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The Highway Code

Global Drug Survey knows pleasure drives drug use, not the avoidance of harm.

As far as we know, no guide has ever outlined the impact of harm reduction strategies on the pleasure users obtain from drugs, until now.

Based on the experience of almost 80,000 people who took part in the Global Drug Survey 2014, the High-way Code is the first guide to safer drug use voted for by people who take drugs. The results seem to suggest that safer drug use can be more enjoyable drug use.

Disclaimer

Global Drug Survey does not condone or promote the use of illegal drugs. Global Drug Survey does promote the use of common sense when going about one's daily activities. Drugs and alcohol can be very dangerous. They can kill you. Using drugs when you are young can have a lasting negative impact on your cognitive and emotional well-being. The only way to avoid these harms is not to take drugs. This document represents the views of those who responded to the Global Drug Survey. Please note that no amount of planning and care can ensure you will have either a safe or enjoyable experience when you take drugs. Global Drug Survey is simply reporting the results of the survey which may provide some guidance in reducing the risk of harm only. The best way to avoid drug related harm is to not use drugs.

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Global Drug Survey knows pleasure drives drug use, not the avoidance of harm. As far as we know, no guide has ever outlined the impact of harm reduction strategies on the pleasure users obtain from drugs, until now.

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Drugs and Me | Harm Reduction | Safe Drug Use Guide

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drugsand.me is an educational website that provides information about existing harm reduction methods for drug users. We do not promote drug use, but we do encourage you to be safe if you are thinking of taking any kind of drug. This website was inspired by the thousands of deaths that occur in the UK due lack of correct drug education.

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Pragmatics & pleasure in effective harm reduction

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A series of films we made for the Harm Reduction Works campaign to comprehensively cover the key issues causing drug related harm.

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Mental health hospital admissions linked to cocaine use treble in 10 years

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NHS data shows surge, with increased availability of drug and government cuts blamed

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Description of service

Offers free support and information from advisors and contact with other families. Also arranges a series of workshops and training for anyone affected by someone else's substance use. Help and advice is available monthly at The Wickbourne Centre, Clun Road, Littlehampton. Drop in anytime between 2pm-4pm on the first and third Friday of the month. Offers a safe place where people can receive support and information from a team of friendly advisers.

Littlehampton

Self referral

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West Sussex Drug & Alcohol Action Team - Families & Friends Project - Littlehampton - Helplines Partnership

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Offers free support and information from advisors and contact with other families. Also arranges a series of workshops and training for anyone affected by someone else's substance use. Help and advice is available monthly at The Wickbourne Centre, Clun Road, Littlehampton. Drop in anytime between 2pm-4pm on the first and...

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Find links to all resources created for Alcohol Awareness Week 2017 here #AAW2017

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PDF: Recovery Plus Autumn 2017 - How families can deal with addiction

We are nations in crisis. There is hardly a family that has not been affected by addiction. The statistics on the matter of opioids, alcohol and marijuana are alarming:

105 US and 23 UK lives (the highest in Europe) lives are lost each day to an opioid-related overdose

At least 1 in 8 people in the US and UK experience an alcohol addiction

16.2% of americans smoke marijuana as legalisation rolls out, the 2nd-highest rate in the world; in the UK, only 6.2% admit smoking it.

What can we do? I am a fierce advocate for systemic change on the micro (individual), mezzo (family) and macro (community) levels. In the wake of our national drug crises, action must be taken to help loved ones and their families achieve health and wellness. In this article, I'll start by describing what addiction is. Then, we'll look at what not to do: bail out your loved ones. I'll guide you through the 7Cs of change, to end on a note of hope. First know this: if your loved is caught up with drugs, you did not cause it.

Let's begin with unpacking a definition of addiction. Addiction is defined as a "chronic, relapsing brain disease characterised by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain. These brain changes can be long-lasting, and can lead to the harmful behaviours seen in people who abuse drugs. Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences, and are preventable and treatable but, if left untreated, can last a lifetime".

Addiction is typically characterised by any combination of the following: dysfunctional emotional response to experiences and circumstances, inability to quit the drug and stay quit, cravings, impaired behavioural control, impaired ability to see problems with one's behaviour and impaired ability to see problems in interpersonal relationships. Addiction takes many forms from alcohol and other drugs to process disorders. Consider the following list of possible non-drug addictions: eating disorders, gambling, love, sex, shopping - even digital addiction. These addictions often overlap and the difference between them and substance use disorder can be blurred. And they can twirl with other co-occurring (mental health) disorders.

Addiction creates a volcano effect.

Like a volcano that slowly and steadily builds pressure, steam and corrosive lava, addiction erupts with a powerful force and disrupts families and friends, colleagues and associates, business partners and co-workers. And because one form of addiction bleeds into another - co-occurring mental health disorders such as depression, anxiety, personality disorders, juxtaposed with medical problems such as chronic pain, legal or school issues - many family members feel like they are constantly caught in pent-up destruction and despair. They struggle to find a quick fix with the next bail out for a loved one or for an employee. Emotions hiss and pop. However, a heated concoction of nagging, pleading, begging, lecturing, or screaming will not work.

Add to this... chronic pain issues.

There are over 133million people in the US and almost 28million in the UK - 1.5billion worldwide - who experience chronic pain. This is often treated with a prescription pain killer, an opioid that is highly addictive. Substance use disorders often start with a simple prescription. Whether or not someone is "addicted" is confusing to many family members. They believe their loved one's problems have a firm medical rationale.

Chronic pain is clinically defined as "pain which is persistent and lasts more than 3 months". Our bodies are designed to heal in 90 days; after that, emotions fuel our pain. Our thoughts and feelings drive us into the belief that we need painkillers. University of Arkansas findings in 2016 on opioid use are alarming: with a 10-day supply of opioids, 1 in 5 become users a year later.

Families can make addiction worse.

Families often respond to addiction in ways that do not help anyone. They become codependent. In fact, addiction and codependency become soul mates... holding each other hostage. Codependency is defined as "excessive emotional or psychological reliance on a partner, typically a partner who requires attention due to an illness or an addiction". A codependent relationship causes the loved one of the person experiencing addiction to make excuses for their behaviour. I don't really like the term "codependency". Instead, I call this phenomenon "the ultimate bail out". But bailing out a loved one is counterproductive. You fuel the addiction. You get in the way of progress.

How can you know if you are making an addiction worse? Below are signs to look for:
..."No" is not part of your vocabulary
...Always saying "yes" to whatever is asked of you
...Apologising to others for your loved one's behaviour
...Being secretive
...Calling work, school, or rearranging appointments for your loved one
...Difficulties showing intimacy
...Difficulty setting limits or boundaries
...Feeling anxious and fearful about being abandoned or rejected
...Feeling responsible for a loved one's problems
...Feeling trapped in your relationship
...Giving money or not realising money is missing from your wallet
...Hypervigilance
...Keeping addiction a secret
...Lying to the person so as to hide the truth
...Making excuses for your loved one
...Making up stories about why your loved one is the way s/he is
...Needing to be in control
...Needing to look good to the outside world.

If you or a loved one are also in a relationship with someone who has a substance abuse or mental health disorder, below are some more common behaviours you might be taking on.
...Accepting that the situation will not change: "It's just this way"
...Being a martyr: "Look what I do for her"
...Being a victim: "Look what s/he has done to me and our family. Poor little me"
...Being unable to distinguish the difference between you and your loved one's problems
...Blaming situations or other people instead of the addicted loved one: "He has such a tough boss" or "She has a mean teacher"
...Blaming your loved one who has an addiction for everything that's not right with your life
...Feeling angry and resentful about someone's behaviours and still bailing them out
...Feeling angry with righteous indignation towards the person
...Finishing your loved one's sentences for them
...Ignoring the addicted individual's negative or dangerous behaviours such as stealing, lying, fighting, or legal trouble
...Not being able to label your feelings beyond mad, sad or angry
...Putting the addicted loved one's needs first
...Refusing or denying there is a problem
...Repeating that "everything is alright"
...Inability to share, know or express feelings
...Using excessive "we" terms, rarely "I" or "me".

Change is possible: change agreements.

Despite the destructive and painful reality of addiction and its grip on circles of families, friends and business associates, change is possible. There are several parts to this. The first is to learn about substance abuse, process disorders, mental health
and chronic pain. The second is that you need not be part of the problem - be the solution! Let the 7 Cs guide you to a new way of being:

1. You did not Cause your loved one's addiction

2. You alone cannot Cure the addiction

3. You alone cannot Control the addiction

4. You can take better Care of yourself

5. You can learn to Communicate your feelings

6. You can make healthier Choices

7. You can Celebrate yourself and your growth.

The third aspect of change is creating healthy boundaries for you and your family members and the loved one with addiction. Here are questions that need to be asked related to building honest and healthy boundaries:
> What is okay behaviour and what is not okay?
> What was okay before treatment and how has that changed?
> What was not okay before treatment and how can you make it better this time?
> What gets confusing?

I always tell the families I work with that they must be able to wake up each morning, look themselves in the mirror and know that they are worthy and can stick to the boundaries they have set and their personal recovery map. To assist in this process, clients and families can collaboratively develop Change Agreements to help guide the way.

These are written documents in which a person clearly articulates what they are willing to do to support their loved one in recovery. Plus, you get to define ways in which family members are going to do to take care of themselves. Change Agreements often include family members attending Al-anon and other support groups and/or professional counselling as well as setting firm limits on their financial and other types of supports for recovery. Expectations are concisely articulated. For example, a loved one could engage in treatment as outlined by a professional. This usually includes randomised drug testing, attending meetings, attending intensive outpatient treatment.

The key notion is that healthy boundaries are critical for personal health and happiness. Once a loved one experiencing addiction seeks treatment, all family members, friends and colleagues and business associates must take a hard look at their own behaviours and re-draw these boundary lines to find change.

Fourth, it is of paramount importance for the codependent to begin to take care of themselves, physically and emotionally. Turn to your personal values to find strength. This might come in the form of spirituality or a connection with a higher power. Al-anon, other support groups, meditation, mindfulness, exercise and social bonding aid in the healing process. Lastly, movement starts with a willingness to change, sprinkled with fierce love and commitment to family and loved ones, coupled with the tools necessary to change. When those are in place, family members (you) no longer have to travel a pity path that leads to cajoling and bargaining, no longer will you mortgage your home or blame others or pivot your life around trying to stop your loved one using.
You can help your family with addiction.
I am here to proclaim, announce, shout that you can overcome the sleepless nights, the GPS tracking of cell phones, you can relinquish the baited breath waiting for that overdosed unconscious voice on the phone that disrupts your 4am reverie. There is no need to start and finish everyone's sentences or be an indentured to the endless employment of the royal "we". You no longer have to make up false stories in your head about where your loved one is or is not, nor do you have to sign that a medical marijuana card for your 15 year old is OK.

