alcohol safely and reduce any potential harm to your physical and mental health. Do you know the guidelines for the weekly consumption of alcohol? Do you know your own average weekly intake of alcohol in units? This risk tool will help you find out if you are risking your health because of the amount of alcohol you are regularly drinking. Your total score from the following six questions will help you find out if you need to think about your alcohol use and make any changes for your health and wellbeing. Question 1: How often do you have an alcoholic drink? Never (0) Monthly or less (1) 2-4 times per month (2)
2-3 times per week (3) 4+ times per week (4) Question 2: How many units of alcohol do you consume on a typical day when you are drinking? 1-2 (0) 3-4 (1) 5-6 (2) 7-9 (3) 10+ (4) Question 3: How often do you consume six or more alcoholic drinks on one occasion? Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4) Question 4: Has there been a time where you
have consumed more alcohol than you feel you should have? Never (0) Maybe (1) Sometimes (2) Regularly (3) Every time (4) Question 5: Have you ever put yourself in a harmful situation because of drinking alcohol? Never (0) Maybe (1) Sometimes (2) Regularly (3) Every time (4) Question 6: Have you ever had sex that you wished you hadn’t had because of drinking alcohol? Never (0) Maybe (1) Sometimes (2) Regularly (3) Every time (4) Total up your score from the six questions. Score of 9 points or under This score indicates that you are a low risk drinker. This means you are less likely to develop an alcohol related illness in the future. If the amount of alcohol that you drink changes, or you have concerns, get in touch. We’re here to help.
Score of 10 to 18 points This score indicates that you are drinking at increasing risk levels. Continuing to drink at this level could cause serious health implications later in life. We suggest that you either drink less amounts of alcohol each time you drink, or give yourself a break between times. Check out our service directory for details of support services. You can also contact us, speak to your GP or check out the Drink Aware website. Score of 19 points or over This score indicates that you are drinking at higher risk levels. Continuing to drink at this level is likely to cause a serious alcohol related illness. We suggest that you attempt to significantly reduce your alcohol drinking and speak to someone who may be able to help, such as your GP. Check out our service directory for details of support services or the Drink Aware website. Reducing the amount of alcohol you drink can help lower your blood pressure, reduce your diabetes risk, lower your cholesterol, and reduce levels of cancer-related proteins in your blood. It can also help you save money, get a better night’s sleep and give you more energy. Drink Smart!
Methamphetamine meth / crystal meth / tina
What is it? Meth comes as tablets, powder or crystals. It can be swallowed, smoked with a pipe, injected (slammed), snorted or rubbed into the lining of your ass (booty bumping).
also worsen other mental health conditions, such as anxiety and depression. Some people become isolated from friends and family. Injecting crystal meth can cause collapsed veins, abscesses, sepsis, and heart infections.
The law Meth is a Class B drug. Possession can lead to a fine and a prison sentence up to 5 years. Supplying the drug can lead to a larger fine and up to 14 years in prison.
Mixing it Mixing meth with ecstasy, cocaine, Viagra, MDMA or poppers can cause heart attacks or strokes. Mixing alcohol with crystal meth is unpredictable, increasing the risk of harm or death. The drug can alter the benefits of antidepressants and cause high blood pressure or serotonin syndrome.
The effects Meth is a powerful stimulant that can keep you awake for very long periods of time. It can also make you feel euphoric, self-confident, and extremely aroused. The downsides The euphoria you may experience by taking meth and having sex, means it can become more difficult to have sex without meth. Reduced inhibitions caused by meth can lead to risk taking and engaging in different sex that you are not used to, such as kink or BDSM. Meth can cause physical and mental health issues resulting in psychosis and paranoia. It can
Using meth while taking HIV drugs (including PrEP) can lead to fatal levels of meth being stored in your body. HIV drugs can slow down your metabolism, making it possible for you to overdose.
GHB / GBL G / gina
What is it? G is a sedative drug and comes as a clear liquid (GBL) which has a chemical taste and smell. GHB, however, is either a salty liquid or a powder that is added to liquid, such as a soft drink, but never alcohol. The law G is a Class C drug. Possession can lead to a fine and a prison sentence up to 2 years. Supplying the drug can lead to a larger fine and up to 14 years in prison. The effects G increases the desire for sex, reduces inhibitions, creates euphoria, and relaxes you. The effects can be similar to alcohol. The downsides G can cause dizziness, vomiting, confusion, drowsiness, memory loss, unconsciousness and even death. Regular use can cause addiction and withdrawal symptoms, such as seizures and coma. Dosing needs to be accurate and precise, as overdosing is easily done and can be fatal. Because G can easily make you ‘go under’, there is risk of sexual assault, or rape if you cannot consent to the sex that is happening.
Mixing it Alcohol is particularly problematic when mixed with G. It can cause breathing problems leading to death. Many party nights can start with alcohol and G users can forget they have taken alcohol earlier in the evening. Mixing G with downers, such as Diazepam or Valium can slow down your breathing and risk you ‘going under’. Mixing G with ketamine or antihistamines can also cause breathing problems leading to fits, coma, or death. G can interact with HIV drugs, including PrEP. It can result in high levels of G being stored in your body and result in serious side effects.
