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From heart damage to seizures: The dangers of mixing different drugs

To many people, the thought of putting multiple drugs in your system all at once might seem pretty extreme.

Stories in the news about people dying from a ‘cocktail of drugs’ make it look like something that takes place on the fringes.

However, Fiona Measham, director of drug checking charity The Loop, says ‘polydrug use’ is actually quite common.

‘From the dawn of time when we’ve been using drugs we’ve been using them in combination,’ she tells Metro.co.uk.

‘You can see how it happens, people are attempting to control, moderate and minimise the unwanted effects of drugs and maximise the pleasures.

‘What’s important is understanding where some of the greatest risks lie in terms of specific substances.’

Alcohol with illegal substances one of the most common ways people mix drugs (Picture: Getty Images/iStockphoto)

Probably one of the most common forms of drug combinations involves alcohol with something else, according to Release.

The drug education charity say people don’t often even think of booze as a drug, but it definitely has its own dangers, and mixing it with other substances can lead to a damaging and potentially fatal reaction.

Mixing depressants, such as alcohol and benzodiazepines (like Valium and Xanax) are particularly risky, says Adam Waugh, senior health team member at The Loop.

As drugs that slow down your breathing and heart rate, taking the two in combination increase the likelihood of something going wrong.

‘I would also caution strongly against mixing ketamine with other drugs, in particular ones that depress the central nervous system – like alcohol, GHB and benzodiazepines,’ he adds.

It might be normalised among users, but combining cocaine and alcohol is actually very risky (Picture: The Loop)

As an anaesthetic that can seriously affect movement and coordination, Adam also advises people to think carefully about the setting they chose to do ketamine in to avoid getting hurt by the environment around them.

Mixing depressants and stimulants also come with their own dangers – particularly alcohol and cocaine – which put extra stress on the heart when taken together.

‘Often people will take cocaine to be able to drink all night, so there is this symbiotic relationship with it,’ says Niamh Eastwood, director of Release.

But the combination can create a toxic substance in the body called cocaethylene, which, raises blood pressure and increases the risk of damage to the heart and liver.

In fact, a US study published in the Journal of Addictive Diseases says the risk of dying with cocaethylene running through your system is 18-25 higher than if you just did cocaine on its own.

‘People underestimate alcohol all the time, they focus on drugs and they just underestimate the damage that alcohol does,’ says Niamh.

Another thing to bear in mind is that people who combine uppers and downers often tend to consume more of each than they otherwise would, says Adam.

‘Say you’re taking cocaine and diazepam. Both make the other feel less strong.

‘Someone might take more of each until they end up taking a grossly large amount of drugs that risks disproportionate harm.’

Claire Robins, nurse advocate and drugs advisor for Release, adds that stimulants like cocaine can make you ‘overestimate your ability’ when taking other drugs.

For example, she says, this could lead to someone doing a much larger line of ketamine than they can handle.

The Loop says mixing ketamine with other depressants heightens the risk of losing consciousness and possibly death (Picture: The Loop)

‘I think that people will find stimulants make them less aware of being intoxicated with alcohol,’ she adds.

‘Your body, your brain and your liver continue to get intoxicated but the drugs kind of cut through that.’

But the risks associated with combining drugs can’t be oversimplified and are about more than just stimulants and depressants, says Adam.

‘An upper and a downer is one glass of wine and one Red Bull but it’s also intravenous cocaine and heroin.

‘You’ve got this big spectrum of risk. It’s not just the combination that affects risk, it’s also things like dosage and the context of the use.’

For example, he says MDMA and tramadol are a very high risk pairing, because they can lead to serotonin syndrome, which in severe cases can cause seizures, irregular heartbeat, unconsciousness and death.

It’s important to take into account any prescribed medication you’re on, particularly anti-depressants (Picture: Getty Images)

This isn’t because one is a stimulant and the other is an opioid – it’s just the way each of these drugs interact with the brain, Adam says.

‘If someone’s taking LSD and cannabis that’s not a high risk in most circumstances.

But if someone’s been up for three days at a music festival, they’ve not slept, they’ve got previous mental health problems and they take LSD – that addition of cannabis can be enough to send them over the edge.

‘So even things that are “low risk” combinations in certain contexts can be high risk.’

Legal pharmaceuticals, particularly psychiatric medication, can also produce dangerous interactions with a lot of illegal drugs, Adam warns.

‘A lot of people don’t think a prescribed drug is a drug, even though it is.’

For those looking to learn more, The Loop recommends a site called Tripsit, which has an interactive app showing how different drugs combine, as well as a chart.

Niamh recommends doing your research before doing any drug – ‘with caveats because it’s an unregulated market’.

Release’s website has lots of good information, as does DrugScience, the Loop and Erowid, which Claire describes as ‘the encyclopaedia of it all’.

This article is a part of the series High Alert, a harm reduction campaign from Metro.co.uk and The Loop.

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