Fisting: A General Introduction - Drugs Part III

So now I tried to explain you what there is to get and what it does sexually...

It is I think also necessary to tell what can happen? 

What can go wrong at long term? 

or 

What happens if you mix drugs or use in combination with other drugs? 

While I was writing part I & II, I came on a page of 

the Terrence Higgens Trust

and I found some interesting information so I will share it with you here:

Alcohol

A long term relationship?

Alcohol is a low level toxin which is the reason it can damage the heart and liver of heavy drinkers and why pregnant women shouldn’t drink.

Heavy drinking over a long period can lead to liver disease, cancers of the throat, mouth and liver, and brain damage. Excessive drinking kills thousands each year.

Addiction to alcohol can be physical, for example, the ‘shakes’ are a withdrawal symptom, or psychological, giving you an intense urge to keep drinking.

Alcohol with other drugs:

• Depressants  – because alcohol is a depressant drug, mixing it with other depressants like GHB, ketamine or tranquillisers can make you pass out or interfere with your breathing or heart which can kill. GHB-related overdoses and deaths often involve alcohol. It’s risky to take GHB if you have booze in your system.
• Ecstasy  – booze deadens the effects of E and together both can dangerously dehydrate the body. E-related deaths often involve alcohol.
• Cocaine – in the body alcohol combines with cocaine to make cocaethylene, which can make the effects of the coke stronger. Mixing the two increases the harm done by both drugs. There’s a bigger risk of sudden death when people use cocaine and alcohol together.
• HIV medication – there are no significant bad reactions with moderate alcohol use, but if booze makes you throw up within an hour of taking HIV medication, the dose should be taken again. As drinking often causes vomiting, mixing it with other drugs carries the risk of choking on vomit if you fall unconscious.

Useful to know

Drinking water between drinks and/or before sleeping cuts down on dehydration and hangover symptoms.

Alcohol can make anxiety, depression or sleep problems worse, so should be treated with caution if you’re vulnerable to these.

Coffee can’t sober you up. Only alcohol leaving your system over time does this.



Poppers

A long term relationship?

Poppers aren’t addictive in the way some drugs are but they can be habit-forming and the more you use them the less effect they have. Sensitivity comes back after a few days of not using them.

Poppers with other drugs

• Viagra-type drugs  – makers of erection drugs like Viagra warn against using them with poppers, as both lower blood pressure. Poppers are nitrites. Similar drugs (nitrates) are used by people with heart problems. Taking Viagra and similar drugs while on nitrates has killed people by causing a fatal drop in blood pressure. So to be on the safe side, caution is advised with poppers (nitrites) too.
• HIV medication – protease inhibitors push up levels of erection drugs in the body, meaning a bigger risk of a dangerous interaction if poppers are used.
• Ecstasy,  speed , cocaine or crystal meth– these all put strain on the heart. Taking them with poppers stresses it even more.

Useful to know

• Because poppers can kill an erection, it’s better to put a condom on before the first hit of poppers.
• Poppers easily catch fire so should be kept away from naked flames, cigarettes, etc.
• You should avoid poppers if you’ve got high or low blood pressure, a heart condition or glaucoma (an eye condition).

Viagra

A long term relationship?

In males, this typically results in penile erection. The use of Viagra can cause side effects affecting multiple organ systems in the body. Additionally, long-term use of this drug can potentially increase the risk of psychological dependency.
Long-term use of Viagra has been associated with various problems affecting the auditory (hearing) and visual systems. Loss or decrease of hearing have been reported in association with use of Viagra

Viagra with other drugs

• HIV medication – protease inhibitors push up levels of the erection drug in the body, so a lower dose of Viagra will be needed. It is important to check what dose you should take with your HIV doctor as there has been one reported death of a man using Viagra and also taking ritonavir and saquinavir.
• Poppers – some makers of erection drugs warn against using them with poppers, as both lower blood pressure. Poppers are nitrites. Similar drugs called nitrates are taken by people with heart conditions. Taking Viagra and similar drugs while on nitrates has killed men by causing a fatal drop in blood pressure. So to be on the safe side, caution is advised with poppers (nitrites) too.
• Ecstasy– Viagra and E together (called ‘sextasy’) could strain the heart and has been known to cause a hard-on that won’t go down. An erection lasting over 4 hours can damage a dick. Get medical help straight away.
• Cocaine, crystal meth and speed, or chems that might have speed in them such as ecstasy tablets -- when taken together with Viagra these put extra pressure on the heart.

