A brief guide to the effects of alcohol and drugs.

A brief guide to the effects of alcohol and party drugs And what to do if you think someone is having a bad reaction

What is SX Scotland? What is this booklet? SX is about improving the sex, For many men who have sex with health and wellbeing of gay men, drinking alcohol or taking and bisexual men, and all men drugs can be a big part of our who have sex with men, living in culture. Scotland. Heading out for a drink offers the Our ethos at SX is to be sex possibility to socialise, meet up positive and we strive to improve with friends and potentially hook the physical, sexual and mental up with new guys for sex. Alcohol health and wellbeing of all men lowers our inhibitions, making who have sex with men. SX works us feel more relaxed, which can with cis and trans men, and many contribute to a fun night out. Of other allies across Scotland. course, sometimes it can go too far – it can affect our judgement and Through listening to the people in lead us to making bad choices. our community, and empowering them to have their voices heard, we Recently, an increasing number provide support to those we work of men have started using certain with, encouraging them to have drugs, as well as alcohol to consensual and pleasurable sex enhance their sex life. Drugs can with the least harm. also make you feel less inhibited, more aroused and focused on the SX is provided by Waverley Care. sex you are having. In recent years Waverley Care is positive about we have started to refer to this as HIV, hepatitis C and sexual health in ChemSex. Scotland. By being part of Waverley Care, we have benefited from over In this booklet you will find 30 years of learning and expertise information on the effects of working to reduce new infections, alcohol and the most common increasing access to testing and drugs used by men who have challenging the stigma experienced sex with men. You will also find by our communities. information on the complications of mixing drugs and alcohol as well as important first aid informatin on what to do if something goes wrong.

Alcohol booze / bevvy / vino / drink What is it? drinking can cause liver damage, Alcohol is a legal drug sold as beer, high blood pressure, strokes and wine or spirits. The potency of cancer. Alcohol can also lower alcohol is stated on the packaging you inhibitions which can lead to as a percentage of the liquid. It can risk taking, such as unprotected range from 4 to 5% in beer, 11 to sex. It can also allow you to be 14% in wine, to 35 to 55%+ in spirits. taken advantage of, or being hurt by others. Regular alcohol The law consumption can lead to addiction. Alcohol can be consumed legally by people over the age of 18. Mixing it Taking alcohol with cocaine Guidance creates a toxic combinaton that UK Government Medical guidance stays in the body longer leading suggests you should not drink to increasedrisk of damage to the more than 14 units of alcohol a heart and liver. Mixing alcohol week and no more than 3 to 4 units with crystal meth is unpredictable, in one sitting. This is approximately increasing the risk of harm or death. 14 shots of spirits, 7 pints of regular Mixing alcohol with G (GBL) or lager or 7 average size glasses of mephedrone (M-Cat) increases the wine. risk of dangerously slowing down your breathing, increasing the effect The effects of the drugs and causing overdose. The right amount of alcohol may Mixing alcohol with ecstasy will help reduce feelings of anxiety reduce the effects of the drug but and inhibitions and make you feel taking more ecstacy to increase the sociable, chatty and confident. high can lead to dehydration, and risk of stroke or heart attack and The downsides damage to your vital organs. Mixing Too much alcohol can cause ketamine with alcohol can make hangovers, nausea, headaches and you feel nauseous and dizzy. sweats. Excessive consumption can cause black-outs, accidental There is no current evidence to injury, unconsciousness, coma suggest that alochol affects HIV and even death. Long term excess medication.

Understanding your drinking Units of alcohol in drinks We want to help you to understand 2-3 times per week (3) how to use alcohol safely and 4+ times per week (4) reduce any potential harm to your physical and mental health. Do you Question 2: know the guidelines for the week How many units of alcohol do you consumption of alcohol? Do you consume on a typical day when know your own average weekly you are drinking? intake of alcohol in units? 1-2 (0) 3-4 (1) This risk tool will help you find out if 5-6 (2) you are risking your health because 7-9 (3) of the amount of alcohol you are 10+ (4) regularly drinking. Your total score from the following six questions Question 3: will help you find out if you need to How often do you consume six think about your alcohol use and or more alcoholic drinks on one make any changes for your health occasion? and wellbeing. Never (0) Less than monthly (1) Question 1: Monthly (2) How often do you have an Weekly (3) alcoholic drink? Daily or almost daily (4) Never (0) Question 4: Monthly or less (1) Has there been a time where you 2-4 times per month (2)