You can unequivocally tell the truth without shame, guilt, fear, humiliation or fear of recrimination and a scapegoating that you are the bad sister, mother, father, brother, husband, wife, partner, lover, grandparent, business manager, or personal assistant. Because now you know you do not have to have all the actions. Now you can take positive action.

Be the warrior! Be strong. Be vunerable and be the non-codependent YOU!

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PDF: Recovery Plus Autumn 2017 - How families can deal with addiction We are nations in crisis. There is hardly a family that has not been affected by addiction.

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Drugs Meter | New apps are available now

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Information about a wide range of legal and illegal drugs

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Take the drinks meter survey, enter your details and get instant information on how you measure up against our community

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Guidance

A comprehensive and collaborative strategy to enable public health professionals to use behavioural and social sciences to improve health and wellbeing.

Documents

Details

The behavioural and social sciences are particularly important for public health because many of the issues that undermine or enhance our health outcomes have structural, social and behavioural determinants.

Academics, public health professionals, and representatives from funders and learned bodies have collaborated to produce this strategy, to better enable the broad public health system to use behavioural and social sciences to more effectively and efficiently reduce inequalities and improve the health and wellbeing of the population.

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Improving people's health: applying behavioural and social sciences

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Guidance A comprehensive and collaborative strategy to enable public health professionals to use behavioural and social sciences to improve health and wellbeing. The behavioural and social sciences are particularly important for public health because many of the issues that undermine or enhance our health outcomes have structural, social and behavioural determinants.

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Time for safer injecting spaces in Britain?

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Drug and Alcohol Findings Effectiveness Bank analysis titled: Time for safer injecting spaces in Britain?

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The Complete Guide to LSD, by TripSafe

Overview

Lysergic acid diethylamide (LSD) is a common recreational drug. It is also commonly known as acid. LSD is usually consumed on small pieces of paper called blotter.

LSD has been taken by about 25 million Americans at least once, and 1.5 million Americans in the past year, based on 2015 numbers.

We do not endorse the acquisition and use of illegal drugs. If you make the choice to use psychedelic drugs, please do your research.

What is a psychedelic?

Psychedelics are drugs that can induce an altered state, perhaps best described as a dreamlike state, for some number of minutes or hours, depending on the specific psychedelic.

Psychedelics have been used by indigenous people for thousands of years.

Intelligent and creative researchers discovered this indigenous use in the 1950s and 1960s and introduced psychedelics to a tight community of psychotherapists and psychiatrists who found that these tools were very useful.

Psychedelics then entered the popular culture, and were made illegal.

Psychedelic research is now approaching a renaissance.

Are psychedelics good?

If used with care and expertise, there's a solid argument that psychedelics can do the world a lot of good.

Now Rick had an opportunity to work within the system, by the system's rules, to find, or force, common ground around what he believed to be an incontrovertible truth: psychedelics, used with care and expertise, could do people and the world a lot of good.

Is acid the same as LSD?

Sort of. Acid is a street name for LSD, and LSD is a chemical compound. Unfortunately, not all substances sold as "acid" or "LSD" contain just the pure LSD compound. Pure acid would contain 100% LSD. We will try to use the term LSD in this guide, instead of acid.

See more at: LSD vs acid.

Is LSD (acid) safe?

LSD is relatively safe if it pure LSD, and if you have a trusted and experienced guide who can prevent any risk of harming yourself or others due to intoxication.

"Hallucinogens generally possess relatively low physiological toxicity, and have not been shown to result in organ damage or neuropsychological deficits (Strassman, 1984; Gable, 1993, 2004; Halpern and Pope, 1999; Hasler, et al., 2004; Nichols, 2004; Halpern, et al., 2005)."

LSD has been taken by about 25 million Americans at least once, and 1.5 million Americans in the past year, based on 2015 numbers. This 2008 paper noted that "there have been no documented human deaths from an LSD overdose."

"Since the early 1990s, approximately 2000 doses of psilocybin (ranging from low to high doses) have been safely administered to humans in the United States and Europe, in carefully controlled scientific settings, with no reports of any medical or psychiatric serious AEs, including no reported cases of prolonged psychosis or HPPD (Studerus et al., 2011)." Psilocybin is not the same as LSD, though we should expect an extremely similar dosage dependent safety profile.

"This finding is consistent with a US population (2001-2004 data from the National Survey on Drug Use and Health) based study that found no associations between lifetime use of any of the serotoninergic psychedelics (including psilocybin) and increased rates of mental illness (Krebs and Johansen, 2013)."

"The incidence of risky behavior or enduring psychological distress is extremely low when psilocybin is given in laboratory studies to screened, prepared, and supported participants."

"There is no evidence of such potential neurotoxic effects with the prototypical classical hallucinogens (i.e. LSD, mescaline and psilocybin)."

"Cohen (1960) reported that only a single case of a psychotic reaction lasting more than 48 hours occurred in 1200 experimental (non-patient) research participants (a rate of 0.8 per 1000). Notably, the individual was an identical twin of a schizophrenic patient and thus would have been excluded under the proposed guidelines." The key methods to minimize this risk are the medical condition guidlines below.

Acid was ranked as the third safest drug by Nutt et al. All drugs can still be harmful under certain circumstances.

How can LSD be most beneficial?

What had been clear to Hofmann almost immediately had by this time been observed independently by Osmond and a host of others: for LSD to have the greatest positive effect, subjects needed to take it in a safe, supportive, and aesthetically pleasing environment with a clear idea of what to expect. When difficult issues arose-as they often did-the safe setting and supportive presence of a therapist would allow the subject to process this emotional dynamite, defuse it, and transcend it.

Psychedelic usage was associated with improved mental health indicators

"Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72-0.91)), past year suicidal thinking (weighted OR=0.86 (0.78-0.94)), past year suicidal planning (weighted OR=0.71 (0.54-0.94)), and past year suicide attempt (weighted OR=0.64 (0.46-0.89))"

The two biggest risks of LSD

Fake acid: Ingesting what you believe to be pure acid (pure LSD), but is actually something else, particularly NBOMe which has been involved in a few deaths in the last few years

Doing something unsafe during the ~10 hours of being in a decently altered mindstate on the drug. "If someone experiences high anxiety, fear, or paranoia during a psilocybin session, itʼs not hard to imagine them behaving in ways harmful to themselves or others."

What are the effects of LSD (acid)?

This assumes pure acid, i.e. 100% LSD.

Acid feels like "seeing the world for the first time," with stimulated and profound seeming thoughts, and sort of a dreamlike feeling. Hallucinations also exist, though it would be more accurate to think of them as visual distortions - i.e. seeing extra patterns in the grass, a photo of a waterfall might look like the water is moving when it's actually not - but don't think of it as you'll be seeing green leprechauns that will talk to you.

See the first few images on this page for an accurate depiction of low to moderate acid dosage visual effects.

Read more on the effects of LSD here.
How long does LSD last?
LSD generally lasts ~8-13 hours, though it's wise to plan for ~16-18 hours.

During and after use
Side effects during use
Possible side effects during use include: anxiety, paranoid thinking, discomfort, temporary moderate increases in blood pressure.
Side effects after use
"Cohen (1960) reported that only a single case of a psychotic reaction lasting more than 48 hours occurred in 1200 experimental (non-patient) research participants (a rate of 0.8 per 1000). Notably, the individual was an identical twin of a schizophrenic patient and thus would have been excluded under the proposed guidelines."

If you have close schizophrenic relatives, you should not take LSD. This will be discussed futher in the safety section below.

Read the full page on LSD's side effects.
Desirable effects during use
Possible desirable effects during use: joy/intense happiness and peace/harmony.
Desirable long-term benefits
Users following a specific guided trip protocol experienced a variety of benefits including increased purpose, more energy for work, more initiative, getting more work done, increased self-confidence, marriage satisfaction, and more friends at and outside work.

Read the rest at the page on LSD's effects, including positive effects.

"Bad" trips

What is the probability of having a bad trip on LSD?

This depends heavily on the dosage, your mindstate going into the trip, and the environment where you take LSD.

We can approximate from a psilocybin mushroom study:

At a dosage of 200 micrograms of LSD in a therapeutic clinical environment, we might expect 86% of people to experience some extreme fear, for an LSD-adjusted (increase time to account for longer trip with LSD vs psilocybin) average of around ~22 minutes of strong anxiety, and we might expect around ~65% to report a persisting positive increase in mood from this dosage assuming they had first tried 35 micrograms, then 67, then 133, then 200

At a dosage of 133 micrograms in a therapeutic clinical environment, we might expect 14% of people to experience some extreme fear, for an LSD-adjusted average of around ~4 minutes of strong anxiety , and we might expect around ~60% to report a persisting positive increase in mood from this dosage assuming they had first tried 35 micrograms, then 67, then 133

At a dosage of 67 micrograms in a therapeutic clinical environment, we might expect 0% of people to experience some extreme fear, for an LSD-adjusted average of around ~2 minutes of strong anxiety, and we might expect around ~45% to report a persisting positive increase in mood from this dosage assuming they had first tried 35 micrograms, then 67

Bad trips can increase long-term well-being, so call them "challenging trips" instead

Challenging or "bad" acid trips can be most beneficial if they are short, but difficult.

"Multiple regression analysis showed degree of difficulty was positively associated, and duration was negatively associated, with enduring increases in well-being."

Are you currently having a bad trip?

Please visit tripsit chat if you need immediate assistance.

"Say hi, tell us your substance and dose, and describe your issue.

If no one responds within 30 seconds, say ~tripsit and someone will be with you immediately."

Also, see these two calming videos for if you are having a "bad" trip:

Medical benefits

"For example, a recent meta-analysis of six randomized clinical trials of treatment for alcoholism conducted between 1966-1970 found that a single dose of LSD [acid] reduced the probability of alcohol misuse almost two-fold relative to comparison conditions (Krebs and Johansen, 2012)."

There is less medical research into LSD (acid) vs psilocybin (shrooms), because psilocybin is less stigmatized, and psilocybin also has a shorter duration, which is easier for researchers as with psilocybin they can spend more like 8 hours with a participant instead of having to spend ~16 hours with the participant.

Researchers are also interested in studying LSD microdosing, which involves taking around 10 micrograms of LSD, often with the goal of boosting mood or boosting productivity / entering a flow state. See this article for more.

With psilocybin (we would expect similar results for LSD) for cancer-related emotional distress, "83 percent said it [psilocybin + psychotherapy] increased their well-being or life satisfaction moderately or very much, and 89 percent said it lead to moderate, strong, or extreme improvements in their behaviors. Of the 90 total sessions conducted during the study, none were rated as having decreased well-being or life satisfaction."

Watch this video, this video, or this video to get a sense for the therapeutic uses of LSD - these videos are using psilocybin, but they should be useful to anyone evaluating LSD, too.

Psychedelic retreats

While not LSD, magic mushrooms are decently similar in effects and therapeutic potential to LSD.

It is our understanding that magic truffles are legal in the Netherlands, and in Jamaica magic mushrooms are either outright legal or the laws don't seem to be enforced.