Useful to know

Viagra is the trade name for the drug sildenafil citrate. It works by relaxing the smooth muscle lining of certain blood vessels, causing them to expand and fill with blood. 
It is also sold over the internet  but attention some of them are fakes. 
Check with a doctor before taking erection drugs, especially if you’re in one of these groups of men more likely to have a dangerous reaction. These are men who are:

• older
• overweight

Cocaine

A long term relationship?

As your tolerance builds to both cocaine and crack, more will be needed to gt the same high. Coke has a reputation for being more addictive than most chems and crack is even more addictive. The drugs can cause lasting damage to how the brain works and, given the drug’s price, becoming addicted can ruin you financially.

Using cocaine or crack for a long time, or large doses, can cause panic attacks, hallucinations, depression, paranoia, and psychosis. Snorting coke can, over time, destroy the lining of the nose and the skin between nostrils called the septum.

Coke/crack with other drugs:

• Alcohol – using booze together with coke or crack makes the bad effects of both worse and can give you the illusion of being sober when you’re drunk. These drugs mix together in the body with alcohol to make cocaethylene, a toxin that damages the brain, liver and heart. This is the reason for the bigger risk of sudden death in people using alcohol and coke or crack together.
• Speed, Crystal meth, Ecstasy, or Viagra – mixing these drugs with coke or crack means even more pressure on the heart and circulatory system, with a bigger risk of stroke and heart attack.
• Anti-depressants – taking cocaine or crack when you’re on some anti-depressants can cause ‘serotonin syndrome’. This could be dangerous and causes symptoms like a fast heart beat, sweating, muscle spasms, and not being able to sleep. You need to seek urgent medical help if this happens to you. If you’re on anti-depressants check with a doctor before using these drugs.
• HIV medication – as the body processes these differently than cocaine or crack, there are no known dangerous interactions.

Useful to know

If you share straws or bank notes to snort coke tiny amounts of blood could go from the lining of one person’s nose to another. This might possibly spread blood borne viruses like hepatitis C. The same could happen if crack pipes are passed from a mouth with ulcers or burns to another person’s mouth.

Methamphetamime/Crystal meth 

A long term relationship?
Tolerance to crystal meth soon builds and users need more to get the same high. The drug has a reputation for being quickly addictive. Many who party with Tina have waved goodbye to jobs, homes, money, boyfriends, friends and health. Hardened gay scene party animals who can control their use of other drugs have found themselves out of their depth with crystal. It can get hard to think of having sex without being on meth.
Using crystal long term can get scary -- we’re talking psychosis or lasting mental health problems, even after quitting the drug.
Quitting crystal can be very hard and its effects on the brain can last long after giving the drug up.

Crystal with other drugs:

• HIV medication – protease inhibitors could cause a big, maybe fatal rise in levels of crystal in the body. And if you’re tweaking the weekend away you’re less likely to take your HIV drugs on time (if you remember at all). Meth itself damages the immune system, as does going without food or sleep when you’re on it.
• Ecstasy, cocaine, poppers and Viagra-type drugs - all these put your heart under strain. If you’re using crystal too you’re pushing your heart even harder.
• Anti-depressants – taking crystal while on anti-depressants can make life-threatening reactions more likely, including dangerously high blood pressure - check with your HIV doctor.

Useful to know
Injecting is best avoided. It’s the quickest way to getting addicted and runs the risk of serious health problems (skin abscesses, collapsed veins, blood poisoning, and heart infections). Sharing injecting equipment puts you at high risk of getting or passing on HIV, hepatitis C and other infections.
Using hot pipes might injure your mouth and if you share them it risks passing on - in tiny amounts of blood - infections like hepatitis C and HIV.
Condoms are more likely to break after about half an hour of fucking. So during long sex sessions on crystal it makes sense to check rubbers during sex and put a fresh one on after 30 minutes.


Ecstasy (MDMA) 

A long term relationship?
Tolerance to E can soon build, with more needed to get the same high. Some people come to rely on the drug and can’t imagine clubbing without it. Whether ecstasy use can cause long term memory loss or depression is unclear – research is still looking at this.

