If you're aged 18-25 and would like to share your experiences of taking benzos – both good and bad–, submit your anonymous testimony to [HERE](https://www.drugsand.me/benzo-research-project/submission/)

If you’re from the UK or US, you’ve most likely heard of benzodiazepines, or ‘benzos’ for short. They’re commonly used as a form of tranquilliser in medical fields for treating anxiety and sleep disorders. When prescribed by medical professionals and taken correctly, benzos such as diazepam can be lifesavers for individuals experiencing anxiety attacks or dealing with heightened levels of general stress. 
There is, however, a dark side to these drugs - as tends to be the case with many substances targeted by the war on drugs. ‘Street benzos’ which are usually derived from non-medical sources have risen in popularity in recent years. The unregulated nature of these drugs – combined with government policy that often seeks to punish users instead of helping those suffering from addiction – has created a situation whereby recreational users of the drug can face serious health risks.

You might remember the panic in America a few years ago regarding fentanyl-laced Xanax[^1], which led to many cases of overdose and fatalities. This major problem was exacerbated by the ease by which this type of drug could be accessed illicitly, as well as having a population that was increasingly being prescribed the drug[^2] for various medical conditions. What you may not be aware of, however, is that the UK suffers from the same combination of factors when it comes to illegal benzo use. 
Increased use in recent years has warranted health warnings regarding the drug all across the UK. Far from being an issue restricted to certain counties, benzo addiction and the subsequent risks to health it incurs has become a nationwide problem. Worryingly little is being done to combat this, with the general assumption seeming to be that issues relating to benzo addiction are only prevalent in cities with a lively drug culture.[^3] Benzo misuse and addiction does not only take place in these underground scenes where recreational drug use is part of the norm, but also in homes and hospitals across the nation.[^4] Owing to this, benzo consumption has rapidly become a prolific problem within the UK.

Benzos aren’t used solely by people with diagnosed anxiety. As a result of long waiting lists to receive support[^5] in regions across the UK, individuals with mental health issues often self-medicate with benzos. Heightened demand for these services has come as another side effect of the pandemic. Intermittent lockdowns over the course of two years have increased feelings of loneliness and depression[^6] amongst young people, exacerbating mental health issues. Each of these factors have led to a spike in unregulated use across the UK.[^7]

On top of this, illicit benzos in this country are incredibly cheap, with diazepam being sold for as little as a pound per pill via the dark web, WhatsApp group chats, and dealers.[^8] They are also easy to access, making them popular amongst students on nights out. This leads to concerns regarding poly-drug use, which poses a serious health risk to those under the influence. 
Combining alcohol and benzos could be fatal: risk of asphyxiation, dehydration, comas, and heart attacks are potential side effects. When you consider that many of the worst affected areas of the country for benzo misuse (e.g. Brighton) are student cities, the levels of potential harm towards students on a night out are high if they take the drug.

Despite all these worrying factors, there is still a lack of UK-focused research in academic spheres, and a disconnect between policy-makers and those who take drugs. There also isn’t sufficient knowledge about the long-term effects of benzo use. As recreational benzo use is illicit, it is therefore difficult to have accurate ONS statistics capturing the scale of consumption. The relevant quotes found in NGO or local council reports rarely include individuals who take drugs, only from those in a position of authority. All of these factors lead to a pervasive literature gap. That’s why I joined the [Benzo Research Project](https://benzoresearchteam.weebly.com/), a grassroots platform to listen to previously silent voices. 

This project is a student-led initiative to investigate the lived experiences of recreational benzo consumption amongst young people (18-25) across the UK. We aim to collect anonymous testimonies over the course of a few months, providing us with an insight into the lived effects of benzo usage. 
Our prompt questions to those submitting testimonies relate to their experiences taking benzos, interactions with local NGO outreach and services, the role of secondary and further educational institutions, and music subcultures such as UK garage or drum and bass. These are all factors that could provide unique insights into the UK’s growing benzo culture. This data will be analysed by our research team and published as a report, including policy suggestions to local NGOs, council authorities, and the government.
Beyond collecting testimonies, we also have a dedicated social media team who aim to connect with young people and disseminate harm reduction information. We will hopefully be conducting drug education workshops for young people in the city during summer, as well as continuing to develop partnerships with stakeholders. On this front, we are currently working on producing harm reduction leaflets for university students with the social enterprise [Drugs and Me](https://www.drugsand.me/). We hope that this information can contribute to keeping drug users safe and to avoid drug-related injuries. You can find our social media handles below. 