Retreats for therapeutic use of psilocybin:

How to take LSD (Acid) the TripSafe way 👽
Thank you to Matthew Johnson, Bill Richards, and Roland Griffiths, for all of their work, and particularly their safety research.
These guidelines are designed to maximize the chance of lasting positive benefits, and to minimize the chance of any offputting experience.

Many LSD users are instead seeking to optimize fun instead of lasting positive benefits and safety, in which case some of these guidelines may not apply. For example, if optimizing more for fun and less for safety, a user may prefer not to use a blindfold and headphones, and may choose to drop acid at a festival or in nature instead of in a safe home environment.

We believe the most important tips that should be followed by everyone regardless of their purpose for using acid are:

1. Avoid with LSD-dangerous health conditions

2. Avoid drugs that interact with LSD

3. Have a trusted, sober guide who is experienced in supporting psychedelic sessions

4. Respect psychedelics

5. Test your LSD

🙋 Safe use is important to avoid adverse reactions

These safe use guidelines are based off research into the clinical and research use of psychedelics.
"Persisting adverse reactions are rare when research is conducted along these guidelines. Incautious research may jeopardize participant safety and future research."
☑️ Safer and more enjoyable usage checklist

Many LSD users are instead seeking to optimize fun instead of lasting positive benefits and safety, in which case some of these guidelines may not apply. For example, if optimizing more for fun and less for safety, a user may prefer not to use a blindfold and headphones, and may choose to drop acid at a festival or in nature instead of in a safe home environment.

We believe the most important tips that should be followed by everyone regardless of their purpose for taking LSD are:

1. Avoid with certain health conditions

2. Avoid drugs that interact with LSD

3. Have a trusted, sober guide who is experienced in supporting psychedelic sessions

4. Respect psychedelics

5. Test your LSD

🚫 Risks to avoid
Serious risks:

1. Death or injurity due to ingesting fake LSD (i.e. not pure LSD).

2. Doing something unsafe while on the drug. Users may not have their regular common sense about them, and may cause minor or serious harm to themselves or others.

3. Psychotic episodes if you have a pre-disposition to mental illness

These risks can be reduced to near zero with proper precautions.

It's also preferrable and possible to reduce the risk of having a bad trip.

Extra info

Myths

LSD is probably one of the most mythologized and demonised drugs, and its history is full of episodes which are as outlandish as the stories, such as the illegal experiments with the drug carried out by American and British intelligence agencies. Countless urban myths exist about bizarre and frightening things people did whilst tripping.
"Bad Acid"
People have believed in batches of so-called "bad acid" which are blamed for horrible effects and bad trips. Doses of different batches can be very variable and 'bad' experiences with LSD can usually be related to unwanted high doses, irresponsibility or unpreparedness and/or the ingestion of a different substance. There are no different types of LSD.
LSD stays in your spinal fluid, causing flashbacks years later
LSD does not stay in your body for long. Flashbacks and HPPD are poorly understood, but the symptoms occur in the absence of LSD.
Orange Juice/ Vitamin C can be used as an antidote to stop a bad trip
This is not true, there are no easy home remedies to end a trip, although doctors use benzodiazepines to ease agitation. However, people are very suggestible when tripping and this can contribute to the perception of such effects.
You can be declared legally insane if you take LSD more than seven times
There is an old rumour that taking LSD more than seven times means that you can be declared legally insane. This is not true and there are plenty of people who have taken LSD more than seven times and are not insane.
People going blind staring at the sun
The rumour about people going blind from taking LSD and staring at the sun was created by a TV show in the 1960s. However, there have been a few case reports of people partially damaging their eyes from staring at the sun whilst on LSD. People do strange things whilst on LSD and LSD dilates your pupils which exposes your eyes to more light than usual.
People think they can fly and jump out of a window
People have fallen out of windows and off cliffs whilst on LSD, but these were probably accidents due to impaired judgement, or suicides, rather than thinking they could fly.

Source: Professor David Nutt and others at DrugScience.org.uk

Alternatives to LSD

Shrooms

DMT (substantially shorter duration)

Ayahuasca

Mescaline

2C-B. Shulgin, a well respected chemist who synthesized thousands of drugs, said 2C-B was "one of his favorite drugs".

Other means of reaching altered states of consciousness: holotropic breathwork, chanting/drumming, sweat lodges, meditation, yoga, float/isolation tanks

Actively recruiting LSD clinical studies
View the studies here.
Email [email protected] to advertise your study here for free.

Actively recruiting LSD surveys

What are your motives for using LSD or other drugs?

Take this questionnaire from Maastricht University about the motives of your drug use: Survey

"Imperial College has set up a new study to investigate the psychological effects of psychedelics. Everyone who has planned to take a psychedelic in the near future can sign up!

You will receive a survey on different time-points, before and after your psychedelic experience. See the website for more information: www.psychedelicsurvey.com

Share your experience and contribute to science!"

Have you overcome alcohol or drug addiction after using psychedelics?

Take this anonymous online survey from Johns Hopkins
https://www.surveymonkey.com/s/AddictionFree
Disclaimer

Do not consume any drugs without consulting a medical professional. This is for informational purposes only.
Full Disclaimer
Organizations we recommend supporting

Heffter
Donate to Heffter to make psilocybin a medicine
Do you contribute to any Patreon campaigns? If so, please contact Heffter and say that you'd love to contribute to them on Patreon.

Other organizations

Other recommended guides
😍 RollSafe.org, guides on MDMA❤️ Datewell.org, a romantic relationship guide🔥 )'( BurnerList.org, a more useful version of the burning man shopping checklist
Things to learn next
What you need to know about Shrooms About the research into psilocybin (active ingredient from magic mushrooms)How to help someone having a bad trip What the effects of LSD are How to take LSD Drug Harm Reduction: A List of What You Should Know If You're Considering Using Other Drugs, like Salvia, Tobacco, Alcohol, etc.
References

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Lysergic acid diethylamide (LSD) is a common recreational drug. It is also commonly known as acid. LSD is usually consumed on small pieces of paper called blotter. LSD has been taken by about 25 million Americans at least once, and 1.5 million Americans in the past year, based on 2015 numbers.

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Impact of parental alcohol and drug misuse on children

Parental substance misuse can have a negative impact on children at each stage of their development.

Women who misuse substances during pregnancy may put their babies at risk of impaired brain development, congenital malformations, premature delivery, low birth weight and withdrawal symptoms after birth.

In later stages, impacts to children can be:

physical and emotional abuse or neglect as a result of inadequate supervision, poor role models and inappropriate parenting

behavioural, emotional or cognitive problems and relationship difficulties

taking on the role of carer for parents and siblings

preoccupation with, or blaming themselves for, their parents' substance misuse

infrequent attendance at school and poor educational attainment

experiencing poverty and inadequate and unsafe accommodation

exposure to toxic substances and criminal activities

separation from parents due to intervention from children's services, imprisonment or hospitalisation

increased risk of developing drug or alcohol problems or offending behaviour themselves.

( Altobelli & Payne, 2014; Cleaver et al, 2011; Cornwallis, 2013; Home Office, 2003; Templeton, 2014)

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Parental substance misuse can have a negative impact on children at each stage of their development. Women who misuse substances during pregnancy may put their babies at risk of impaired brain development, congenital malformations, premature delivery, low birth weight and withdrawal symptoms after birth.

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DrugScience - Addiction: from basic neuroscience to clinical treatments

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A chapter by David Nutt aimed at sixth formers discussing the mechanisms and treatment options for a wide range of drug addictions and dependencies

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As punishments are disproportionate to drug harms, criminalisation causes more harm than it allieves. In the 2017 Addaction lecture, David Nutt lays out why decrimalisation of personal possession is a rational and evidence-based step to take.

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Drugs > Local services and more / West Sussex Wellbeing / Provided by West Sussex County Council

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The West Sussex Children and Young People's Drug and Alcohol Wellbeing Service (under 25 years old) works across the whole of West Sussex and has many places to meet with you in your local community for example, in Find it Out Centres, Family Centres and more, as well as our office base in Worthing.

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In a lab in Basel in April 1943, Swiss scientist Albert Hofmann accidentally touched his hand with his mouth while he was synthesising a chemical intended to stimulate respiration and the nervous system. After ingesting the drug, he realised he had made something far more potent: what we now know as LSD. In the 1950s and 1960s, thousands of LSD studies were carried out after a group of pioneering psychiatrists showed that hallucinogenic drugs had therapeutic potential. It became the age of psychedelics.

In the 50 years since this golden era, scientific progress in psychedelic research has been limited. A backlash against the hippy counterculture - "the war on drugs" - halted research into psychedelics. In 1971, the UK parliament introduced the Misuse of Drugs Act, classifying psilocybin, LSD and DMT as illegal class A drugs.

However, this year could see a watershed moment in British drug policy. After the government rejected the use of medicinal cannabis for a six-year-old epileptic boy who had 3,000 seizures a year, the home secretary Sajid Javid ordered a review of the drug being used for therapeutic purposes.

Could magic mushrooms help the fight against depression?

Only weeks after the cannabis review was announced last month, the London-based Psychedelic Society, a campaign group that believes that psychedelics can improve wellbeing, launched its Psychedelics for Mental Health campaign. The launch discussed the rescheduling of psilocybin, the psychedelic compound found in magic mushrooms, from schedule 1 to schedule 2.

The government sees schedule 1 drugs - including LSD, MDMA and cannabis - as having no therapeutic value, meaning it is illegal to possess or prescribe them. Schedule 2 drugs - such as methadone and diamorphine (heroin) - can be prescribed and legally possessed by pharmacists and doctors. Rescheduling a drug from schedule 1 to schedule 2 makes it much cheaper to conduct research into its effects.

"It feels like the narrative around these substances is changing very quickly," says Stephen Reid, the founder of the Psychedelic Society. "We anticipated that now would be a good time to make a serious push for rescheduling. What we didn't know when we started planning the campaign was that there would be this news around cannabis. It is a further sign of how fast things are changing."

Depression is a growing problem and antidepressants continue not to work for up to half of the people who take them, according to research published in the journal Brain, Behaviour and Immunity. Reid and other representatives of the society believe that psychedelics could potentially treat depression.
Psilocybin and depression
There have been several studies that support the society's theory. One study, led by Dr Rosalind Watts, clinical psychologist at Imperial College London, tested 20 participants who were suffering from severe depression. The participants went through psilocybin and therapy sessions with a "guide", a therapist who would interact with them when they were taking the drug. A psychiatrist also interviewed the participants.

After three months, the antidepressant effects were found to be greater for those taking psilocybin than for people taking typical antidepressants and therapy. Patients said they went from feeling "totally disconnected" with themselves and the world to "connected", and from repressing and avoiding emotions and memories to accepting them.

Watts is about to start work on her next study, which compares the effects of psilocybin with a leading antidepressant, escitalopram. Unlike antidepressants, which are taken daily, psilocybin therapy would take place several times over a series of months, with top-up sessions every few months until the patient decides that they no longer need it.

