For many people, the idea of putting multiple drugs in your system at once can seem pretty extreme.
Stories in the news about people dying from a “cocktail of drugs” make it seem like something is happening on the sidelines.
However, Fiona Measham, director of the drug control charity The Loop, said that “multiple drug use” was actually quite common.
“Since the dawn of time when we use drugs we have used them in combination,” she told Metro.co.uk.
“You can see how it goes, people are trying to control, moderate and minimize the unwanted effects of drugs and maximize pleasures.
“What is important is to understand where some of the most important risks lie in terms of specific substances.”
One of the most common forms of combination drugs, according to Release, probably involves alcohol with something else.
The drug education charity says people don’t often even think of alcohol as a drug, but it certainly has its own dangers, and mixing it with other substances can cause a damaging and potentially fatal reaction.
Mixing depressants, such as alcohol and benzodiazepines (like Valium and Xanax) is particularly risky, says Adam Waugh, senior member of the health team at The Loop.
Like drugs that slow your breathing and heart rate, taking the two in combination increases the likelihood of something going wrong.
“I would also like to warn against mixing ketamine with other drugs, especially those that depress the central nervous system – like alcohol, GHB and benzodiazepines,” he adds.
As an anesthetic that can seriously affect movement and coordination, Adam also advises people to think carefully about the setting in which they have chosen to take ketamine to avoid being harmed by the environment around them.
The mix of depressants and stimulants also comes with its own dangers – especially alcohol and cocaine – which put additional stress on the heart when taken together.
“A lot of times people take cocaine so they can drink through the night, so there’s this symbiotic relationship with it,” says Niamh Eastwood, director of Release.
But the combination can create a toxic substance in the body called cocaethylene, which increases blood pressure and increases the risk of damage to the heart and liver.
In fact, an American study published in the Journal of Addictive Diseases indicates that the risk of dying with cocaethylene in your body is 18 to 25 higher than if you had just taken cocaine alone.
“People underestimate alcohol all the time, they focus on drugs, and they just underestimate the damage that alcohol does,” says Niamh.
Another thing to keep in mind is that people who combine highs and lows often tend to consume more of each than they otherwise would, Adam says.
“Say you take cocaine and diazepam. Both make the other less strong.
“Someone could take more of each until they end up taking an extremely large amount of drugs that are likely to cause disproportionate harm.”
Claire Robins, nurse advocate and drug counselor for Release, adds that stimulants like cocaine can make you “overestimate your ability” when taking other drugs.
For example, she says, it could cause someone to make a much larger ketamine line than they can handle.
“I think people will find that stimulants will make them less aware of being intoxicated by alcohol,” she adds.
“Your body, brain, and liver keep getting drunk, but the drugs have somehow managed to overcome that.”
But the risks associated with the combination of drugs cannot be simplistic and are not limited to stimulants and depressants, says Adam.
“An upper and a downer is a glass of wine and a Red Bull, but it’s also intravenous cocaine and heroin.
“You have this wide range of risks. It’s not just the combination that affects the risk, it’s also things like dosage and context of use.
For example, he says MDMA and tramadol are a very high risk couple, as they can lead to serotonin syndrome, which in severe cases can cause seizures, irregular heartbeats, unconsciousness and death.
Just because one is a stimulant and the other is an opioid – it’s just how each of these drugs interacts with the brain, says Adam.
“If someone takes LSD and cannabis, it’s not a high risk in most circumstances.
But if someone has been up for three days at a music festival, hasn’t slept, has had a history of mental health issues, and is taking LSD – that addition of cannabis may be enough. to make him lose his mind.
“So even things that are ‘low risk’ combinations in some contexts can be high risk. “
Legal pharmaceuticals, especially psychiatric drugs, can also produce dangerous interactions with many illegal drugs, Adam warns.
“A lot of people think that a prescribed medicine is not medicine, even if it is.”
For those who want to learn more, The Loop recommends a site called Tripsit, which has an interactive app showing how different drugs combine, as well as a chart.
Niamh recommends that you do your research before taking any medication – “with caveats as it is an unregulated market”.
The Release website has a lot of good information, as does DrugScience, the Loop, and Erowid, which Claire describes as “the encyclopedia of everything.”
This article is part of the High Alert series, a harm reduction campaign from Metro.co.uk and The Loop.