have consumed more alcohol than Score of 10 to 18 points you feel you should have? This score indicates that you are drinking at increasing risk Never (0) levels. Continuing to drink at this Maybe (1) level could cause serious health Sometimes (2) implications later in life. Regularly (3) Every time (4) We would suggest that you either drink less amounts of alcohol on Question 5: each occasion or give yourself a Have you ever put yourself in longer break between occasions a harmful situation because of where you drink alcohol. drinking alcohol? For further information, check out Never (0) or service directory for details of Maybe (1) support services for alcohol use. Sometimes (2) You could also contact us, speak Regularly (3) to your GP or check out the Drink Every time (4) Aware website. Question 6: Score of 19 points or over Have you ever had sex that you This score indicates that you wished you hadn’t had because of are drinking at higher risk levels. drinking alcohol? Continuing to drink at this level is likely to cause a serious alcohol Never (0) related illness. Maybe (1) Sometimes (2) We would suggest that you attempt Regularly (3) to significantly reduce your alcohol Every time (4) drinking and speak to someone who may be able to help, such as Total up your score from the six your GP. For further information, questions. check out or service directory for details of support services for Score of 9 points or under alcohol or check out the Drink This score indicates that you are Aware website. a low risk drinker. This means you are less likely to develop an alcohol related illness in the future. If the amount of alcohol that you drink changes, or you have concerns, get in touch. We’re here to help.

Methamphetamine meth / crystal meth / tina What is it? also worsen other mental health Meth comes as tablets, powder conditions, such as anxiety and or crystals. It can be swallowed, depression. Some people become smoked with a pipe, injected isolated from friends and family. (slammed), snorted or rubbed Injecting crystal meth can cause into the lining of your ass (booty collapsed veins, abscesses, sepsis, bumping). and heart infections. The law Mixing it K is a Class B drug. Possession can Mixing meth with ecstasy, cocaine, lead to a fine and a prison sentence Viagra, MDMA or poppers can up to 5 years. Supplying the drug cause heart attacks or strokes. can lead to a larger fine and up to The drug can alter the benefits 14 years in prison. of antidepressants and cause high blood pressure or serotonin The effects syndrome. Meth is a powerful stimulant that can keep you awake for very long Using meth while taking HIV drugs periods of time. It can also make (including PrEP) can lead to fatal you feel euphoric, self-confident, levels of meth being stored in and extremely aroused. your body. HIV drugs can slow down your metabolism, making it The downsides possible to for you to overdose. The euphoria you may experience by taking meth and having sex, means it can become more difficult to have sex without meth. Reduced inhibitions caused by meth can lead to risk taking and engaging in different sex that you are not used to, such as kink or BDSM. Meth can cause physical and mental health issues resulting in psychosis and paranoia. It can

GHB / GBL G / gina What is it? Mixing it G is a sedative drug and comes Alcohol is particularly problematic as a clear liquid (GBL) which has when mixed with G. It can cause a chemical taste and smell. GHB, breathing problems leading to however, is either a salty liquid or a death. Many party nights can start powder that is added to liquid, such with alcohol and G users can as a soft drink, but never alcohol. forget they have taken alcohol earlier in the evening. Mixing G The law with downers, such as Diazepam G is a Class C drug. Possession can or Valium can slow down your lead to a fine and a prison sentence breathing and risk ‘going under’. up to 2 years. Supplying the drug Mixing G with ketamine or can lead to a larger fine and up to antihistamines can also cause 14 years in prison. breathing problems leading to fits, coma, or death. The effects G increases the desire for sex, G can interact with the HIV drugs reduces inhibitions, creates (including PrEP). It can result in euphoria, and relaxes you. The high levels of G being stored in effects can be similar to alcohol. your body and result in serious side effects. The downsides G can cause dizziness, vomiting, confusion, drowsiness, memory loss, unconsciousness and even death. Regular use can cause addiction and withdrawal symptoms, such as seizures and coma. Dosing needs to be accurate and precise, as overdosing is easily done and can be fatal. Because G can easily make you ‘go under’, there is risk of sexual assault, or rape if you cannot consent to the sex that is happening.

Ketamine Hydrochloride K / special k / vitamin k What is it? sex, such as fisting, these activities K can be snorted as a white powder can result in internal injuries or swallowed in liquid form, without realising it. Internal injuries powder or as a pill. can increase the risk of contracting HIV or hepatitis C. The law Meth is a Class B drug. Possession Mixing it can lead to a fine and a prison High doses of K with downers, sentence up to 5 years. Supplying such as alcohol or GHB/GBL, the drug can lead to a larger fine opiates or benzodiazepines, can and up to 14 years in prison. dangerously suppress breathing and heart function, which can The effects lead to unconsciousness. Mixing K K can boost energy levels, make with ecstasy or amphetamines can you aroused, lower inhibitions, and result in dangerously high blood reduce sensitivity to pain. pressure. Alcohol mixed with K can cause nausea and feeling of vertigo The downsides (dizziness). K can cause panic attacks, depression, and may make existing Taking K while on HIV medication, mental health conditions worse. particularly protease inhibitors, Those with a history of fits, heart is not advisable as it can lead or liver problems or high blood to dangerously high levels of pressure should not use K. K can ketamine in the body. also make it difficult to get an erection or cum. High doses of K can lead to a ‘K hole’ where you can have difficulty moving and have out of body experiences. Overdoses are rare but tolerance can be developed to K, which means that higher doses are required to experience the same effect. Although guys use K because of its pain-relieving properties in heavier