If psilocybin therapy hits the mainstream, psychiatrists would need training for the new type of therapy, which would cost time and money. It also helps if the "guide" has had their own psychedelic experiences, so they can better understand the patient's.
Hyper-flexible pathways
Neuroscience suggests that psilocybin causes the default mode network (DMN) - the part of the brain that is active when you're not focused on the outside world - to temporarily deactivate. Watts describes the DMN as the "safe network", the part of the brain that ruminates and worries.

The DMN is protective and considered evolutionarily adaptive, but it can become overly critical. When this occurs, people ruminate and worry more, bringing out depression.

I was able to question my life through this 'higher consciousness' - it was me but a very wise part of me

Watts says that psilocybin can make these brain communication pathways "hyper-flexible". Following a therapeutic dose of psilocybin, she believes that for around two weeks, patients should start new habits and hobbies, to help them get out of the depressive cycle. If they don't do this during the two-week window, the depressive symptoms may return sooner.

"People get stuck in their heads, it's like a prison," she says. "When that stops, it allows people to get in touch with their feelings, their bodies and their senses."

Watts believes that psilocybin could be particularly effective as a way of treating depression when combined with therapies such as Acceptance and Commitment Therapy (ACT), as well as other group therapies. ACT is not about eradicating suffering; it's about accepting your suffering and trying to live a meaningful life regardless. Watts believes that psilocybin induces similar feelings, complementing ACT well.

"This combination could lead to a really good treatment model, where people don't just get well for two months, but really manage what they're going through and experience joy and meaning."

After Watts's study, one participant compared antidepressants to taking a painkiller for a toothache: you just numb the pain, but you don't get to the source of the problem. "Psilocybin gave him an understanding about the root causes of his distress and he could change those," she says. "Many people described how antidepressants made them feel numb and more disconnected."
Other psychedelics
Psilocybin isn't the only psychedelic drug that has shown potential to treat depression. Studies indicate that ketamine and LSD could help treat the condition. A recent study into Amazonian psychedelic ayahuasca in the journal Psychological Medicine suggests that it could also be used for hard to treat depression.

People get stuck in their heads, it's like a prison. When that stops, it allows people to get in touch with their feelings, their bodies and their senses

Leon, a 29-year-old Brazilian man who has struggled with depression for eight years, turned to psychedelics to try and cure his condition. In his early twenties, he developed severe depression and after researching the potential of psychedelics, he decided to take part in an ayahuasca ceremony at a Santo Daime Church in Rio de Janeiro, one of several Brazilian religions that use ayahuasca as a sacrament. He had already tried 12 types of antidepressants and none of them worked for him long term.

Leon felt antidepressant effects for 10 days after the ayahuasca ceremonies. The drug helped him analyse personal topics such as being closer to family members and although he didn't find the experience easy, it made him more accepting and able to face his fears.

"I was able to question my life through this 'higher consciousness' - it was me but a very wise part of me," he says. "It was questions and answers most of the time and this is was highly therapeutic - I could analyse a lot of things in my life with a new perspective.

"This higher consciousness always gave me a to-do list and for someone with depression this is a very good thing; it takes you out of your comfort zone."
'Lose-lose situation'
Further research, following the rescheduling of psychedelics, could help people like people Leon who suffer from depression. The scheduling of drugs differs to the classification of drugs; classification is related to controlling access to drugs and imposing sanctions on those who possess and use them.

"It's bizarre why the scheduling of drugs even exists," says David Babcock, CEO of drug research charity DrugScience. "The supposed theory behind it is that drugs schedule 1 are deemed to have either no therapeutic value or to be potentially harmful to the user."

"In my mind, that's just ridiculous, because there are many drugs in schedule 1 - including psilocybin, LSD, ketamine, MDMA and cannabis - and we have evidence that all these drugs have a therapeutic use."

Babcock calls it a "lose-lose situation" as drugs are often labelled schedule 1 because scientists don't know how dangerous or useful they might be, but the fact that they're schedule 1 means it is harder to research how safe they are.
Road to rescheduling
Dr James Rucker, head of psychedelic research at King's College London, says more questions need to be answered before the UK government would think about rescheduling psilocybin.

"The most important question is: 'is it safe?' and that's what we're answering at the moment," says Rucker.

Rucker is organising three trials at the Institute of Psychiatry at King's College London designed to answer that question, but the funding for these trials can be hard to come by. King's College London and Imperial College London are the only places in the country currently researching the effects of psilocybin on mental health conditions, according to Watts. She adds that she is "one of the lucky ones" who receives some funding, but it often runs out.
Building a coalition
Although challenges lie ahead, the Psychedelics for Mental Health Campaign is gaining momentum. Caroline Lucas MP, the former leader of the Green Party, has recently backed the campaign.

The most important question is: 'is it safe?' and that's what we're answering at the moment

The movement has also seen support from popular musicians, including Jon Hopkins, who told The Guardian in April that psilocybin inspired his latest album, Singularity. Among others, the project has also received backing from founder of DrugScience and the government's former chief drugs adviser, Professor David Nutt; The Beckley Foundation; and publication Live Learn Evolve.

"At this stage, it's about building a coalition," says Reid. "There's never been a serious coalition before of organisations and high profile individuals calling for change in this area. This is now backed by a number of leading drug policy institutions in the UK."

The Psychedelic Society is waiting until the review of medical cannabis is complete, though it's not entirely clear about how long that will take. Reid anticipates it taking a few months before he looks to begin bringing a case to the Home Office.

"If there is a decision to change the schedule of cannabis, I think that will set an excellent precedent for other substances being rescheduled," he says. "The first intention off the back of the cannabis review is to push further on psilocybin."

Woman reveals 'what depression looks like' in viral Facebook post

The Psychedelic Society is planning on doing some extensive polling of the current state of attitudes on drugs policy in the UK. From there, it will work out the best calls to make for manifestos in the next general election.

Although there is still plenty of ground to make up since the Seventies, Reid is optimistic.

"I hope there will be much, much stronger suggestions than simply rescheduling by the time 2022 comes around," says Reid. "Jeremy Corbyn, for example, has already backed the decriminalisation of small amounts of medical cannabis and the government seems to be rescheduling it. Things are moving very, very quickly.

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Could psychedelics be prescribed for depression?

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In a lab in Basel in April 1943, Swiss scientist Albert Hofmann accidentally touched his hand with his mouth while he was synthesising a chemical intended to stimulate respiration and the nervous system. After ingesting the drug, he realised he had made something far more potent: what we now know as LSD.

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Community Service Category: Community Services

Change, grow, live provides a range of health and wellbeing support and advice for adults over the age of 25 years old, and their families, carers and friendship networks, who are affected by the use of alcohol and / or drugs (substances).

The West Team covers Chichester, Littlehampton and Bognor Regis, and has many places to meet with you in your local community, in GP surgeries, pharmacies, Family Centres and more.

We have office bases in Bognor Regis, Littlehampton and Chichester. We work alongside a range of local, expert partners.
The support we offer

We are a friendly and non-judgmental team, and will meet with you and complete an assessment to agree which issues you need support with. If you would like to have an informal discussion please get in touch using the details in the contact section. The service is confidential (within safeguarding protocols designed to keep you and others safe) and we can offer:

- Tailored support to all adults aged over 25, whatever the level of use
- A safe place for people to come and feel safe to explore issues relating to their substance use
- One-to-one support to look at how drugs and alcohol are affecting you, your relationships, and your overall health and wellbeing.
- Practical harm reduction advice and information
- A 'drop-in' service so people can access us easily
- Same-day assessments
- Helpful tips around knowing your 'triggers', and how to manage potentially difficult situations
- Medical support if you need it, from our team of Nurses and Doctors
- Referrals into other local services
- Support for family members and friendship networks
- BBV testing and Hepatitis B vaccination
- Needle and Syringe Programme
- Health and well-being checks
- Holistic support through workshops, counselling, key-work sessions, 'pods' & groups

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Drug and Alcohol Wellbeing Network: West Team, Bognor Regis, Chichester and Littlehampton areas

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Change, grow, live provides a range of health and wellbeing support and advice for adults over the age of 25 years old, and their families, carers and friendship networks, who are affected by the use of alcohol and / or drugs (substances). The West Team covers Chichester, Littlehampton and Bognor Read more [...]

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N-ethylpentylone in Montreal, Canada

''Although unadulterated MDMA capsules have been common in eastern Canada since 2017, pure N-ethylpentylone (also called ephylone, or BK-EBDP) has lately made its way into the streets of Montreal and was reported to be sold as MDMA in capsule form. An official warning has yet to be issued as most users are unaware of this designer drug. This compound is far more toxic than MDMA and may cause death at high dosage but still within the range of what heavy MDMA users would ingest.

The appearance of the drug or the subjective user's experience of the drug aren't good indicators of its nature. N-ethylpentylone may look like MDMA and feel similar to MDMA. Marquis drug reagent test is your best ally as it will turn bright yellow if it is N-ethylpentylone instead of purple/black for MDxx.''

Anonymous concerned Montreal citizen.

New Zealand - dangerous drug n-ethylpentylone sold as ecstasy

A new drug masquerading as ecstasy has experts worried after six kilograms were netted in a bust by Wellington police this week.

Wendy Allison, director of free drug testing service Know Your Stuff, says many who believe they're taking ecstasy are actually taking something far more dangerous.

"In our testing this season approximately 25 percent of substances brought us as MDMA have turned out not to be, and of those the majority have been n-ethylpentylone."

N-ethylpentylone is a newcomer to New Zealand, only being detected in the country late in 2017. It's cheap and easy to manufacture, but is also far more toxic if it's taken in the same dosage as ecstasy.

Full article here:

http://www.newshub.co.nz/home/health/2018/03/police-concerned-by-emergence-of-new-drug-n-ethylpentylone-sold-as-ecstasy.html

NB Pentylone and N-ethyl-pentylone turning up in more pills

Please read this excellent article on NB Pentylone and N-ethyl-pentylone detection by The Loop in the UK.

"... with all the valerones being more potent than MDMA, the mis-selling of valerones as ecstasy causes added concern given that an amount that could be considered an â€˜averageâ€™ dose of MDMA would be a very strong dose of any of these impostors."

"NB Pentylone and N-ethyl-pentylone can also both be detected at home with [Marquis] drug reagent tests as they turn bright yellow instead of purple/black for MDMA."

Official Facebook Page for Pill Reports

We've decided to create an official Facebook page for Pill Reports, here's the link: Pill Reports Official.

There are a few imitation Fan Pages on Facebook and we want to avoid any confusion and let you know that they aren't us - nor do they represent what we are about.

We want to make it as easy as possible to stay up to date with the latest information and warnings that are posted on our website and other relevant info that is brought to our attention.

- PR Team

2017 News Update

Hello PR Family,

The turkish section will be removed due to people in that section consistantly breaching our rules/guidelines and its alot harder to maintain due to language barriers.

Pillreports.net will recieve a brand new look / website update in the near future thanks to johnboy.

