Drug usage effects vary from person to person. It’s important to note that any existing health problems or multiple illicit drug usage, alcohol consumption or medications (including over the counter medicines) can affect every individual very differently.

• Using alcohol and heroin together can cause your central nervous system to slow down too much, which can cause your heart to completely stop. This outcome can result in sudden death.
• The use of alcohol with cocaine is an extremely high risk practice that holds many dangers. The combination of usage creates a toxin called cocoaethylene which can be extremely damaging or cause irreparable consequences to your liver. 
• The practice of using heroin with methadone is extremely dangerous. It is important that you should never use more than your prescribed medication. If you believe that your medication is not enough please access support from local drug services, whose prescribing team will clinically review and make changes (where identified as required) to support your safe treatment. It is important to understand that using heroin and methadone at the same time is potentially a fatal combination, that could result in you overdosing.

Using a combination of drugs and/ or alcohol can be very dangerous on occasions resulting in permanent damage or death. 

Within the following ‘Coping with’ section basic advice is provided to help you to reduce risks.  There are some really helpful websites that provide more in-depth information about various drugs and further information around alcohol misuse. You can find these within the ‘Finding help’ and ‘Getting more help’ sections

Cannabis Risks

• Regular heavy cannabis smoking can impact on your concentration. There is also higher associated risk with younger people as the brain is at a crucial stage of development.
• Regularly smoking cannabis can cause people to lose their motivation.
• Cannabis use can psychologically negatively impact your mind. Cannabis usage can lead to panic attacks, increased anxiety, paranoia and increased levels of aggression and violence.

Cannabis withdrawal symptoms

If you smoke cannabis regularly you may get withdrawal symptoms when you cut down or stop. Take the withdrawal symptoms as a positive sign that your body is recovering. They usually stop within a few weeks. Below is some advice to assist you to get through the withdrawals.

Signs and Symptoms linked to Cannabis Withdrawal

It’s normal to experience low mood and cravings when you cut down or stop any drug. If you cut down or stop cannabis, you may also experience:-

• Sleep problems
• Strange dreams
• Anxiety and restlessness
• Irritability and anger
• Sweats and chills
• Changes in your appetite
• Nicotine withdrawal (if you smoke cannabis with tobacco)

Cannabis Withdrawal Symptoms (How Long Do They Last?)

Cannabis withdrawal symptoms usually peak about four days after you stop or cut down. They are likely to be more intense in the following circumstances:-

• When you stop completely rather than cutting down
• When you have smoked cannabis every day or most days

The good news is that most symptoms stop at around ten days but in some cases some people do continue to get them for up to four weeks. This is because the active ingredients in cannabis are stored in fat cells in your body. It takes up to four weeks for your fat cells to release them all.

How to Manage Cannabis Withdrawal Symptoms

Cannabis withdrawal symptoms can be difficult to deal with but they don’t last forever. Remember to give yourself some slack and show patience towards yourself given your body is in a phase of recovery. 

Sleep Problems

Unfortunately you can expect a few sleepless nights when you give up cannabis, this will be especially the case if you previously used cannabis to help you sleep.  Here are a few tips to help improving your sleep

• Get up and go to bed at the same times each day– having a regular sleep routine helps to train your body to fall asleep at the same time each night.
• Have a calming bedtime routine– having the same routine each night tells your body it’s time to sleep. Include calming things like a warm bath, reading or watching TV in your routine – whatever helps you feel relaxed and sleepy.
• Avoid going on your phone just before bed– the light from the screen makes it harder for your brain to switch off and go to sleep.
• Get out and about during the day– even a short walk in daylight hours will improve your mood and your sleep, and help with stress and anxiety too.

Anxiety and Restlessness

Anxiety is quite a common feeling when you stop using cannabis. This will further enhanced when you have previously used cannabis to manage your anxiety. The key to success is to develop new ways to cope with your anxiety. Avoiding coffee and other caffeinated drinks will assist in reducing feelings of anxiety.  Without the sedating effects of cannabis, caffeine can make you feel more jittery and anxious than usual. Writing your worries down can help. So can using simple breathing exercises to calm your breath.

Irritability and Anger

There are people who say that they feel irritable and angry when they stop using cannabis. These feelings are quite normal and over time will pass. To help try to cut down stress in your life and build in things that you find relaxing, such as playing games or listening to music. Telling a close friend or family member how you are feeling can be a great source of support. If you don’t want to tell them you’ve stopped using cannabis, you could just say you’re feeling under the weather.