There is a serious problem regarding benzos in the UK, which can impact the quality of life young people have when exposed to the long-term effects of the drug. Despite this, we have yet to see major policy reforms, or any serious actions taken to remedy the situation. In fact, the government seems more determined than ever to treat drug users as criminals[^9] rather than providing them with the necessary psychological, social, and economic support. Young people have simply not got a voice in this matter – our project looks to rectify this, by giving young people a platform to voice their feelings about benzos and their experiences with it. 
Striving for change is an uphill struggle and one that won’t be over quickly, which is why projects like ours are so important. What this project hopes to achieve – at the very minimum – is to provide a platform for people to share their experiences, and to create a report on the findings to be used by stakeholders to gauge and remedy this. With the help of like-minded organisations, everyone on the project, and research advisors in the medical field, I am confident that we can achieve this goal. 

Instagram: [@benzoresearchproject](https://www.instagram.com/benzoresearchproject/)
TikTok: [@benzoresearchproject](https://www.tiktok.com/@benzoresearchproject)
LinkedIn: [Benzo Research Project](https://www.linkedin.com/company/benzo-research-project)

Whilst the Benzo Research Project does not condone the use of illegal drugs or the misuse of prescription drugs, we recognise that some people may use drugs during their lifetimes. We hope that the information provided [here](https://www.drugsand.me/drugs/benzodiazepines) will help readers to be better informed about their/ their friends drug use, the risks posed, how these can be mitigated, and where to seek help for harmful drug use.

To read testimonies submitted so far, see [here](https://www.drugsand.me/benzo-research-project/testimonies/)

### References
[^1]: Zalkind, Susan (2020). ['Death pill': fentanyl disguised as other drugs linked to spike in US overdoses](https://www.theguardian.com/society/2016/may/10/fentanyl-drug-overdoses-xanax-painkillers). The Guardian. Accessed: 5 Mar 2022.
[^2]: Vestal, Christine (2018). [These Pills Could Be Next U.S. Drug Epidemic, Public Health Officials Say](https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2018/07/18/these-pills-could-be-next-us-drug-epidemic-public-health-officials-say). Pew. Accessed: 5 Mar 2022.
[^3]: Stringer, Connor (2021). [Brighton ranked among top drug hotspots in the UK](https://www.theargus.co.uk/news/19554820.brighton-ranked-among-top-drug-hotspots-uk/). The Argus. Accessed: 5 Mar 2022.
[^4]: Nimmo, Ray (2012). [THE BENZODIAZEPINE SCANDAL](https://www.benzo.org.uk/ray5.htm). Benzo.org.uk. Accessed: 5 Mar 2022.
[^5]: Wright, Charlotte (2021). [Young people's mental health services 'in crisis', MPs warn](https://www.bbc.com/news/uk-england-sussex-58434191). BBC. Accessed: 5 Mar 2022.
[^6]: Walsh, Colleen (2021). [Young adults hardest hit by loneliness during pandemic](https://news.harvard.edu/gazette/story/2021/02/young-adults-teens-loneliness-mental-health-coronavirus-covid-pandemic/). The Harvard Gazette. Accessed: 5 Mar 2022.
[^7]: Robinson, Adele (2021). [COVID-19: Pandemic is pushing more people to buy illegal sleeping pills and anxiety drugs online, evidence suggests](https://news.sky.com/story/covid-19-pandemic-is-pushing-more-people-to-buy-illegal-sleeping-pills-and-anxiety-drugs-online-evidence-suggests-12232644). Sky news. Accessed: 5 Mar 2022.
[^8]: Kroeker, Heather (2020). [Rise in fake benzodiazepines in the UK may put people at risk of serious harm](https://theconversation.com/rise-in-fake-benzodiazepines-in-the-uk-may-put-people-at-risk-of-serious-harm-143874). The Conversation. Accessed: 5 Mar 2022.
[^9]: Cooper, Benjamin (2021). [Passports to be taken off illegal drug users in Boris Johnson’s new crackdown](https://www.independent.co.uk/news/uk/boris-johnson-passports-prime-minister-government-blackpool-b1970019.html). Independent. Accessed: 5 Mar 2022.