Bearlove has officially left the team and deserves a huge thank you for everything hes done for the website over the years.

We appreciate everything and hope you will join us again one day,
til then the best wishes to you.

Bornatubby / PR Team

Mix of 25C-NBOMe, 4-FA and MDMA sold as MDMA in Melbourne AUS

tl;dr NBOMe mixtures sold as MDMA are around, donâ€™t snort unknown caps, use test-kits wisely, look after your mates, and get your lab student/worker friends to contact us so we donâ€™t need to rely on labs in Barcelona to access high-quality drug testing in Australia!

On the weekend 15-16 January 2017, there was a spate of poisonings, hospitalisations and deaths that have been associated a batch of capsules that were reportedly sold as MDMA or Ecstasy. Punters at Revolver nightclub and other clubs on Melbourneâ€™s Chapel Street were affected.

The contents of these caps appeared damp, more like a brown sugar consistency than crystals or powder.

We obtained anonymous reports from people who consumed these capsules. The reports describe very strong hallucinogenic symptoms and paranoia. While in most cases, the symptoms resolved without medical intervention, they were very unpleasant, with one person reporting that they â€˜felt like they were going to die or never be the same againâ€™.

Reagent test kit results were shared by Bernie Maitri: these reports showed the substance was unlikely to be MDMA-like, and could instead contain PM(M)A or 2C-T-X. However these results were inconclusive, so we arranged to send a sample of this drug to Barcelona, where Energy Control conducts an international testing service. Mireia Ventura conducted the tests with GC/MS and LC/MS. The testing confirmed that the contents of the capsules:

- 4-FA (main substance)
- a low amount of MDMA
- 25C-NBOMe

This mixture is consistent with the reports. 25C-NBOMe is highly potent with only microgram doses required to produce strong hallucinogenic effects. 4-FA is an amphetamine-type stimulant which has been described as having an effect somewhere between amphetamine and MDMA. It is concerning that a low amount of MDMA was detected in the mixture, as this may be an indication that the manufacturers were hoping to fool reagent test kits by including enough MDMA to produce a positive result.

PLEASE GO TO BLUELIGHT FOR THE REST OF THIS ARTICLE

http://bluelight.org/vb/content/252-25C-NBOMe-4-FA-and-MDMA-mixture

WARNING! - PMA/PMMA is being sold as MDMA in Victoria Australia

In recent months DanceWize has received a number of reports from our peers in the dance community who use Mecke and Mandelin reagent tests sourced online (or from a limited number of retailers in Melbourne) that substances purchased as MDMA (colloquially referred to as Ecstasy) were in fact other Novel Psychoactive Substances, including methylone, 2CB, 2CI, and 2CE. Further, of more concern, such reagent tests have also indicated with a high degree of certainty that PMA/PMMA is in circulation in Victoria masquerading as MDMA.

The substances tested were described as a clear capsule containing white powder that had a subtle purple hue, and a circular orange pill with a capitalised â€˜Bâ€™ press.

This is extremely concerning due to the dangers associated with PMA/PMMA, which is known to elevate body temperature dramatically and has been linked to deaths around the world from hyperthermia (overheating). When partying, if you or anyone else seems to be experiencing fever-like symptoms please seek urgent medical attention and make every effort to reduce core body temperate (drink water, remove clothing layers, apply ice packs to hot spots, and move to a cooler environment if necessary). Remember emergency services are there to help not judge, so donâ€™t hesitate!

DanceWize encourages partygoers to be aware of this trend and consider pill testing as an advisable harm reduction tool. If you would like additional harm reduction educational information please contact DanceWize via the Harm Reduction Victoria website: http://hrvic.org.au/dancewize/.

from press release dated 5/2/2015

HOW TO RATE REPORTS

***PLEASE NOTE***

When rating a report (thumbs up/thumbs down), you are rating the QUALITY OF THE REPORT - *NOT* THE PILL!!

Thanks!
PR Admin Team & Mods.

Official Facebook Page for Pill Reports

We've decided to create an official Facebook page for Pill Reports, here's the link: Pill Reports Official.

There are a few imitation Fan Pages on Facebook and we want to avoid any confusion and let you know that they aren't us - nor do they represent what we are about.

We want to make it as easy as possible to stay up to date with the latest information and warnings that are posted on our website and other relevant info that is brought to our attention.

- PR Team

We've decided to create an official FB page for Pill Reports. We want to make it

We've decided to create an official Facebook page for Pill Reports, here's the link: Pill Reports Official.

There are a few imitation Fan Pages on Facebook and we want to avoid any confusion and let you know that they aren't us - nor do they represent what we are about.

We want to make it as easy as possible to stay up to date with the latest information and warnings that are posted on our website and other relevant info that is brought to our attention.

- PR Team

Current Staff List - 2016

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Pill Reports - Ecstasy Test Results Database by Enlighten

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N-ethylpentylone in Montreal, Canada ''Although unadulterated MDMA capsules have been common in eastern Canada since 2017, pure N-ethylpentylone (also called ephylone, or BK-EBDP) has lately made its way into the streets of Montreal and was reported to be sold as MDMA in capsule form.

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Deaths related to volatile substances and helium in Great Britain - Office for National Statistics

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Deaths related to volatile substances and helium in England, Wales and Scotland from 2001 to 2016, by region, sex, age, substances involved and cause of death.

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Alcohol > Alcohol - an introduction / West Sussex Wellbeing / Provided by West Sussex County Council

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If you would like to explore information and services available in different areas of West Sussex, then please select an area below.

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Public Health Evidence Bulletin April 13th 2018, No 194

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people can be 'nudged' towards making more positive choices . In the context of public health,behavioural insights can help to design interventions and policy that support health and wellbeing .

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Dazed- Why are pills so strong right now

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Know what's what, with FRANK's A-Z of drugs. It includes all the slang names and all the facts.

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Erowid is a non-profit educational & harm-reduction resource with 60 thousand pages of online information about psychoactive drugs, plants, chemicals, and technologies including entheogens, psychedelics, new psychoactive substances, research chemicals, stimulants, depressants and pharmaceuticals.…

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PDF: RecoveryPlus Nov 2017 - Cycles of change

James Prochaska and Carlo DiClemente's ubiquitous 'five stages of change' seems to offer a scientific system to guide clinicians and therapists on how to work with patients - how to recognise when someone is ready to commit to treatment or, if not, to nudge them towards a more receptive stage, and how to avoid wasteful attempts with people not ready to change. Implicitly or explicitly, this system is used to recognise the motivational state of patients and clarify how to promote progression to sustained recovery. Its simplicity is beguiling. But can it really generate change by matching patients to interventions, or does it simply describe one type of change process?
A 'common sense' model of change.
The stages of change are the "most eye-catching" aspects of a 'transtheoretical' model of behavioural change, based on a comparison of 'self-changers' versus those in professional smoking-cessation treatment. Testing and applications of the model later extended to other health-related behaviours including substance use.

The stages portray motivational transition as a fixed, segmented sequence leading from 'No acknowledged problem,' through to 'No problem now'. Among its attractions is the feeling that one has gained insight into something important, technical and scientifically valid, yet which accords with common sense: that, for example, it is no use trying to close the deal on a change plan if the client has yet to see the need for change, that what it takes to embed change is not the same as what it takes to generate it, and that overcoming dependent substance use is no quick fix, but sequentially requires awareness, thought, preparation, implementation and stabilisation, each stage of which must be completed to provide a foundation on which the next stage can build with a chance of success...

The first stage, pre-contemplation, designates people who are not thinking about performing the behaviour in question and are not sufficiently
aware of the health implications of their actions.
The second stage is contemplation, the stage when people start to think seriously about changing their behaviour, but have not yet acted.
The third stage is preparation, characterised by people preparing themselves and their social world for a change in their behaviour.
When individuals successfully and consistently perform the behaviour in question, they are regarded as being in the action stage.
Progression from the action stage to the maintenance stage occurs when the behaviour in question has been done for six months or more.

The diagram above at the top depicts the stages as a cycle of change, showing how the model can accommodate routine lapses and relapses people experience - patients who face set-backs can continue to do (or redo) the work of pre-contemplation, contemplation, preparation, action, and maintenance until they successfully reach their desired point in recovery. Implying that each relapse cycle can take the user closer to lasting remission, the Australian Government Department of Health describe it as an "upward spiral process", involving progress through a series of stages until reaching the "lasting exit" (see above left).

About relapse, it said: "Research clearly shows that relapse is the rule rather than the exception... Relapses can be important for learning and helping the person to become stronger in their resolve to change. Alternatively, relapses can be a trigger for giving up in the quest for change. The key to recovering from a relapse is to review the quit attempt up to that point, identify personal strengths and weaknesses, and develop a plan to resolve those weaknesses to solve similar problems next time they occur."

Embedded in this explanation of relapse are the mechanisms that explain how people navigate change. These are known as the 10 processes of change, decisional balance and self-efficacy. Studies have shown that use of the processes of change has helped smokers to quit, employees with low socio-economic status to engage in more physical activity, and members of the public to consume less alcohol.
No planning needed.
When behavioural change is intentional, 'cycle of change' and derivative models offer a detailed and possibly valid description. But what if a smoker suddenly becomes disgusted with their smoking, spits out the cigarette half way through, dumps the remnants of the packet in a bin, and never turns back as if something had overtaken them? Intentional change is not the only or it seems the most robust way people initiate change.

Unplanned and famously successful drinking-cessation events have been documented by recovery analyst and advocate William White. They include the account of Bill Wilson, who went on to co-found Alcoholics Anonymous - although he maintained sobriety with the help of others. That doesn't mean unplanned abandonment of substance use is without causes; at the time, the desperate Wilson was ripe for such an experience.

One UK survey discovered unplanned attempts were commonly triggered by health advice/concerns, expense, and pressure from family/friends, though 1 in 6 respondents could cite no particular reason. In California, a survey of problem drinkers found that weighing the pros and cons of drinking as a reason for cutting down was much less likely to lead to lasting remission than 'conversion' experiences like hitting rock bottom, traumatic events or a religious or spiritual awakening. And among young people in a trial of a Dutch motivational intervention, spending too long in the contemplative stage might have done more harm than good - in this case, more talking and thinking about cannabis without an accompanying rapid nudge to action and a strategy for dealing with ambivalence, was linked to more rather than less cannabis use.
A 'natural fit' with mutual aid and group therapy?
Exemplifying its versatility, the stages of change model has been extrapolated from individual therapy and self-change to non-professional mutual aid and group therapy. Describing how they complement each other in practice, one paper listed engagement with 12-steps (specifically Alcoholics Anonymous) alongside each of the five stages, arguing that the combination could help treatment providers with client assessment, case formulation, treatment planning, and treatment implementation, and help clients with their progression through treatment.

Still involved in promoting and developing the application of the transtheoretical model, DiClemente is co-author of a 2nd-edition manual of Group Treatment for Substance Abuse which explains the 10 experiential and behavioural processes or 'engines of change', a suite of 17 groups sessions targeted at the early stages of change (precontemplation, contemplation and preparation), and 18 group sessions targeted at people in the later stages (action and maintenance).