Sweats and Chills

During withdrawal from cannabis you may experience flu-like symptoms like sweats, chills, headaches and muscle pains. If you should experience these symptoms try and look after yourself as you would if you had a bad cold or flu. Keep warm and try to take things easy. Make sure you’re drinking plenty of fluids and take paracetamol or ibuprofen to ease any aches and pains.

Appetite Change

Food may taste different when you’re withdrawing from cannabis, and your appetite may change. If you don’t feel like eating, try to eat little and often or have smoothies instead. Getting some exercise and fresh air may help to build your appetite too. Some people get nausea and stomach pains. These should go away in a week or two.

Smoking Cannabis with Tobacco

If you usually smoke your cannabis mixed with tobacco, you need to be aware that you’ll also get nicotine withdrawal symptoms when you stop. Nicotine withdrawal symptoms are similar to those for cannabis. You may feel irritable, restless and find it difficult to concentrate.

To avoid withdrawing from cannabis, you can use nicotine replacement treatments like patches or gum. It’s best to avoid things like vaping or e-cigarettes. Anything that reminds you of smoking could be a trigger to use cannabis again. For support with giving up cannabis and coping with withdrawal symptoms please contact your local drug services.

If you live in Stoke-on-Trent please contact Stoke CDAS you can call on 01782 283113 or link to the website:-  

Contact Us, Stoke-On-Trent Community Drug and Alcohol Services (scdas.org.uk)

If you live in North Staffordshire please contact STARS on 01782 639856 or link to the website:-

Staffordshire Treatment and Recovery Service – STARS – Humankind (humankindcharity.org.uk)

Heroin Risks

• If you frequently use heroin on a regular basis you are likely to build-up a level of tolerance (see below for more detail)
• It is important to know that if you should stop taking heroin for a number of days your tolerance does rapidly drop.  Therefore the amount of heroin you were previously using may not be tolerated and this could lead to an overdose.
• Heroin can have a sedative affect when used, so it is important to understand there are increased risks of potentially vomiting whilst under the influence of the heroin. Because of the sedation this can prevent you from coughing effectively and vomit could remain in your vital airways preventing you from breathing or being able physically respond to the situation.

Drug Tolerance Risks

Developing tolerance to drugs leads to people tending to increase the amount of drugs they use over time, and also places them at increased risk of overdosing and dying from their substance. It is important to understand the definition of a drug tolerance – this is when a person’s reaction to a drug decreases as they continue to use it. Furthermore, a tolerance to drugs decreases with non-use. The higher the tolerance and dependence on a drug, the larger the doses a person has to take in order to achieve the same effect as they did earlier in their drug use.

Drug tolerance is not an addiction. It is simply the body becoming desensitized to the drug’s effects (addiction is a body chemically dependent on that drug). Many people with addictions also have drug tolerance, which drives them to seek out more potent drugs.

Heroin withdrawal symptoms

If you have become dependent on Heroin, you may be confused, frightened, and unsure about what to do to overcome dependence. You may be worried about managing your Heroin withdrawal symptoms and going through a Heroin (Opioid) detox.

Signs of Heroin Withdrawal

Regardless of the type of opioid used, signs of withdrawal are similar for all opioids and can include:^_

• Nausea and vomiting.
• Diarrhoea
• Insomnia
• Anxiety
• Increased body temperature
• Racing heart
• Muscle and bone pain
• Sweats
• Chills
• High blood pressure.

The Causes Heroin/ Opioid Withdrawal & Dependence

When taken as prescribed by a clinician, opioids can safely and significantly reduce pain associated with surgery or any type of intense physical pain and assist in the safe withdrawal in addiction. However, taking Heroin over a long period of time can lead to tolerance and dependence.  As you build tolerance to heroin, you will need a larger dose to get the same sensations as you used to, which often leads to taking more heroin than before. Eventually, it is possible that you could become physically dependent on the drug. If you are dependent on heroin you are likely to experience symptoms of withdrawal if you reduce or suddenly stop taking heroin. This unfortunately can place you in a vicious cycle where you may be trying to cut back or stop using heroin; but upon doing so you may experience uncomfortable withdrawal symptoms, which results in the need to take heroin again to relieve such symptoms. However, prescribed opiate treatment can result in dependence in its own right.  It is therefore of significant importance that you work with your GP or Drug Service to ensure your prescriptions are reviewed to reduce the time you are prescribed on your treatment.