Ketamine Hydrochloride K / special k / vitamin k
What is it? K can be snorted as a white powder or swallowed in liquid or powder form, or as a pill. The law K is a Class B drug. Possession can lead to a fine and a prison sentence up to 5 years. Supplying the drug can lead to a larger fine and up to 14 years in prison. The effects K can boost energy levels, make you aroused, lower inhibitions, and reduce sensitivity to pain. The downsides K can cause panic attacks, depression, and may make existing mental health conditions worse. Those with a history of fits, heart or liver problems or high blood pressure should not use K. K can also make it difficult to get an erection or cum. High doses of K can lead to a ‘K hole’ where you can have difficulty moving and have out of body experiences. Overdoses are rare but tolerance can be developed to K, which means that higher doses are required to experience the same effect. Although guys use K because of its pain-relieving properties in heavier
sex, such as fisting, these activities can result in internal injuries without realising it. Internal injuries can increase the risk of contracting HIV or hepatitis C. Mixing it High doses of K with downers, such as alcohol or G (GHB), opiates or benzodiazepines, can dangerously suppress breathing and heart function, which can lead to unconsciousness. Mixing K with ecstasy or amphetamines can result in dangerously high blood pressure. Alcohol mixed with K can cause nausea and feeling of vertigo (dizziness). Taking K while on HIV medication, particularly protease inhibitors, is not advisable as it can lead to dangerously high levels of ketamine in the body.
Ecstacy / MDMA
E / pills / disco biscuits / eccies / molly What is it? Ecstasy comes as a loose white powder or pills branded with logos such as Mitsubishi, doves or smiley faces. Ecstasy can be swallowed ‘bombing’, snorted, smoked, or inserted up your ass. The law Ecstasy is a Class A drug. Possession can lead to a fine and a prison sentence up to 7 years. Supplying the drug can lead to a larger fine and a life sentence in prison. The effects Ecstasy increases your perception of colours and music, making it the most commonly used drug on the club scene. It can give intense feelings of love, happiness and sexual desire for those around you. The downsides Ecstasy can increase your body temperature and heartbeat giving rise to paranoia, dehydration and depression. Tiredness, sleeping problems and feeling low for days after taking it is common and known as a ‘comedown’. Mixing it Ecstasy can stop you getting a
hard-on or cumming. Some guys take Viagra to fix this but that can cause a hard-on that doesn’t go away for several hours. Mixing ecstasy with alcohol, ketamine or G, will reduce the effects of the drug. Taking more ecstasy to increase the high can lead to overdose. Alcohol can increase dehydration, overheating and damage to your organs causing strokes or heart attack. Mixing with antidepressants can worsen your mental health. Using ecstasy while taking HIV medication is not advisable. The medication can interact with ecstasy leading to higher levels of ecstasy in your body. This may increase the risk of negative effects.
Mephedrone
M-Cat / meow-meow / bath salts What is it? M-Cat comes as a coarse crystallike white powder which is crushed finely to make it easier to consume. It can be swallowed, smoked with a pipe, injected (slammed), snorted or rubbed into the lining of your ass (booty bumping). The law M-Cat is a Class B drug. Possession can lead to a fine and a prison sentence up to 5 years. Supplying the drug can lead to a larger fine and up to 14 years in prison. The effects M-Cat can give feelings of euphoria, alertness, confidence and affection towards others. Like other chemsex drugs, M-Cat can also make you sensitive to touch and enhance sexual experience, making some men ‘driven’ to have sex. The downsides Snorting can cause damage to your nose while swallowing can cause damage to your teeth and gums. Booty bumping can lead to damage of your anal lining and put you at risk of STIs or HIV. Slamming can cause veins to collapse. M-Cat can also cause anxiety, paranoia, make your temperature fluctuate
and give you heart palpitations. It can increase interest in sex and make you do things you normally wouldn’t do, such as kink or BDSM. M-Cat can cause difficulty in maintaining an erection. Comedowns can make you feel depressed and you may find it difficult to concentrate in the days that follow. Mixing it With alcohol, M-Cat can cause your breathing to slow down and increase the effects of the drug. With antidepressants, it can increase the risk of seizures and heart problems. Ecstasy or cocaine, mixed with M-Cat, can cause dehydration and overheating which can be fatal. With Viagra, it can increase pressure on your heart. Although there is little research on its effect with HIV medication, caution is advised.
What to do if you think someone is having a bad reaction to alcohol or drugs Are they anxious or panicky? Sit calmly with them in a quiet room. Keep away from noise, bright lights and crowds. Encourage them to take slow, deep breaths. Are they drowsy? Sit calmly with them but keep them awake. If they become unconscious phone 999 immediately for an ambulance and tell them what they have taken, if you know. Place them in the recovery position until the ambulance arrives. Don’t try to wake them up with coffee or tea, or a cold shower or bath. Are they unconscious? Check if they are responsive, such as asking their name or squeezing their shoulders. If they are breathing put them in the recovery position. Phone 999 immediately for an ambulance and tell them what they have taken, if you know. Have they stopped breathing or having difficulty breathing? Check there is nothing in their mouth. Phone 999 immediately for an ambulance. If you need to perform CPR, put the person on their back. Kneel next to them. Place the heel of one hand in the centre of their chest. Place your
other hand on top of the first and interlock your fingers. With straight arms, use the heel of your hand to push the breastbone down firmly and smoothly, so that the chest is pressed down between 5–6 cm, then release. Do this 30 times at a speed of 2 presses per second. If they are still not breathing then repeat and check until help arrives. The Recovery position. This position makes sure that a person can still breathe if they become unconscious. It will also stop them choking on their vomit. Roll the person on to their side. Put their upper hand under their chin. Bend their upper leg and put it in front of them. See the image below:
Questions? Get in touch, we’re here to help. www.S-X.scot info@S-X.scot
Funding for this booklet was provided in part by
This resource has been designed and developed by
SX is provided by Waverley Care Scottish Charity No. SC036500