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In 2011, the UK government’s Advisory Council on the Misuse of Drugs concluded its work on poly-drug use. In 21st century Britain, poly-drug has become the norm, while singular drug use has become the exception. This is partly because there has been an increase in the number of drug products and their availability in all four groups of psychoactive substances: licensed drugs, prescribed/pharmacy drugs, controlled drugs, and/or legal highs. In addition to availability, the reason for ‘mixing’ two or more drugs it that this usually produces intoxication effects which are greater than the sum of their parts. Also, as the ACMD report notes, poly-drug use is a term which covers two types of behaviour involving combined drug use: (1) multi-drug use: using two or more drugs in the same ‘hit’ (administration) or ‘session’ (episode of drug-taking); and (2) total drug use: using two or more drugs separately over a longer period of time (eg. month/year). Whilst examining the overall picture, this course focuses on multi-drug use involving different illicit drugs.
There are many possible combinations of all the different illicit drugs people take, but the ones which raise most concern fall into three groups (with tobacco excluded for reasons of clarity): (1) alcohol with illicit drugs - especially cannabis, cocaine, sedatives and/or opiates; (2) heroin/opiates with other illicit drugs, notably heroin injected with crack/cocaine (speedballing); or heroin, methadone and/or benzodiazepines; (3) combinations of ‘dance/party drugs’ (mostly stimulants and hallucinogens) - notably ecstasy (MDMA etc.), amphetamines, cocaine, cathinones (eg. mephedrone), ketamine, and various ‘legal highs’. Some drugs interact chemically in the body (eg. alcohol and cocaine make cocaethylene), while others interact at the effect level, producing new experiences and risks. In either case, the order in which the drugs are taken is another critical factor.
The aim of this course is to give an overview of these main types of poly-drug use in Britain in the 21st century; to identify the specific risks produced by combining different drugs compared with their singular use; and what the implications of poly-drug use are for generic and specialist services for drug users.
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