It is important that you understand that taking heroin can be very dangerous or even lead to death if you take too high a dose, which can lead to extreme effects in terms of drowsiness, nausea, euphoria, and slowed breathing.

How Long Does Opioid Withdrawal Last?

Some types of opioids will cause signs of withdrawal sooner than other types of opioids; and withdrawal from some opioids will last longer than others. Heroin and short-acting opioid withdrawal symptoms can typically be seen within the first 8-12 hours after last used and peaks within 1-3 days and continues for up to 7-days.

For more information and support you can contact:-

If you live in Stoke-on-Trent please contact Stoke CDAS you can call on 01782 283113 or link to the website:- 

Contact Us, Stoke-On-Trent Community Drug and Alcohol Services (scdas.org.uk)

If you live in North Staffordshire please contact STARS on 01782 639856, or link to the website:-

Staffordshire Treatment and Recovery Service – STARS – Humankind (humankindcharity.org.uk)

If you are interested in a self-funded inpatient detoxification the Edward Myers Unit accepts private detoxification referrals. If you would like to call the team to be referred, please Tel 01782 441715 and request a call back or link to the website:-

North Staffordshire Combined Healthcare Edward Myers Inpatient Unit

Cocaine/ Crack Cocaine Risks

• If you frequently snort cocaine this can lead to damage to the cartilage in your nose that separates your nostrils. This can lead to the probability of misshapen nostrils.
• Cocaine usage can exacerbate pre-existing mental health conditions. Evidence indicates that cocaine can also induce psychosis which can cause delusions and potential erratic behaviour.
• Cocaine use can cause you to feel low, depressed and run down. It can lead to serious mental health problems including anxiety and panics attacks.
• It is important to know that when pregnant using cocaine can cause premature labour as well as miscarriages. There are also associated risks of health complications to your baby following birth.
• Smoking Crack Cocaine can cause bronchial related problems such as breathing difficulty and COPD (Chronic Obstructive Pulmonary Disorder).
• “Speed-balling” (injecting Cocaine and Heroin) is a very dangerous practice which increases the risk of overdose and death.

Cocaine withdrawal symptoms

Using Cocaine increases the amount of the “feel-good” chemical dopamine in the brain. When you use Cocaine for a long period of time, you will develop a tolerance to the drug’s euphoric effects.  Importantly over time, the Cocaine user’s brain needs the drug to produce dopamine or even to feel “normal.” As a result, withdrawal symptoms emerge when you stop using cocaine. You may have got stuck in this cycle and continue to use cocaine to avoid the side affects you may have experienced.

Symptoms of Withdrawal

Cocaine’s euphoric “rush” fades quickly, meaning withdrawal symptoms follow shortly after the last dose. Many cocaine users “binge,” or take more and more of the drug over a short amount of time, to delay withdrawal symptoms. Please be aware cocaine binging can lead to fatal overdose.

Common symptoms of withdrawal from Cocaine include:-

• Increased appetite
• Fatigue
• Depression
• Agitation
• Restless behaviour
• Nightmares
• Anxiety
• Suicidal thoughts

Duration of Withdrawal

Withdrawal symptoms can commence within hours of you stopping cocaine use. However, the worst cravings and withdrawal symptoms you will experience are generally appear during the first month of ceasing.  The intensity of withdrawal symptoms you experience will depend on the amount of cocaine taken and the frequency of use.  Unfortunately you may experience withdrawal symptoms over a number of months following your last dose of cocaine. Some symptoms you experience may be uncomfortable, making it difficult for you to quit cocaine. Some people do encounter symptoms of severe depression and suicidal thoughts which are the dangerous side effects that link to stopping cocaine.  If these symptoms are experienced by you it is advisable to seek medical support.

Common Cocaine Withdrawal Timeframes

 First 1-3 hours

Symptoms emerge as soon as you stop. You may start to feel irritable, anxious, exhausted and have an increased appetite. Cocaine cravings actually decrease during this period.

Week 1

Intense cocaine cravings arise. You may feel exhausted but have trouble falling asleep. Vivid, unpleasant dreams are common, as well as depressive mood swings.

Weeks 2-4

Depression and strong cocaine cravings continue. You may find it hard to concentrate or stay on an “even keel” emotionally. Irritability and agitation are also common.

Weeks 5-10

Your mind and body begin to heal, and you will notice that withdrawal symptoms diminish. Cocaine cravings can still crop up during this period. General anxiety and uneasiness sometimes return as well.

For more information and support you can contact:-

If you live in Stoke-on-Trent please contact Stoke CDAS you can call on 01782 283113 or link to the website:-

Contact Us, Stoke-On-Trent Community Drug and Alcohol Services (scdas.org.uk)

If you live in North Staffordshire please contact STARS on 01782 639856, or link to the website:-

Staffordshire Treatment and Recovery Service – STARS – Humankind (humankindcharity.org.uk)

If you are interested in a self-funded inpatient detoxification the Edward Myers Unit accepts private detoxification referrals. If you would like to call the team to be referred, please Tel 01782 441715 and request a call back or link to the website:-

North Staffordshire Combined Healthcare Edward Myers Inpatient Unit

Amphetamine Risk

• The use of amphetamines (also known as Speed) can place an additional strain on your heart so it is important if you have underline medical conditions such as high blood pressure or a heart condition that you do not use speed given the increased of complications or death.
• Regular use of amphetamines can cause damage to your immune system resulting in you becoming more susceptible to colds, flu and infections.

Many of the risks linked with the use of speed are similar to those of cocaine.

Amphetamine withdrawal symptoms

If you have been using amphetamines for a long period of time you will experience physiological symptoms if you abruptly stop taking the drug.  If you use amphetamines it is possible that this can lead to physiological and neurological changes in which the brain becomes reliant on substance use for the presence of amphetamines to function properly.  If you use amphetamines for a long period of time or at high doses, you are likely to experience psychological and psychological signs and symptoms if you drastically reduce the dose or abruptly stop taking the drug.  This is commonly known as the amphetamine withdrawal syndrome, and it can be difficult to get through without support.

Amphetamine withdrawal effects include depression, fatigue, irritability, anxiety, trouble concentrating, and increased appetite. In the worst-case scenario, they can negatively impact your mental health to the point of feeling suicidal or profoundly depressed.  People who stop taking amphetamines can initially experiences a “crash” that lasts 1-2 days and then experiences a longer period of withdrawal that can last anywhere from five days to several weeks.

Symptoms and Effects of Amphetamine Withdrawal

Some of the common amphetamine withdrawal side effects and symptoms include:-

• Fatigue and increased need for sleep
• Increased appetite
• Bodily movements and twitches
• Slowed reaction and movement
• Aches and pains
• Irritability and/or agitation
• Dreams that are often vivid and sometimes unpleasant
• Depression

Withdrawal from amphetamines is not generally life-threatening. However, it can be extremely uncomfortable and trigger relapse. It is advisable to consider detoxification under the supervision of a medically trained clinician given they will provide you with a treatment regime that will assist in reducing the withdrawal symptoms.

Withdrawal Factors

The time it takes for withdrawal signs to commence, the severity of symptoms a person will experience, and the length of time it will take to complete withdrawal from amphetamines will depend on several factors, including:-

• The length of time a person has been using amphetamines
• The dose and frequency of that dose at the time of last use
• Whether or not a person is also using other substances
• Psychological and physical ailments that may complicate withdrawal
• Biological factors such as gender, age, weight, and/or genes, which can affect how each person metabolizes amphetamines during detox

Post-Acute Withdrawal Symptoms

When withdrawal effects last longer than 2 weeks, they are considered protracted or post-acute withdrawal symptoms (PAWS). Chronic users may experience PAWS effects that can last up to a year. Amphetamines have a profound effect on various parts of your brain. Some of the signs and symptoms of PAWS include:-

• Problems with short-term memory
• Impaired ability to focus, concentrate, or maintain attention
• Lack of self-control
• Depression with or without suicidal ideation/behaviours
• Inability to experience pleasure (anhedonia)
• Cravings
• Fatigue
• Sleep problems
• Physical complaints with no medical origin

If you are experience these symptoms it is advisable to seek advice from your medical professional who may prescribe supportive medications to help manage your symptoms, which will assist in enhancing your ability to remain sober and healthy.