The Benzo Research Project: a UK Platform for Young People

We want to bring you a very special series of stories. 

We know our followers probably use our content often but struggle to put a name and face behind Drugs and Me.

For this reason, we have done a series of interviews with our team so you can get to know more about who we are and what we do.

Here, we've interviewed Ivan, who founded Drugs and Me and likes to contribute to all work streams here.

### Q: Where are you from?
A: I was born in the Canary Islands (Spain) where I spent my childhood. I lived in Madrid throughout my teenage years. Then, I moved to London when I was 19 and I’ve lived there since then. I’m moving to Berlin for a few months in 2022 though.

### Q: Could you tell us a bit about your work and study background?
A: I graduated from MSci Neuroscience at University College London (UCL). I’m currently doing a PhD at the Institute of Cognitive Neuroscience in the same university. I combine human, animal and computational work to understand how we perceive temperature. I also do and publish research about psychoactive substances and science of learning (pedagogy).

### Q: How did you get involved with Drugs & Me?
A: I co-founded Drugs and Me during the summer from my first to second year as an undergraduate student. My co-founders (Pablo & Gabriel) had already been playing with the idea, but they had put the project on hold. When I met Pablo at a networking event hosted by the UCL entrepreneurship society, I loved the vision, so we started working on it. Together, we had the energy and skills to give birth to Drugs and Me.

### Q: Why Drugs & Me?
A: Even though I started Drugs and Me and its related projects, it is like they have chosen me, so you should ask Drugs and Me, why me? I often feel that ideas have me, instead of the other way around, and once this happens, I can’t help but clumsily give it a go.

### Q: Tell us a little about a typical month /day in the life of a director at Drugs & Me.
A: It keeps changing and the focus depends on the stage at which the projects we are working on are. I always try to acquire at least the basic skills for the tasks needed to keep the projects going and growing: coding, copywriting, designing, networking, etc. Everyday I’m available on Slack to support the team.

### Q: Tell us a little about your interests - what do you like to do in your free time? How do you switch off from work?
A: I don’t like concepts like free time, work-life balance, etc. I usually work on Drugs and Me or other projects during my “free time”. I’m lucky and privileged to work on intellectually stimulating things that I love (research & entrepreneurship), so I don’t feel the need to “switch off”. A more normative answer would be: I like reading Spanish literature, running and calisthenics.

### Q: What would you say is the highlight of your work at Drugs & Me?
A: The people I’ve met and the friends I’ve made as well as everything I’ve learnt and keep learning on the way.

### Q: What do you think is the best drug to take?
A: It depends on many factors but recently my favourite combination has been love & cannabis..

### Q: What do you think is the best activity to do while on drugs?
A: It depends on the type of drug, but having sex or eating can reach new levels of pleasure when combined with many types of substances.



Interview with Ivan, director

We have all heard the trope of the 'lazy stoner'[^1]. It has permeated modern, Western society to the extent where 'stoners' have come to embrace—or perhaps simply accept—it themselves. But, is this view backed up by science? That was the question Martine Skumlien[^2] set out to address in her talk last December, the first one in a series dedicated to bringing you drug science by young researchers. This article summarises her presentation and goes over some of the salient points that it entailed.

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As a doctoral student at the University of Cambridge, Martine investigates the effects of cannabis use on the brain and cognition, with an especial focus on adolescents. Cannabis is the third most widely used recreational drug in the world, a fact Martine contrasted with the relatively scarce research on some of its effects, such as on reward processing. With the recent push to legalise or decriminalise cannabis in many parts of the world, the time is ripe for a better understanding into how it affects the brain. There are many misconceptions surrounding its use and the stigmatising ones can often have far-reaching, harmful consequences. Martine’s research is pertinent for clearing this smoke.