Matching interventions to stages of change.

The stages of change model amounts to a broad guide to what (not) to do with patients at different stages of change. But at the crunch point when it actively engages with change through treatment or brief interventions, research support appears to be largely absent. That is true not only of drug and alcohol problems but of therapy for psychological problems in general. In contrast to other factors, the American Psychological Association could only say matching interventions to stage of change was "probably effective" - which might seem optimistic.

In 2010, studies were analysed for the Cochrane collaboration, whose verdict was that "Expert systems, tailored self-help materials and individual counselling, appear to be as effective in a stage-based intervention as they are in a non-stage-based form" - in other words, across all relevant studies, it could not be shown that matching to stages led to more non-smokers. More generally, "Direct comparisons between the same intervention in a standard format or modified by stage of change, with each intervention delivered at a similar intensity, demonstrate neither a beneficial nor a detrimental effect of the staged approach." An earlier assessment for the UK's National Health Service came to a similar conclusion.

The model's strength lies in... portraying intentional change as a process rather than a one-off event... featuring conflict, ambivalence, vacillation and regret. Despite its limitations, there are reasons why the cycle of change model remains valuable, if perhaps not in matching interventions to stage of change.

Professor Robin Davidson finds many ways in which the model might be a positive influence - a kind of benevolent fiction which gives hope to and motivates both worker and client. Likewise Nick Heather and Johannes Hönekopp declared themselves not yet ready to abandon the cycle of change, though argued that it itself needs to change. They saw its strengths as portraying intentional change as a process rather than a one-off event, the insight that the process is essentially motivational, and might progress change through stage-matching.

You can find all research references and more at
https://findings.org.uk/PHP/dl.php?file=cycle_change.hot&s=db

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PDF: RecoveryPlus Nov 2017 - Cycles of change James Prochaska and Carlo DiClemente's ubiquitous 'five stages of change' seems to offer a scientific system to guide clinicians and therapists on how to work with patients - how to recognise when someone is ready to commit to treatment or, if not, to nudge them towards a more receptive stage, and how to avoid wasteful attempts with people not ready to change.

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Start the fight back to a healthier you by drinking less. Keep an eye on how much you are drinking and get practical tips for cutting back on alcohol.

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How to take MDMA, Molly, or Ecstasy: A RollSafe Guide

MDMA can be done more or less safely. Emphasizing safety makes the experience more enjoyable, lessons negative comedowns, and reduces the risk of adverse reaction.

Remember, no drug use is perfectly safe. But you can take MDMA in a safer manner.

This guide is designed to increase the safety of MDMA for recreational users who will consume the drug regardless but are willing to consume it in a safer manner - to "roll safer."

MDMA has risks and is illegal. If you're taking MDMA, do your research and be as safe as possible.

We do not promote the use of illegal psychoactive substances. This content has been created strictly for harm reduction purposes, and you should note that the only way to be perfectly safe using MDMA is to not take it at all. The same is true with alcohol, skydiving, and sex - the only way to be perfectly safe in these activities is to not do them.

Do you prefer watching videos to reading text? Many people prefer text, and many people prefer video. It's a personal preference. If you prefer video, watch this excellent video on How to use MDMA Safely on YouTube.

☑️ Safer and more enjoyable usage checklist

🚫 The main risks to watch out for

Short-term risks:

1. Consuming a substance that is not MDMA. Many tablets and powders are fake and/or adulterated with other drugs.

2. Heat stroke and/or serotonin syndrome. Like all serotonergic drugs, MDMA increases heat stroke risk due to its effects on the hypothalamus, the part of our brain that helps us regulate body temperature.

3. Hyponatremia. Generally caused by drinking too much water. MDMA causes water retention. Dancing aerobically in hot environments causes dehydration. Overcompensating by drinking too much water can be fatal.

Long-term risks:

1. Used too frequently, MDMA can temporarily exacerbate symptoms of depression in people who suffer from clinical depression (Sferios).

2. High and/or frequent doses of MDMA have been shown to be neurotoxic in laboratory animals. However, no properly controlled studies have shown cognitive impairments in human users after a period of abstention long enough to rule out temporary effects of MDMA, polydrug use, and a partying/unhealthy lifestyle. Nevertheless, if you are concerned, normal therapeutic doses of SSRI's like Prozac, taken on the comedown, have been shown to prevent MDMA's neurotoxic effects in animals. "For reducing risk of neurotoxicity, limiting dose amount and taking supplements may be most important (BM)."

3. Losing the magic. "Losing the magic" is when people who use MDMA find that over time, they get less and less of the special effects of MDMA. This is unfortunate, especially considering that MDMA is on a path to be used as a prescription medicine to assist therapy.

From side effects.

👨‍⚕️ 1. Avoid MDMA if you have any of these pre-existing health conditions

⛑ Helps avoid acute risks.

Avoid if you have any of these contraindicated conditions:

Cardiovascular disease

Cerebrovascular disease

Uncontrolled hypertension

Malignant Hyperthermia, anhydrosis, central core disease, or any condition that increases the risk of heat stroke or hyperthermia. This includes if you currently have a fever or if you know you are particularly heat sensitive.

Susceptibility to seizures

Liver problems

Malignant hyperthermia is a rare genetic disorder. Many individuals with the condition do not know they have it. If either of your parents have it, or if you have any first or second-degree relatives who have had an adverse reaction to anesthesia, you may have it. If this is true, you should not take MDMA.

💉 2. Know the drugs that interact dangerously with MDMA

⛑ Helps avoid acute risks.

Avoid:

If you've taken any MAOIs (e.g. Nardil, Parnate, Marplan, Ayahuasca) within the last 3 weeks due to potential risk of death

There is no high quality evidence that 5-HTP is dangerous to combine with MDMA, though there are rumors that this is a bad combination. If you know of good evidence either way, please send it to us.

If you've recently taken St John's wort. SJW has a high potential for drug interactions, some of which may be serious.

If you've recently taken any CYP2D6 inhibitors

In combination with drugs that increase heart rate or blood pressure (e.g. many asthma medications, stimulants like cocaine, amphetamine, caffine), DXM (Robitussin), stomach acid mediciations, sedatives (alcohol, opioids), due to an increased risk of serious adverse effects.

If you're concerned about neurotoxicity risk, do not consume at the same time as classic psychedelics like LSD, 2C-B, or shrooms, as this combination increased neurotoxicity in rodents

SSRIs like Prozac, Paxil and Zoloft are not reported to interact dangerously with MDMA, though MDMA might make SSRIs less effective and SSRIs may make MDMA less effective. Increasing your MDMA dosage to compensate is not a good idea. Read here for more.

🔬 3. Avoid if you're not confident your MDMA is pure
⛑ Helps avoid acute risks and 😁 helps maximize positivity.
87% of "Molly" analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing "bath salts." Use a test kit to reduce some risks, but know that even test kits cannot guarantee purity.

Read about testing your MDMA and the recommended test kits.

💊 4. Prepare your MDMA Supplements

🤕 May help reduce neurotoxicity risk and 😁 may help maximize positivity.

In short, supplements may help protect your brain on MDMA, and hypothetically if tolerance and "losing the magic" are related, supplements may reduce the risk that you'll lose MDMA's effects ("the magic") over time.

For example, Alpha Lipoic Acid. Research found that in rats, Alpha Lipoic Acid "fully prevented the serotonergic deficits and the changes in the glial response induced by MDMA."

Read which supplements are recommended, supplement dosage and timing on the page for MDMA Supplements.
RaveBox is a collection of some supplements in one box. $15 with free shipping here.

📅 5. Wait as long as possible between rolls, perhaps 3 - 5 weeks at absolute minimum

😁 Helps maximize positivity.

In short: The less often the better. Research organization MAPS uses three MDMA doses to treat PTSD, spaced 3 - 5 weeks apart, generally in people who have never used MDMA before and are unlikely to use it again. If you're going to use more than 120 mg or going to use more than 3 times in your life, you should consider longer usage breaks. Three months is a reasonable anecdotal-based (Ann Shulgin) rule of thumb, and waiting longer than three months is always better, from a safety perspective.

MDMA researcher Matthew Baggot: "In ten years from now, MDMA may be legally available and used in therapy. You don't want to be unable to save your marriage or fail to come to terms with trauma because you rolled too much in your youth and now can't feel MDMA."

Read more at MDMA frequency of use.

⚖️ 6. Dosage guideline: your weight in kg, plus 50 = total dosage in milligrams for the session.

😁 Helps maximize positivity, 🤕 helps reduce neurotoxicity risk, and ⛑ helps avoid acute risks.

1. Guideline: your weight in kg, plus 50 = total dosage in milligrams for the session. (1.5 mg/kg with a 120 mg max may be more optimal, but the weight + 50 is a good rule of thumb)

2. If finger dipping powder: ideally switch to weighed doses, but if not that, use "crush, dab, wait."

3. If using tablets and you haven't taken a tablet from this exact batch before, start with half, or less.

4. Low doses may be particularly important for your first few uses, as you might unknowingly have a health condition like malignant hyperthermia that makes MDMA more dangerous.

5. A study found that MDMA desirable effects are maximized, and undesirable effects minimized, at doses between 81-100 mg.

6. If you're unwilling to use these dosage guidelines, please make extra sure your friends are aware of the signs of heat stroke and heat exhaustion, and pay extra attention to keeping cool.

7. "I think there's no "safe" dose if you have a preexisting health condition contraindicated with MDMA." For example, malignant hyperthermia, which you may have but be unaware of.

8. A small female died soon after consuming 500 mg of 91% pure MDMA. It is highly probable that they had a health condition that interacted dangerously with MDMA, but this shows why it's important to pay attention to dosage.

9. This dosage advice is only relevant if you actually have MDMA! 87% of "Molly" analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing substances like methylone and mephedrone.

10. 46% of Ecstasy tablets analyzed in a study contained 0% MDMA.

11. There's a reasonable chance it may take a user 90 minutes to feel MDMA's effects, and though rare it's not unheard of for the effects to take 2-2.5 hours to kick in. Particularly if it's one of your first 5 times using MDMA or you had recently eaten a large meal, please wait at least 3 hours before concluding that your dose didn't work.

12. Avoid taking any booster doses or redoses if possible.

Read our page on MDMA (Molly/Ecstasy) dosage for: why you should consider less than 80 mg for your first real roll, why you ideally shouldn't take more than 1.5 mg/kg and 120 mg in a session, and the dosage of MDMA that research found maximizes desirable effects (81-100 mg).

If possible, you should weigh your MDMA dosage out using a milligram scale, or if you have pills, get them tested at a lab or at minimum look online to estimate how much MDMA they contain.

💦 7. Drink up to 1 cup per hour (250 ml) of electrolyte containing fluids, or up to 2 cups (500 ml) if you are dancing or in a hot environment

⛑ Helps avoid acute risks.