E with other drugs:

• Alcohol  – this can deaden the effect of E and mask the effects of the booze, making it difficult to tell how drunk you are. Both dehydrate the body, put strain on the liver and kidneys, and raise body temperature. Ecstasy-related deaths often involve booze.
• HIV medication – some of these, especially protease inhibitors, could send levels of E to life-threatening levels in the body. Check with your HIV doctor.
• Anti-depressants – taking E when on a course of some anti-depressants can cause ‘serotonin syndrome’, a dangerous reaction with symptoms of agitation, sleeplessness, sweating, faster heart beat and muscle spasms. If this happens, you need to seek urgent medical help. If you’re on anti-depressants get medical advice before taking E.
• Cocaine, speed, crystal meth – these stimulant drugs taken with E can put the heart under a dangerous level of stress, leading to a risk of heart attack or stroke.  There is also a potential for ‘serotonin syndrome’.
• Viagra-type drugs – as well as possible extra stress on the heart, there have been a few reports of this combination possibly leading to erections that won’t go down. If medical help isn’t found within four hours this can cause lasting damage to a man’s cock.

Useful to know
You can avoid overheating and dehydration by drinking a pint of water over every hour that you’re dancing, and by taking breaks. But drinking too much water can be dangerous.
Once your brain’s ‘feel good’ chemicals have been used up, they take a few days to be replaced. So there’s little point taking more E. Any extra buzz you might get will come from whatever the pill’s been cut with.
E should be avoided by people with a history of mental illness or depression as it can trigger depression or make it worse if you have it already.
As ecstasy pushes up blood pressure and heart rate it should be avoided if you’ve got high blood pressure, heart, liver, or kidney problems, the eye condition glaucoma or a history of stroke.


Cannabis

A long term relationship?
You can become dependent on cannabis. It can leave some people with a poor memory and less able to concentrate or stay motivated -- the classic ‘dope head’.
Researchers are looking at the link between cannabis and mental illness as the drug seems to trigger mental health problems, including schizophrenia, in a small number of people. This is more likely to happen in people who already have depression or anxiety or who are vulnerable to mental health problems, although they usually won’t know they’re vulnerable.
Mental illness seems more likely if you use cannabis as a teenager, if you use it a lot, or if you use the stronger types.

Cannabis with other drugs:

• Tobacco – smoking cannabis with tobacco has a high risk of addiction to nicotine and smoking-related illness like cancer, heart disease and breathing problems. People smoking both cigarettes and cannabis take in very high levels of cancer-causing tar.
• Alcohol -- using cannabis and alcohol together can have negative effects. You may feel sick or lose track of how much of each substance you've taken. This also leaves you open to taking risks you might not otherwise.
• HIV medication – there are no known dangerous interactions, however, one study has shown that marijuana decreases the levels of Atazanavir in the blood.

Useful to know
Cannabis smoke contains more harmful substances than cigarette smoke.
Smoking it with tobacco has the same health risks as smoking cigarettes, such as cancer, chest and breathing problems. The risk may be higher because cannabis smokers breathe in deeper and for longer.
Eating it gets round these drawbacks but it’s harder to control the dose and the effects can be much stronger than you might want.
Using bongs is more harmful than joints because you breathe in more drugs and smoke.


GHB or GBL

A long term relationship?
Regular users often build up a tolerance to G, needing more to get the same buzz. Some get dependent on it. Withdrawal symptoms include the shakes and heavy duty anxiety attacks.

G with other drugs:

• Depressants - it’s very risky to mix G with other depressant drugs (downers) like alcohol and tranquilisers - but also ketamine or antihistamines (used in allergy medicines). Their combined action can dangerously slow down your breathing or cause a long ‘G sleep’ - which isn’t sleep at all, but unconsciousness. A fit, coma or death is possible. Even drinking booze a few hours earlier can leave enough in your system to risk a collapse. 
• HIV medication - G can also interact with HIV meds, causing dangerously high levels of G and a bigger risk of collapsing.

Useful to know
If someone’s getting drowsy from GHB/GBL, don’t let them fall into a ‘G-sleep’ - they’re not ‘sleeping’, they’re unconscious and may not wake up. Try to keep them awake and moving until the effects wear off or medical help arrives.
If G knocks someone out, to stop them choking on their own vomit they should be laid on their side, not on their back.
If you or friends aren’t feeling well or can’t be woken up, get medical help straight away. There’s always a risk of sudden death if someone’s unconscious. You’ll be in a lot more trouble if you don’t get help and then have a dead body on your hands.

Ketamine

A long term relationship?

Overdose deaths are rare, but you can build up a tolerance to K, with more needed to get the same result. Some people become dependent on it. Using ketamine long term might cause anxiety, depression, suicidal thoughts or memory loss and other mental health problems.

If you use ketamine often it can cause bladder problems, kidney or liver damage, stomach pains and blood in the urine. Ketamine can cause scarring and inflammation of the bladder making the bladder unable to hold much urine, causing a need to piss very often. These symptoms often lessen when ketamine use is stopped, but in some cases surgery is needed. Some people have had to have their bladder taken out and be fitted with a bag that collects their urine.