To get a lay of the land, Martine, first, had to see what science had to say about the link between cannabis use and a lack of motivation. The latter can encompass several different things: do cannabis users find things uninteresting, does cannabis make things unpleasurable, is the motivation to learn weakened, or are users driven by different—perhaps greater—rewards? She and her colleagues went through available literature [^3], finding a nebulous picture with results differing based on the methodology used or the sub-process probed: results were somewhat supportive of a link in domains such as anhedonia while performance on behavioural motivation tasks did not seem to be affected by cannabis use. Where there is evidence of altered reward cognition related to cannabis use, its precise nature and the directionality of the link remain hazy. Furthermore, most research has thus far been conducted to investigate the *negative* effects of cannabis use. As Martine stated, if one sets out to look for a specific thing what else will they find if not that?

To address these issues, Martine's research focuses on determining whether cannabis-use leads to altered reward processing, and if so what processes underlie this change. It also aims to find out whether adolescents are more vulnerable to such alterations; not only are they likely more vulnerable to drug use in general, but they are quite underrepresented in the existing research.

Martine’s PhD is still ongoing, but she has already tested the experimental waters on the subject using the pandemic as a backdrop. Her study investigating change in the effects of cannabis use before and after the first lockdown in the UK found an increase in apathy and anhedonia in all participants regardless of the user’s status during the lockdown[^4]. An important takeaway was the increase being significantly greater in teens and those who were classified as dependents. What this study wasn't able to probe, however, were the processes underlying these alterations.

Through collaboration with the UCL Clinical Psychopharmacology Unit[^5], Martine tests her subjects using tasks that vary the effort required to perform them and the reward gained upon completion. Participants take part in activities such as the Monetary Incentive Delay (MID) task while researchers scan their brains using functional magnetic resonance imaging (fMRI). Experiments are conducted at least 12 hours after instances of cannabis use to minimise any residual effects. There are, of course, caveats to such an approach. When we consume cannabis it isn't in a lab nor under an fMRI, and it is unlikely anyone is instructing us to perform experimental tasks. But, what it may lack in ecological validity, it makes up for with precision. Confounding factors such as nicotine use and depression can obscure the mechanisms underlying any cognitive alterations, and make it harder to establish causal direction for any correlations found; these factors can be measured and controlled for in the lab.

So, while she waits for her research to conclude, what *does* Martine think of the link between cannabis and motivation? While research on reward processing overall is inconclusive, it is becoming clear that using cannabis is unlikely to cause a lack of motivation non-acutely, thus making it difficult to carry on using the trope of the slothful cannabis user. Not only does it rest on a shaky foundation, its stigmatising nature leads to real-world consequences which are rarely positive. Yes, there does seem to be some indication of an altered cognition related to cannabis use, but its precise nature needs to be investigated. Martine is doing just that.

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# References

[^1]: aa4398743873 (2015). [Stoner Sloth Compilation](https://www.youtube.com/watch?v=7rHm8GbTHyE&ab_channel=aa4398743873). YouTube. Accessed: 10 April 2022.
[^2]: Cambridge Neuroscience (2022). [Ms Martine Skumlien](https://www.neuroscience.cam.ac.uk/directory/profile.php?ms2610). University of Cambridge. Accessed: 10 April 2022.
[^3]: Skumlien, M., Langley, C., Lawn, W., Voon, V., Curran, H. V., Roiser, J. P., & Sahakian, B. J. (2021). [The acute and non-acute effects of cannabis on reward processing: A systematic review](https://www.sciencedirect.com/science/article/abs/pii/S0149763421003912). Neuroscience & Biobehavioral Reviews, 130, 512-528.
[^4]: Skumlien, M., Langley, C., Lawn, W., Voon, V., & Sahakian, B. J. (2021). [Apathy and anhedonia in adult and adolescent cannabis users and controls before and during the COVID-19 pandemic lockdown](https://academic.oup.com/ijnp/article/24/11/859/6291328?login=true). International Journal of Neuropsychopharmacology, 24(11), 859-866.
[^5]: Clinical Psychopharmacology Unit (2022). [CannTeen](https://www.ucl.ac.uk/psychopharmacology/trials/cannteen). Univeristy College London. Accessed: 10 April 2022.

Are Stoners Actually Lazy?

The summer of 2021 was a liberation for many of us. Clubs, festivals and parties opened after months in the dark. We could dance and laugh together again. We exchanged cheeky glances with strangers on the dancefloor. We could also take drugs with our friends again. Enjoy the highs together, and make the lows more bearable with the most wholesome company.

Drug use changed during the pandemic[^1]. lLast year, we found that about half of people who were already using cannabis, benzos (Valium, Xanax etc), or opioids were using them more during the beginning of the pandemic. Meanwhile, about a third of people who used cocaine or ketamine reported they took less than usual. The supply chains were also impacted by the pandemic. Any other market also suffered the effects of the pandemic. But, unlike other markets, malfunctioning supply chains in the drug market can have harmful or lethal consequences. If your delivery takes a few more days to arrive and it’s a bit more expensive, it’s painful, but you can get over it. However, if your drugs don’t contain what you think they do, it’s not only painful, it could kill you[^2][^, ][^3].

During the summer of 2021, The Loop,[^4] a drug testing organisation in the UK, found that out of four versions of MDMA pills, only one contained the actual drug, while the three others contained 4-CMC, Eutylone, or Benzocaine. The pills only differed in colour, but the overall design was identical. In some cases, taking imposter pills is benign, you might not enjoy any sort of high. However, in other cases, the consequences can be fatal. Why? Depending on their actual content, these pills can have effects on your brain very different to MDMA’s neuropharmacology. In this article, I will explain the effects of MDMA and compare it to the other drugs, so it will be easier to recognise if you have been given a fake variant. I will also talk about the neuroscience of these substances and help understand how exactly they affect your brain. 


## So, what exactly are the drugs the Loop found in pills instead of MDMA? 

4-CMC and Eutylone are designer drugs, and have effects comparable to MDMA, while the anaesthetic Benzocaine has barely anything in common with it. 


### Benzocaine 

 
Benzocaine is an outlier among the four substances the Loop reported, as it’s the only one that isn’t psychoactive – it doesn’t change your mental state. It’s used in surgical and dental procedures as a local anaesthetic, and some over-the-counter pain relief medicines also contain it. Benzocaine is an ester anaesthetic, as it has the atoms shown in a red circle. Anaesthetics generally fall into either the category of amides or esters.
![Benzocaine.png](https://dnm-storage.s3.amazonaws.com/Benzocaine_8493d37c1d.png)


**Action as an anaesthetic**
Neurons transmit information between the brain and periphery (such as limbs and organs) by passing on a signal coming from either end. For example, when you’re in a surgical procedure, pain receptors close to the skin will get activated and create a pain signal. But in order to feel this sensation, the signal needs to be passed on from one neuron to the other, all the way to the brain. Once it reaches the brain, the signal registers, and you feel the pain.
Neurons speak to each other to exchange messages. The speaking neuron releases small molecules, neurotransmitters, that the listening neuron can recognise with its receptors. The listening neuron might activate and speak to other neurons. 

The difference between an active (speaking) and inactive (resting) neuron is their electrical charge. An active neuron will become positively charged momentarily compared to its resting state. To become positively charged, neurons open their sodium channels. By opening the sodium channels, they allow positive sodium ions to flow into the cell. This positive charge then travels down on the neuron. The neuron is then ready to speak to other neurons.
Benzocaine binds to these sodium channels, and blocks the sodium inflow. By doing this, it  stops neurons from being able to get activated- neurons can’t speak to each other. As the pain signal never reaches the brain, it’s not registered, and you don’t feel pain – this is why Benzocaine works as an anaesthetic. 

 
### 3,4-Methyl​enedioxy​methamphetamine (MDMA)

![mdma.jpeg](https://dnm-storage.s3.amazonaws.com/mdma_7a7df11d09.jpeg)

MDMA is a well-known party drug that was first synthesised in the 1910s and gained popularity with the emerging rave culture in the 1980s. In the 1970s, MDMA was sometimes used during conventional psychotherapy sessions, to help patients heal from Post Traumatic Stress Disorder (PTSD). The substance later was strictly regulated. Recently, MDMA and its potential therapeutic effects have become a popular topic in scientific communities. New studies are indicating that MDMA-assisted psychotherapy could be more helpful for treatment-resistant PTSD than psychotherapy alone[^5]. 
 
**Effects**

MDMA has both stimulant and empathogenic properties. As a stimulant, it increases energy, leads to higher blood pressure and heart rate, and decreases appetite. It can also increase teeth-grinding. At the same time, as an empathogen, it gives a sense of relating to others, a sense of emotional connectedness, openness, and sympathy. 
 
**Neuropharmacological action**

MDMA is known for its ability to increase serotonin, dopamine, and noradrenaline levels in the brain. Serotonin, dopamine and noradrenaline are some of the molecules (neurotransmitters) neurons use to speak to each other. A speaking neuron will release these neurotransmitters, and the listening neuron will understand the message thanks to its receptors. When the message is loud enough, the listening neurons get activated and pass the message to other neurons. 

By changing neurotransmitter levels, MDMA alters brain activity. MDMA acts by inhibiting the reuptake of dopamine and serotonin from the space between two neurons that are communicating. Usually, once these neurotransmitters are released and have interacted with the listening neuron, the speaking neuron takes the neurotransmitters back up for recycling. If the reuptake is inhibited, higher levels of neurotransmitters remain in this space between the neurons which are communicating. This is how MDMA increases serotonin, dopamine and noradrenaline in the brain.[^6]

 
These processes are responsible for the changes in brain activity when people are high on MDMA. MDMA’s effects are mainly due to increases in the levels of serotonin and dopamine in the space between neurons that communicate. Processes that operate through serotonin and dopamine might get enhanced, while other activities get tuned down. For example, MDMA’s interaction with serotonin is responsible for its empathogenic actions, causing feelings of connectedness and empathy. At the same time, its interaction with dopamine is responsible for its stimulant effects such as increased energy and heart rate. 


Clearly, Benzocaine and MDMA have little in common, both in mechanism of action and their effects on people. However, the other two substances the Loop found in imposter pills are more similar to MDMA. 
4-CMC and Eutylone are both designer drugs. They belong to the family of substituted cathinones. This family is known for their stimulant and empathogenic effects, just like MDMA. 
 
### 4-Chloromethcathinone (4-CMC)
![4cmc.png](https://dnm-storage.s3.amazonaws.com/4cmc_e941078723.png)

 
4-CMC is a stimulant designer drug mostly sold online, and often used as a bulking agent. Its effects resemble Khat, a plant that has been used for centuries as a stimulant in the Arabian Peninsula and southern Africa. The main active component in Khat is Cathinone. Many designer drugs derive from Cathinone, including 4-CMC and Methcathinone. The family of drugs ending in -cathinone are all stimulants, and are closely related to methamphetamine. 

**Effects**
The main target of 4-CMC is dopamine. This drug increases central nervous system function, leading to a higher blood pressure and heart rate, and increased alertness. Compared with MDMA, both share some stimulant features, but they are heightened in 4-CMC. Its interaction with the dopaminergic system makes it similar to methamphetamine. As 4-CMC doesn’t interact with the serotonergic system as much as MDMA, it doesn’t cause effects related to “connectedness and love”.
 
**Neuropharmacology**
As a relatively new designer drug, there hasn’t been many studies on 4-CMC. According to a report by the WHO, it stimulates mainly dopamine and serotonin release, but doesn’t interact much with their transporters. This means that, like MDMA, 4-CMC also causes increased levels of dopamine and serotonin in the spaces between the neurons that communicate, but through a different mechanism.[^7] 
 
### Eutylone
![eutylone.png](https://dnm-storage.s3.amazonaws.com/eutylone_fcefa379c8.png)

Like 4-CMC, Eutylone too is a designer drug with stimulant properties. It was designed to mimic the effects of N-Ethylpentylone. In addition to the stimulant effects, Eutylone can also cause feelings of connectedness, similar to MDMA. This is because the subclass of designer drugs ending in -ylone are a hybrid of MDMA and cathinones (like 4-CMC, which I explained above). Their chemical structure is based on MDMA, but its core is modified to get a molecule that also possesses characteristics of cathinones. This can be seen in their physiological effects too, as they are empathogens (mimicking MDMA), but are stronger stimulants than pure MDMA (similar to cathinones).[^8]

**Neuropharmacology**
Like with many new designer drugs, the neuropharmacology of Eutylone hasn’t been scientifically described. There has been research done on N-Ethylpentylone, the “parent drug” of Eutylone. They are very similar in structure.

### N-Ethylpentylone
 
Its pharmacological action is very similar to MDMA, in that it doesn’t cause any direct neurotransmitter release anywhere. Instead, it inhibits the reuptake of dopamine, serotonin and noradrenaline by interacting with the transporter of neurotransmitters].[^9] 
Importantly, it is more potent at the dopamine transporter than MDMA. This can be dangerous and lead to toxicity, and there is a bigger chance of people experiencing stronger, potentially more negative stimulant effects.

## Potential risks and benefits of designer drugs 
Designer drugs like 4-CMC and Eutylone are synthesised to mimic pharmacological effects of a “parent drug”, but with slightly modified chemical formula. This could be with the aim to modify the potency or effects with respect to the parent drug. As a designer drug gets more widespread and authorities begin to take actions, new drugs are rapidly created that are very similar in structure. Therefore, not much is known about the exact pharmacological and physiological effects of each substance, but speculatively, they are very close to well-established drugs in the same drug class.
Many of the risks of designer drugs are a result of people unknowingly taking them. For example, expecting a specific drug experience, waiting for the expected effects but never experiencing them can induce anxiety. Additionally, people might assume they’re not feeling the desired effects because they haven’t taken enough and re-dose, which can lead to an overdose. 
If designer drugs are designed to be more potent than the parent drug, they can cause an overdose. In some cases, the designer drug will have similar characteristics but will be more potent. In others, their potency will be similar to the original drug regarding one neurotransmitter family, but will be more potent on others. For example, Eutylone has similar potency on the serotoninergic system as MDMA, but is more potent on the dopaminergic system. As people are unaware that the substance they are consuming acts differently than expected, even with the most extensive research and preparations, they might unwillingly miscalculate the dosage. Taking a bigger dose than intended can lead to various side effects, from anxiety and paranoia to physiological responses, such as irregular heartbeat or loss of consciousness.
However, most of these scenarios could potentially be avoided if people knew exactly which substances they are taking, and if more scientific research assessed their neuropharmacological properties. The possibility of designing substances that are a chemical hybrid of two parent drug classes might provide drugs more suitable in certain scenarios. 
People sometimes take multiple drugs simultaneously to mix their effects. However, combining substances can be dangerous because these drugs might enhance or cancel out each other, and result in unexpected effects. When someone is planning to take different drugs, it might be less harmful if there was a substance available designed to mimic the effects of the chosen drug cocktail. This would eliminate the risk of certain drug-drug interactions. However, for this to be feasible, extensive research would be needed to develop these substances, determine their optimal use and potential risks. 

![table.png](https://dnm-storage.s3.amazonaws.com/table_dbaa3a9d19.png)

## References

[^1]: Drugs and Me (2020) [Full report: Recreational drug use during COVID-19 outbreak](https://dnm-storage.s3.amazonaws.com/Full_report_COVID_19_recreational_drug_use_Drugs_and_Me_21348272dc.pdf). Accessed: 9 Jan 2021. 
[^2]: Leask, D. (2021). [Blues warning as Glasgow suffers "unprecedented" wave of drugs deaths](https://www.heraldscotland.com/news/17390620.blues-warning-glasgow-suffers-unprecedented-wave-drugs-deaths/). Accessed: 26 December 2021.
 [^3]: Farrell, J. (2021). [Drug dealer's warning over deadly batches of illegal party drugs - 'not everything you get is safe, even if you think it's from a reliable source'](https://news.sky.com/story/drug-dealers-warning-over-deadly-batches-of-illegal-party-drugs-not-everything-you-get-is-safe-even-if-you-think-its-from-a-reliable-source-12374711). Sky News. Accessed: 26 December 2021.
[^4]: The Loop (2021). [CAUTION: Pharaoh pills, 4 pills - 4 different drugs](https://twitter.com/WeAreTheLoopUK/status/1438909110381125632/photo/1). Twitter. Accessed: 26 December 2021.
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