"When dancing in hot conditions the most serious dangers are dehydration (loss of water) and heatstroke, which can be fatal." "However, excessive water consumption after taking ecstasy can also lead to medical complications and some deaths have occurred."

If you're dancing or in a hot environment: 2 glasses of fluid, ideally part electrolyte containing (e.g. sports drinks) per hour.

If you're not dancing: No more than 1 regular sized glass of fluid per hour. Ideally Gatorade or another electrolyte beverage. If drinking water only, keep up sodium levels by eating some salty snacks.

MDMA makes you feel thirstier than you actually are by increasing saliva production and increasing temperature.

Consuming isotonic or electrolyte containing fluids helps prevent hyponatremia which is caused by low sodium, and hyponatremia has been the cause of some MDMA-related deaths in women. Hyponatremia "can be deadly and the symptoms of overhydration (headache, nausea) are hard to tell from those of dehydration."

To prevent hyponatremia, avoid over hydrating, and consume electrolyte containing fluids like Gatorade, coconut water, etc.

Electrolyte products:

🔥 8. Watch out for heat stroke

⛑ Helps avoid acute risks.
Heat stroke risk is increased by MDMA
Heat stroke is a risk on MDMA even if you are inside and not in the sun.

"When dancing in hot conditions the most serious dangers are dehydration (loss of water) and heatstroke, which can be fatal."

"MDMA combined with aerobic dancing, a hot crowded environment and not drinking enough water, can become a lethal mix, sometimes resulting in heatstroke. A standard dose of MDMA raises body temperature about one degree, and also inhibits the body's natural thermoregulation, increasing likelihood of heatstroke."
Increased temperature increases neurotoxicity risk in rodents
See the rodent studies.

"I think the jury is out on the role of elevated body temperature in MDMA-induced neurotoxicity in non-rodents. We know it is important for rat toxicity, but it might not be for humans. So I don't think I have a strong basis for a recommendation either way."

😟 MDMA "Bad Trips"

Fact: MDMA can bring to the surface issues that you may be emotionally struggling with.

The good news: Anecdotal reports suggest that "bad trips" on MDMA are extremely rare. This may be due to the fact that MDMA is often consumed in a positive environment - dancing, with friends, and music that you enjoy.

It is possible to have bad experiences on Ecstasy, though we don't know if the users studied here took pure MDMA.

"The findings suggest that most negative experiences with Ecstasy can be attributed to the interaction between two or more factors, nearly always involving set or setting."

Fact: In some MDMA studies, 19% more of the people who received MDMA experienced some anxiety during the MDMA session compared to people who received placebo. This does not mean that they had a bad trip, it just means they experienced anxiety. Read more.

🏠 9. Find a safe, cool, positive environment
⛑ Helps avoid acute risks and 😁 helps maximize positivity.
Takeaway: Only consume MDMA in a positive environment to minimize the chance of a negative experience.

Being at home can be more enjoyable than being out. You can be as weird as you want without judgement, you can control the music, you can dance and then stop and sit around and talk because it's not too loud, there are no aggressive people around to make you feel uncomfortable, etc.

As a bonus, MDMA is generally safer in a house instead of a club: being at home allows you to take frequent cool off breaks, to take your supplements easily, and means you can get electrolyte-containing fluids easily.

Don't be with people that make you uncomfortable, and consider avoiding sober people that you don't know. It can also be more enjoyable to avoid drunk people, even if you know them.

😊 10. Be conscious of your mindset before taking MDMA

😁 Helps maximize positivity.

MDMA can bring to the surface issues that you may be emotionally struggling with.

If you're seeking a happy and euphoric experience, consider waiting until you're in a consistently good emotional state.

🚑 11. Know the early signs of heat stroke and pay attention to your friends

⛑ Helps avoid acute risks.

Signs of heat exhaustion:

Heavy sweating

Weakness

Cold, pale, and clammy skin

Fast, weak pulse

Nausea or vomiting

Fainting

If you experience or see early signs of heat exhaustion, move to a cooler location, lie down, loosen your clothing, and apply cool and wet cloths to as much of your body as possible. "If you have vomited and it continues, seek medical attention immediately."

Signs of heat stroke:

Hot, red, dry or moist skin

Rapid and strong pulse

Body temperature above 103 degrees F

Seizures

Possible unconsciousness

If you see any of the signs of heat stroke above, this is a medical emergency. Call 911, move the person to a cooler environment, use cool cloths or a cool bath. Do not give fluids.

🎯 12. Know your intention for taking MDMA, even if it is just to have fun, and state it out loud to the people you roll with

😁 Helps maximize positivity.

Recommendation by Emanuel Sferios. This is a good practice.

👍 Other general MDMA recommendations and tips

Get 8+ hours of sleep the night before and after using MDMA

Take the rest of the day after using MDMA, and the entire following day off, for rest, recovery and integration back into the world

Don't drive on classic psychedelics or MDMA. MDMA has been involved in traffic accidents.

Create a document and track the dates/dosages of your MDMA usage. Also try and write down how you felt about the dosage. This way you remember and know what to do if you take it again.

Hanging around with drunk people while on MDMA can be very odd/uncomfortable, even if you know them. Hanging around with sober people that you don't know can also be uncomfortable.

Don't order food! Regular food is typically not very good while rolling. If you order pizza/takeout/make a big meal, it may feel like a good idea, but then when it arrives, you'll likely regret it (your milage may vary and of course feel free to do this).

Consider having a hearty and healthy meal ~4 hours before you take MDMA. This way, the food will be digested before you take MDMA, but you will also have food in your system which is good, particularly if you're dancing and active.

Many men find that MDMA makes them unable to get or maintain an erection during the ~6 h MDMA duration

Have a buddy who will watch out for you

Make sure you're comfortable with the idea of taking a drug and temporarily altering how you think and feel.

If you think you might be rolling more than you should, consider talking to friends or seeking help. MDMA is not a good long-term anti-depressant.

What are the best activities to do while rolling?

See fun activities.

What if I'm concerned about myself or a loved one's use of MDMA?

While "research hasn't definitively answered whether MDMA is addictive," there are certainly still people who may be concerned about their own use of MDMA or a loved one's use of MDMA. This may be especially relevant for MDMA use that is particularly suboptimal - e.g. high doses, very frequent use (e.g. >1x per month), using in particularly unsafe or hot environments, etc.

Please read this free guide: the 20 minute guide. It's for parents, but it applies to friends, etc. There's also a separate version for romantic partners.

Alternatively, there's a full book version of the same guide called "Beyond Addiction" which is excellent, or you can buy the PDF of the 20 minute guide.

If you prefer video content and have access to HBO, please watch the HBO Documentary 'Addiction.'

Please start with the above resources, even if you're ready for treatment.

Once you've gone through the above resources and your loved one is ready for treatment, the most effective treatment appears to be cognitive behavioral approaches, so seek out an addiction treatment provider who uses cognitive behavioral training. See the chapter on finding treatment in the book "Beyond Addiction" for more info.

Why is this important?

Millions of people take MDMA each year.

Follow the steps on RollSafe to be as safe as possible and have the best, most rewarding MDMA experience. Remember, no drug use is perfectly safe. But you can take MDMA in a safer manner.

Things to learn next
How Does Molly Make You Feel? What Are MDMA's Side Effects?
About MDMA for PTSD
What is Ecstasy? What is Molly? Drug Harm Reduction: A List of What You Should Know If You're Considering Using Other Drugs, like Salvia, Tobacco, Alcohol, etc.
References

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MDMA can be done more or less safely. Emphasizing safety makes the experience more enjoyable, lessons negative comedowns, and reduces the risk of adverse reaction. Remember, no drug use is perfectly safe. But you can take MDMA in a safer manner.

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Unbiased information about global drug issues from TalkingDrugs.

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Statistics to support improvements in decision making when planning alcohol and drug misuse treatment services.

Prevalence data and analysis

Statistics showing prevalence of alcohol and drug misuse issues among national and local populations.

Alcohol and drug treatment statistics: adults

Alcohol and drug misuse and treatment in adults from the National Drug Treatment Monitoring System ( NDTMS).

Alcohol and drug treatment statistics: young people

Alcohol and drug misuse and treatment in young people (aged under 18) from the National Drug Treatment Monitoring System ( NDTMS).

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Alcohol and drug misuse and treatment in prisons and other secure settings from the National Drug Treatment Monitoring System ( NDTMS).

Research and analysis

Further research and analysis into alcohol and drug misuse.

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Alcohol and drug misuse and treatment statistics

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Statistics to support improvements in decision making when planning alcohol and drug misuse treatment services.

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Drug and Alcohol Findings Effectiveness Bank analysis titled: Drug Treatment Matrix

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The world's first guidelines for safer drug use. Nobody takes recreational drugs to have a bad time. People take drugs to have fun and many people do. But sometimes they don't and people can end up in all sorts of messed up places - sometimes for a night, very rarely for life.

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Friday/Monday is an information and support service from Terrence Higgins Trust for gay and bisexual men concerned about issues around alcohol and drug use and sex.

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https://tripsit.me/

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HarmReduction.eu - Data, knowledge and e-learning hub on Harm Reduction in Prison Settings - Home

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Data and knowledge on drug use and related risks in prisons and on drug treatment, harm reduction, overdose prevention in custodial settings and reintegration upon release.

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While it has been some time since we've written an update on our blog, TripSit itself has by no means been dormant! In this post, I hope to give an overview of a few major updates we've been working on, and an idea of what you can expect from us as 2018 continues. We also post more frequent updates on Twitter and Facebook.

Towards the end of the last year, we were invited to present at several harm reduction conferences in Europe, through which we were excited to find that many harm reduction organisations are actively using our resources. We had many productive discussions with these organisations, and hope to work with them more closely in future. To build on this network, we're currently trying to compile a list of harm reduction organisations using our resources, or who are interested in working with us. In doing this, we can more easily gain feedback and maintain closer relationships with those relying on our services. For this purpose, we've placed several adverts around our websites, but if you work for such an organisation, you can let us know about you here.

We have also put a lot of work into improving our online services, publishing two new harm reduction tools and making a major update to our factsheets service.

We've created a DXM calculator, inspired by the now defunct tool that used to be available on DarkRidge. This page allows users to easily calculate their DXM doses based on various preparations of DXM-containing medicines, and their weight. Over the coming weeks, we will be expanding this service to include a greater variety of products, and then add harm reduction information concerning dangerous and undesirable additives.

Our other new tool provides a calculator for dosage equivalencies between benzodiazepine drugs. This is possible because the strength of most benzos are measured in terms of their potency in relation to the 'gold-standard' of 10mg diazepam. While the base calculator is now finished, work will continue to provide coverage for a greater number of benzodiazepine drugs, and to provide additional advice based on the differing properties of the various drugs in the class: their tendency towards hypnosis, analgesia, anxiolysis, etc.

We've also recently rolled out changes to our online chat system, making it easier for people to get help and to improve the general user experience. Most obviously, our web client received a major update, primarily visible through its entirely redesigned user interface. We'd like to thank prawnsalad and the other developers working on Kiwiirc for their stellar software, which helps support what we do.

After being asked many times by willing potential volunteers how to get involved with tripsitting, we decided to streamline the process. Now, when browsing to our chat page, you can see a 'Here to Help' button, which will allow you to drop into the support channels in a supporting role.

We have also made a few load-bearing changes to our assistance infrastructure - provisioning more channels, and balancing users between them. These changes were prompted by a large influx of users following coverage of our network from a popular YouTube personality. While these initially presented a challenge for the community both in dealing with the increased load from legitimate users and trolls, it allowed us to develop a more robust and scalable tripsitting service, able to better serve a larger amount of people concurrently as we grow.

In the coming months, we hope to continue developing our existing resources and finding opportunities for realising new ideas. We're hoping to place a particular focus, this year, on forging relationships with other harm reduction organisations, and investigating how we can all work together to improve continuity of care, and to provide a more cohesive harm reduction infrastructure worldwide.

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While it has been some time since we've written an update on our blog, TripSit itself has by no means been dormant! In this post, I hope to give an overview of a few major updates we've been working on, and an idea of what you can expect from us as 2018 continues.

# data[].attributes.attachment_link.readable_text
While it has been some time since we've written an update on our blog, TripSit itself has by no means been dormant! In this post, I hope to give an overview of a few major updates we've been working on, and an idea of what you can expect from us as 2018 continues. We also post more frequent updates on Twitter and Facebook.

Towards the end of the last year, we were invited to present at several harm reduction conferences in Europe, through which we were excited to find that many harm reduction organisations are actively using our resources. We had many productive discussions with these organisations, and hope to work with them more closely in future. To build on this network, we're currently trying to compile a list of harm reduction organisations using our resources, or who are interested in working with us. In doing this, we can more easily gain feedback and maintain closer relationships with those relying on our services. For this purpose, we've placed several adverts around our websites, but if you work for such an organisation, you can let us know about you here.

We have also put a lot of work into improving our online services, publishing two new harm reduction tools and making a major update to our factsheets service.

We've created a DXM calculator, inspired by the now defunct tool that used to be available on DarkRidge. This page allows users to easily calculate their DXM doses based on various preparations of DXM-containing medicines, and their weight. Over the coming weeks, we will be expanding this service to include a greater variety of products, and then add harm reduction information concerning dangerous and undesirable additives.

Our other new tool provides a calculator for dosage equivalencies between benzodiazepine drugs. This is possible because the strength of most benzos are measured in terms of their potency in relation to the 'gold-standard' of 10mg diazepam. While the base calculator is now finished, work will continue to provide coverage for a greater number of benzodiazepine drugs, and to provide additional advice based on the differing properties of the various drugs in the class: their tendency towards hypnosis, analgesia, anxiolysis, etc.

We've also recently rolled out changes to our online chat system, making it easier for people to get help and to improve the general user experience. Most obviously, our web client received a major update, primarily visible through its entirely redesigned user interface. We'd like to thank prawnsalad and the other developers working on Kiwiirc for their stellar software, which helps support what we do.

After being asked many times by willing potential volunteers how to get involved with tripsitting, we decided to streamline the process. Now, when browsing to our chat page, you can see a 'Here to Help' button, which will allow you to drop into the support channels in a supporting role.

We have also made a few load-bearing changes to our assistance infrastructure - provisioning more channels, and balancing users between them. These changes were prompted by a large influx of users following coverage of our network from a popular YouTube personality. While these initially presented a challenge for the community both in dealing with the increased load from legitimate users and trolls, it allowed us to develop a more robust and scalable tripsitting service, able to better serve a larger amount of people concurrently as we grow.

In the coming months, we hope to continue developing our existing resources and finding opportunities for realising new ideas. We're hoping to place a particular focus, this year, on forging relationships with other harm reduction organisations, and investigating how we can all work together to improve continuity of care, and to provide a more cohesive harm reduction infrastructure worldwide.

# data[].attributes.attachment_link.description
While it has been some time since we've written an update on our blog, TripSit itself has by no means been dormant! In this post, I hope to give an overview of a few major updates we've been working on, and an idea of what you can expect from us as 2018 continues.

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Home | Research archive | Subject search | Text search | Key treatment studies | Hot topic reviews | Contact

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Alcohol drinking patterns and liver cirrhosis risk

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Alcohol continues to be an accepted part of everyday life in the UK, despite being one of the three biggest lifestyle risk factors for disease and death. This report, which is based on a survey carried out by the AHA, gives some insights into what people think about alcohol, how aware they are about the risks associated with alcohol, and what they would like to be done to address the harms caused by alcohol.

The report shows that awareness of the low-risk drinking guidelines and health risks connected to alcohol remains low: 4 in 5 people do not know that the recommended low-risk guideline is not to drink more than 14 units a week. While awareness of the link between alcohol and cancer has increased compared to previous years, the large majority of the public still do not link cancer and alcohol spontaneously.

The data also shows that the majority of the public want the UK Government to do more to address the harms caused by alcohol to society, such as ill health, violent crime, domestic abuse and anti-social behaviour. Only 3% think the government is doing too much. There is support among the public across political affiliations for a range of policy measures to reduce alcohol harm, including:

policies to decrease the affordability of alcohol, such as minimum unit pricing and, in some circumstances, alcohol tax increases;

regulations for more and better information on alcohol product labels; and

greater alcohol advertising restrictions to protect children, such as a ban on alcohol TV advertising from 6am-11pm.

Download How we drink, what we think (2018)

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How we drink, what we think - 2018 - AHA

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Alcohol continues to be an accepted part of everyday life in the UK, despite being one of the three biggest lifestyle risk factors for disease and death. This report, which is based on a survey carried out by the AHA, ... Read More

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Corresponding Author: Yasmin Hurd, PhD, Director of The Addiction Institute of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, and other coauthors.

Bottom Line: Young adults with exposure to THC (the psychoactive component of cannabis) during adolescence have alterations in the structure of neurons and gene expression within these brain cells (which are critical for maintaining synaptic plasticity) in the prefrontal cortex, a brain region that mediates decision-making and other cognitive functions.

Results: Adolescent THC exposure reduces the branching of prefrontal cortical neurons and the number of spines, which are critical for cellular communication. This adolescent exposure is also associated with a reorganization of the gene expression of specific genes that are predominantly related to neuron development, synaptic plasticity and chromatin organization (epigenetic mechanisms). The gene networks affected by THC exposure mimicked those networks observed to be impaired in the prefrontal cortex of individuals diagnosed with schizophrenia.

Why the Research Is Interesting: The findings demonstrate that adolescent THC exposure can induce long-term structural changes, thus altering the developmental trajectory of adult cortical cells along with altering gene networks that are similarly disturbed in individuals suffering from schizophrenia.

Who: Animal model with exposure to THC, the psychoactive ingredient of cannabis. Analysis of a gene expression database of human schizophrenia patients.

When: Animals were exposed during adolescence and their brains studied into adulthood.

What: The study measured gene expression and the structure of neurons in the prefrontal cortex.

How: Cells were examined under a microscope using a computerized system to determine the shape of the neurons in the prefrontal cortex. A laser was used to specifically capture neurons in the prefrontal cortex and the cells were sequenced to determine the expression of genes. Computational analysis was used to compare the gene expression networks in the animal model and those of individuals with schizophrenia.

Study Conclusions: Adolescent THC exposure reduced the structural complexity of cortical neurons and associated genes that regulate the development of neurons. These were accompanied by significant changes in genes related to the epigenetic mechanisms which regulate DNA openness and chromatin structure that determines whether genes are turned "on" or "off." Moreover, the gene expression networks that were altered were similar to those observed to be impaired in the prefrontal cortex of human subjects with schizophrenia, meaning that adolescent THC exposure may alter psychiatric vulnerability, particularly in individuals with overlapping genetic disturbances within THC-sensitive gene networks.

Paper Title: Adolescent exposure to ? 9 -tetrahydrocannabinol alters the transcriptional trajectory and dendritic architecture of prefrontal pyramidal neurons

Said Mount Sinai's Dr. Yasmin Hurd of the research:

The study emphasizes that cannabis, particularly THC-prominent strains, has the capacity for long-term effects into adulthood, even after the drug is no longer in the body. These findings have important implications for the changing sociopolitical discussions regarding the recreational use of marijuana. The ability of THC to change the actual shape of developing neurons that are well-known to be essential for normal cortical communication is alarming. This emphasizes that even a drug that is not considered to be very harmful can alter the sensitivity of critical brain regions during adolescent development and, in particular, change the sensitivity of gene networks relevant to psychosis risk. More education is needed to inform teens about this and about other drugs that can impact the trajectory of the developing adolescent brain.

To request a copy of the paper or to schedule an interview with Dr. Yasmin Hurd, please contact Mount Sinai's Director of Media and Public Affairs, Elizabeth Dowling, at elizabeth.dowling@mountsinai.org or at 212 241-9200

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Adolescent THC exposure alters neurons/gene networks associated with psychosis risk

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Adolescent THC exposure reduces the branching of prefrontal cortical neurons and the number of spines, which are critical for cellular communication. This adolescent exposure is also associated with a reorganization of the gene expression of specific genes that are predominantly related to neuron development, synaptic plasticity and chromatin organization (epigenetic mechanisms).

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Research and analysis

Report on the findings of a Public Health England and Home Office investigation into the increase in crack cocaine use in England.

Documents

Details

Recent evidence suggests that there has been a rise in crack cocaine use in England. The Serious Violence Strategy committed the government to understand more about this rise. Public Health England and the Home Office led an inquiry based on a series of interviews and focus groups. These were held in 6 local authorities across England with:

drug treatment workers

service users

police officers

The report's findings can be used by local authorities and their partners to help them understand some of the factors that might lie behind any rise in crack use in their area. It can also be used by policy makers and other people involved in responding to crack and related drug problems.

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Crack cocaine increase: inquiry findings

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Research and analysis Report on the findings of a Public Health England and Home Office investigation into the increase in crack cocaine use in England. Recent evidence suggests that there has been a rise in crack cocaine use in England. The Serious Violence Strategy committed the government to understand more about this rise.

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The white stuff: why Britain can't get enough cocaine

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Britain snorts more of the drug than almost anywhere in Europe, more young people are taking it and deaths are rising. Why?

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'County lines': huge scale of £500m drug industry revealed

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Crime agency reveals trebling of individual phone numbers used by criminal gangs linked to murder and exploitation

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Please check your email for instructions on resetting your password. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.

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Strengths-based social work: practice framework and handbook

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The framework and handbook support social workers and social care professionals in applying a strengths-based approach to their work with adults.

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Understanding Substance Use: A health promotion perspective | Here to Help

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Health is a state of total well-being-physical, mental and social-helping us both survive and thrive in our everyday lives.

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New psychoactive substances: new service provider challenges

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Drug and Alcohol Findings Effectiveness Bank analysis titled: New psychoactive substances: new service provider challenges