Ecstacy / MDMA E / pills / disco biscuits / eccies / molly What is it? hard-on or cumming. Some guys Ecstasy comes as a loose white take Viagra to fix this but that can powder or pills branded with logos cause a hard-on that doesn’t go such as Mitsubishi, doves or smiley away for several hours. Mixing faces. Ecstasy can be swallowed ecstasy with alcohol, ketamine ‘bombing’, snorted, smoked, or or G, will reduce the effects of inserted up your ass. the drug. Taking more ecstasy to increase the high can lead to The law overdose. Alcohol can increase Ecstasy is a Class A drug. dehydration, overheating and Possession can lead to a fine and damage to your organs causing a prison sentence up to 7 years. strokes or heart attack. Mixing with Supplying the drug can lead to a antidepressants can worsen your larger fine and a life sentence in mental health. prison. Using ecstasy while taking HIV The effects medication is not advisable. The Ecstasy increases your perception medication can interact with of colours and music, making it ecstasy leading to higher levels the most commonly used drug on of ecstasy in your body. This may the club scene. It can give intense increase the risk of negative effects. feelings of love, happiness and sexual desire for those around you. The downsides Ecstasy can increase your body temperature and heartbeat giving rise to paranoia, dehydration and depression. Tiredness, sleeping problems and feeling low for days after taking it is common and known as a ‘comedown’. Mixing it Ecstasy can stop you getting a

Mephedrone M-Cat / meow-meow / bath salts What is it? temperature fluctuate and give you M-Cat comes as a coarse crystal- heart palpitations. It can increase like white powder which is crushed interest in sex and make you do finely to make it easier to consume. things you normally wouldn’t do, It can be swallowed, smoked with such as kink or BDSM. M-Cat can a pipe, injected (slammed), snorted cause difficulty in maintaining an or rubbed into the lining of your ass erection. Comedowns can make (booty bumping). you feel depressed and you may find it difficult to concentrate in the The law days that follow. M-Cat is a Class B drug. Possession can lead to a fine and a prison Mixing it sentence up to 5 years. Supplying With alcohol, M-Cat can cause the drug can lead to a larger fine your breathing to slow down and up to 14 years in prison. and increase the effects of the drug. With antidepressants, it can The effects increase the risk of seizures and M-Cat can give feelings of heart problems. Ecstasy or cocaine, euphoria, alertness, confidence and mixed with M-Cat, can cause affection towards others. Like other dehydration and overheating which chemsex drugs, M-Cat can also can be fatal. With Viagra, it can make you sensitive to touch and increase pressure on your heart. enhance sexual experience, making some men ‘driven’ to have sex. Although there is little research on its effect with HIV medication, The downsides caution is advised. Snorting can cause damage to your nose while swallowing can cause damage to your teeth and gums. Booty bumping can lead to damage of your anal lining and put you at risk of STIs or HIV. Slamming can cause veins to collapse. M-Cat can also cause anxiuety, paranoia, make your

What to do if you think someone is having a bad reaction to alcohol or drugs Are they anxious or panicky? The Recovery position. Sit calmly with them in a quiet This position makes sure that a room. person can still breathe if they Keep away from noise, bright lights become unconscious. It will also and crowds. stop them choking on their vomit. Encourage them to take slow, deep Roll the person on to their side. Put breaths. their upper hand under their chin. Bend their upper leg and put it in Are they drowsy? front of them. See the image below: Sit calmly with them but keep them awake. Questions? If they become unconscious phone Get in touch, we’re 999 immediately for an ambulance. Place them in the recovery position here to help. until the ambulance arrives. Website: www.S-X.scot Don’t try to wake them up with coffee or tea. Email: [email protected] Don’t try to wake them up with a cold shower or bath. Are they unconscious or having difficulty breathing? Phone 999 for an ambulance immediately. Place them in the recovery position until the ambulance arrives. Tell the ambulance crew what they have taken, if you know. Remember! Stay calm and be calm. Don’t scare them. Find out what they’ve taken. Stay with them until they are better or until help arrives.

Funding for this booklet was provided in part by This resource has been designed and developed by SX is provided by Waverley Care Scottish Charity No. SC036500