Common Amphetamine  Withdrawal Timeframes

First 1-2 days

A person usually experiences symptoms within 36 hours of the last use. This initial phase of withdrawal is referred to as the “crash” and can include increased need for sleep, depression, increased appetite, and cravings.

5 days to several weeks

Symptoms during this time can include mood swings, irritability, aches and pains, depression, cravings, trouble sleeping, and fatigue.

2 weeks to a year

Some withdrawal effects can last up to a year if a person experiences protracted symptoms from long-term amphetamine use.

Medical Complications

Amphetamine withdrawal is rarely associated with medical complications. However, there are always exceptions. Some possible medical complications include:-

• Cardiac problems such as chest pain or irregular heartbeat
• Seizures
• Headaches that could be caused from bleeding in or around the brain
• Complications resulting from withdrawing from multiple substances

If you experience any of these symptoms you should seek immediate emergency assistance. Left unmanaged, these medical complications may have life threatening consequences.  Appropriate medical interventions can not only assist with your recovery but also may assist in saving your life.

If you live in Stoke-on-Trent please contact Stoke CDAS you can call on 01782 283113 or link to the website:- 

Contact Us, Stoke-On-Trent Community Drug and Alcohol Services (scdas.org.uk)

If you live in North Staffordshire please contact STARS on 01782 639856, or link to the website:-

Staffordshire Treatment and Recovery Service – STARS – Humankind (humankindcharity.org.uk)

If you are interested in a self-funded inpatient detoxification the Edward Myers Unit accepts private detoxification referrals. If you would like to call the team to be referred, please Tel 01782 441715 and request a call back or link to the website:-

North Staffordshire Combined Healthcare Edward Myers Inpatient Unit

Monkey Dust is a synthetic cathinone and are part of a drug class called new psychoactive substances (NPS). NPS are unregulated psychoactive substances that have no accepted medical use and are made to mimic the side effects of controlled substances.

The main ingredient of monkey dust is methylenedioxypyrovalerone (MDPV). Monkey dust acts as a central nervous system to produce hallucinogenic side effects. MDPV or monkey dust may also contain numerous other chemicals or additives that can be harmful to the mind and body.

Monkey Dust Drug Side Effects

Monkey dust works by binding to dopamine, norepinephrine, and serotonin transporters to inhibit or block the uptake of these chemicals in the brain. Similar to cocaine monkey dust has been shown to inhibit the uptake of dopamine and norepinephrine, flooding the brain with these drugs.

Some common side effects of monkey dust that may occur can include:-

• Increased empathy
• Stimulation or increased energy
• Increased alertness
• Euphoria
• Increased awareness of the senses (brighter colors and louder sounds)
• Tachycardia (rapid heart rate)
• Hypertension (high blood pressure)
• Vasoconstriction (narrowing of the blood vessels)
• Excessive sweating
• Panic attack
• Paranoia and anxiety

Monkey Dust (MDPV) withdrawal symptoms

If you use Monkey dust it is likely that you will become addicted to the substance.  This will be further enhanced if you use the drug over a long-term period time.  The effects of long term use may include:-

• Psychosis
• Cravings
• Dependence
• Fatigue
• Sleep problems
• Aggression

Common Monkey Dust Withdrawal Timeframes

If you take Monkey Dust the side effects usually last for about two to three hours, whereas the adverse effects may last for six to eight hours. The duration and severity of these symptoms depend on how much of the substance you have taken and the frequency.

The risks linking to Monkey Dust use are well publicised and exposes you to other types of drug use which can lead to self-destructive and violent behaviour. Mixing alongside other drugs or alcohol can lead to more high risk side effects and the risk of overdose.  If you need help with Monkey Dust then please contact the below:-

If you live in Stoke-on-Trent please contact Stoke CDAS you can call on 01782 283113 or link to the website:- 

Contact Us, Stoke-On-Trent Community Drug and Alcohol Services (scdas.org.uk)

If you live in North Staffordshire please contact STARS on 01782 639856 or link to the website:-

Staffordshire Treatment and Recovery Service – STARS – Humankind (humankindcharity.org.uk)

The information provided has focused on a number of common drugs that can be used. 

It is important to know that there are many other drugs that have not been covered within this information that you may require help with.  If you have concerns or require help around a drug you are using please seek advice from your local drug service.