Ketamine with other drugs:

• Depressants -- this includes ‘downers’ like alcohol, GHB/GBL , Valium, barbiturates. As K and other depressants slow the body and its functions down, the combined effect can knock you out and/or slow your breathing to a dangerous level.
• HIV medication – some of these, especially protease inhibitors, can cause higher levels of ketamine in your body. There is a theoretical risk that NNRTIs could also increase the amount of ketamine in the body.
• Tobacco/cannabis  – smoking cigarettes or joints when using K carries a risk of fires as K can make you unable to move. There is also a risk of burns as K’s anaesthetic effect can stop you feeling pain.

Useful to know

K is usually snorted in its powder form although some people add it to drinks. However, you should never mix K with alcohol. Sometimes people smoke K mixed with cannabis in a joint, however smoking it is unpleasant and can damage the lungs. Ketamine powder might also be mixed with water and injected into a muscle, but never inject into a vein. However, injecting is always best avoided because of the health risks it poses. K can also come in pill form.

If you share your injecting equipment there’s a real risk of getting or passing on infections such as HIV or hepatitis C. Injecting can also cause skin abscesses, blood poisoning, life-threatening blood clots or heart infections.

Someone in a K hole should be taken away from music and bright lights and reassured that it’ll be over soon and they will be OK.

K should be avoided by people who have fits, high blood pressure or heart or liver problems.

Speed

A long term relationship?

You can become dependent on the drug, with larger doses needed to get the same effect and withdrawal symptoms if you stop. These can include exhaustion, insomnia, depression and feeling irritable. Long-term use of speed can damage the heart, liver, kidneys and lungs, causing aggression and ‘speed psychosis’ which can include violent behaviour, paranoia and hallucinations.

Speed with other drugs:

• HIV medication – protease inhibitors, particularly Ritonavir, can cause a big increase in the amount of speed in the body, leading to overdose.
• Cocaine, crystal meth, Ecstasy, poppers – mixing these drugs with speed risks a dangerous strain on the heart.
• Anti-depressants – taking speed when on these drugs can cause a life-threatening rise in blood pressure.
• Alcohol – speed masks the effects of booze, leading people to drink more without realising how drunk/over the limit they are.
• Viagra-type drugs  - speed causes loss of erections, but taking Viagra etc. puts even more stress on the heart.

Useful to know

Swallowing the drug wrapped in a cigarette paper (a speed bomb) or mixing it with water is less harmful than snorting which can damage the nose. When snorting there’s less damage to the nose if the powder’s fine, if you alternate nostrils and rinse them out after. Injecting is best avoided as this is more likely to lead to addiction. Also, speed deaths are linked to taking the drug this way, and it can cause skin abscesses, damaged veins, blood poisoning and heart infections. Sharing injecting equipment can pass on HIV and hepatitis B and C. Speed should be avoided by people with high blood pressure or heart conditions.

Mephedrone

A long term relationship?

The effects of mephedrone wear off after about an hour and it’s easy to get dependent on it and get into a situation where you take more and more to keep the buzz going. 

Mephedrone with other drugs:

As mephedrone is pretty new on the scene there’s no research to say what effects it can have.

Useful to know

Less is known about mephedrone than most other drugs as it is relatively new. It is clear that it stimulates the heart, causing a rapid heartbeat. Some people have also experienced their fingers being cold or turning blue.

People have also reported it causing similar side effects as amphetamines, such as teeth grinding, anxiety, paranoia, short-term memory loss and changes in body temperature.

There hasn’t been much research into mephedrone so it is hard to know the effect it has on other drugs such as HIV meds. It is best to be cautious and if you are using it talk to your doctor about how it might affect your other pills.

Acid (LSD)

A long term relationship?

Using acid for a long time can cause paranoia and schizophrenia-like mental illness.

Weeks, months or years after taking LSD you might get panic attacks or flashbacks, which is where parts of the trip are relived.

Acid with other drugs:

• Anti-depressants can lower or boost the effects of LSD. Some anti-depressants and the mood stabiliser lithium can make the effect of the drug a lot stronger and cause dangerous reactions. Check with a doctor before taking acid if you’re on these other drugs. Acid can be very strong and unpredictable, so mixing it with other chems isn’t a good idea at all.
• There are no known dangerous interactions between LSD and anti-HIV medication.

Useful to know

If someone’s having a bad trip, take them somewhere quiet and reassure them the drug will wear off in a few hours. But if they are out of control, get medical help as they may need sedating. Acid can.

With special thanks to the: