This information will help guide you through some of the  potential risks of a night or weekend clubbing and provide tips on reducing the risks and staying as safe as possible.

The UK has a vibrant nightlife scene attracting a diverse range of clubbers using an ever-changing range of drugs, legal and illegal.

Taking drugs is risky and taking them in a nighttime environment brings its own set of risks. It's essential to know as much as possible about what drugs you're taking. This guide will help you understand those risks and help you stay safer.

Before we get into the drug information, let's take a look at a couple of important harm reduction strategies, pill testing and how you consume your drugs.

Pill testing kits

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Pill testing kits can provide some information about the chemicals that might be present, but they don’t indicate the strength of a pill or what else it may contain. A positive result doesn’t guarantee safety – a pill can still contain other harmful substances. Testing is better than nothing, but it should always be combined with caution and other harm reduction steps.

Snort it or eat it?

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The way you take drugs affects how soon the effects start and how long they last.

Snorting drugs will cause the effects to start within a very short time and with a higher intensity, but they will wear off relatively quickly. Eating your drugs, pills, or powder means the effects will come on much slower and steadier, but last for a longer period with much less of a crash at the end.

Passing around notes or straws for snorting drugs can pass around germs like hepatitis and other blood-borne viruses. Keep your nostrils healthy by flushing out your nose with clean water at the end of each session.

Find out more about reducing harm in our snorting and swallowing guide.

Club drugs

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Now let’s get into the drugs themselves. In the uppers section, you’ll find drugs such as cocaine, speed, ecstasy and MDMA. The spacing-out section covers substances like cannabis, mushrooms and ketamine. The downers section features alcohol, benzos and GHB. Finally, the new psychoactive substances section looks at drugs such as mephedrone and nitrous oxide.

UPPERS

Stimulants that speed up the body and mind, giving energy and confidence but carrying risks like anxiety, insomnia, and dependence.

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SPACED

Psychedelics that alter perception, mood, and senses, sometimes leading to insight or euphoria but also anxiety, paranoia, or accidents.

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DOWNERS

Depressants that slow the body and mind, creating relaxation and calm but increasing risks of dependence, accidents, and overdose.

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Find out more about reducing harm in our GHB/GBL harm reduction section.

NEW PSYCHOACTIVE SUBSTANCES

Lab-made drugs designed to mimic other substances, often unpredictable in strength and effect, with limited knowledge of long-term risks.

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Each part of a night out has it's own set of unique risk so we split this part of the guide into sections to make it easier to follow.

Before the Club looks at pre-drinks, the law and getting through the door safely. In the Club covers looking out for your mates, what happens if you’re caught with drugs, and health risks like heatstroke, water intoxication and mixing. After the Club gives advice on getting home, sex and ED drugs, handling the come-down and looking after yourself. Finally, the Overdose section explains the signs and what to do in an emergency.

BEFORE THE CLUB

Pre-club drinks

Mixing alcohol with drugs is dangerous. If you must drink, try and stick to drinks with a low percentage of alcohol. Avoid the high-strength lagers, shots and spirits. Alternate your drinks with soft drinks, fruit juice or lemonade.

Drugs and the law

Under a new law, all psychoactive substances (i.e. drugs) are illegal - apart from alcohol, tobacco, and caffeine. So if it doesn’t look like booze, fags, or coffee, the police can pull you. So is picking up drugs for yourself and your mates to share. If you are stopped by the police and tell them the drugs are for you and your mates, that would be considered possession with intent to supply, a very serious offence.

If you are in a car in which the police find drugs and no one claims ownership, everyone in the car could be charged with possession or supply.

On the door

Many clubs insist on a search. You can refuse, but the club also has the right to refuse you entry.

Only the outside of clothes, pockets and bags can be searched. The search must be conducted by a member of staff of the same sex. They cannot search inside clothes without your permission and can never conduct intimate searches, such as inside underwear or strip-searches.

Necking all your drugs at once to get around the search is dangerous, you could also still be standing in the queue when your drugs start to come up. Make sure you bring some warm clothes for waiting in the queue and for going home.

Don’t buy drugs in the club. You can’t be sure what you are buying in a dark club if you are off your face.

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IN THE CLUB

Look after each other

Know what drugs your mates have taken so you can tell the medical staff if they are taken ill. If anyone starts to have a bad trip, take them somewhere quiet and reassure them it’s just the effects of the drugs and the feelings will wear off.

Don’t let a friend leave with strangers. Try to find out who they are and where they are going first.

Getting caught with drugs in the club

Any club that allows its premises to be used for the consumption of drugs can be closed down. So it’s unsurprising they keep a close eye on what’s happening inside. Openly snorting powders and necking tablets aren’t good looks.

If you are lucky, you will only have your drugs confiscated and have a very long wait outside the club for your mates to come out, rather than being reported to the police and ending up with a criminal record.

Uppers and heatstroke (Hyperthermia)

Uppers can raise your body temperature and decrease the release of heat by constricting blood vessels near the skin, combined with physical exertion it can cause your body to overheat. If it reaches extreme levels it can permanently damage your organs or prove fatal.

Signs of heatstroke are:

• Headaches
• Dizziness
• Hot dry skin
• Nausea (this can also be caused by your drugs starting to kick in)

If you start to feel ill stop what you are doing, get some fluids and take some time out. Go to the chillout area and try and get some fresh air. If the symptoms don’t improve, get medical help straight away.

Water intoxication (hyponatraemia)

While it is important not to become dehydrated when out clubbing, taking on too much fluid can also cause its own problems. It can upset the balance of sodium in your body and cause your brain to swell, which is extremely dangerous.

You should try to sip about a pint of fluid an hour. Try to include some fruit juice or Isotonic sports drinks.

Mixing drugs

Mixing drugs is dangerous as the effects of the two drugs together are unpredictable. Your body can only process so much at once. Putting extra pressure on it by asking it to do too much can lead to a dangerous build-up of drug levels in your body which could have serious consequences. If you drink alcohol and take cocaine, your body produces a third substance called Cocaethylene. This is highly toxic and can cause heart problems.

Mixing alcohol or prescription drugs with illegal drugs is asking for trouble.

Those on HIV or hepatitis meds should seek specialist advice before using GHB/GBL or Ketamine. They can cause serious interactions with prescribed medication.

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AFTER THE CLUB

Driving home

It’s simple – DON’T DRIVE IF YOU HAVE BEEN TAKING DRUGS! They affect your vision, coordination, concentration, perception and spatial awareness, and reaction times. You will be affected for a long time after you have taken drugs.

It’s illegal to drive if either:

• you’re unfit to do so because you’re on legal or illegal drugs
• you have certain levels of illegal drugs in your blood (even if they haven’t affected your driving)

The police can stop you and use a roadside drug kit if they think you’ve been using drugs. If convicted, the penalties are:

• a minimum 1-year driving ban
• an unlimited fine
• up to 6 months in prison
• a criminal record

Your driving licence will also show you’ve been convicted of drug driving. This will last for 11 years

Sex and ED (erectile dysfunction) drugs

Some drugs give you a loved-up feeling and increase sexual desire, but they can also make it difficult to get an erection. Some of you may consider using ED drugs to try and overcome this. But combining uppers (ecstasy, speed or cocaine) with ED drugs can have an increased effect on body temperature, blood pressure and heart rate. Using Poppers with ED drugs can also compromise your immune system, increasing the risk of sexually transmitted infections. Poppers are dangerous for anyone with chest or heart problems, anaemia or glaucoma.

ED drug’s ability to prolong sex increases the risk of breaks in the skin, increasing the risk of passing on sexually transmitted infections. Always carry condoms and use them.

Handling the come-down

The best way to ensure a bad come-down is to take more drugs or drink alcohol. You won’t get any higher, but you will regret it later on. Taking downers to ease the landing will only put off the inevitable for a few hours.

When you get back from the club, try to resist the temptation to keep the party going by taking more drugs. Treat it as a different part of the experience. This is the best time of the night. Relax. Change into fresh, loose-fitting clothes. Turn the lights down low. Put on some chilled tunes. Get a cup of tea - the best come-down drug there is! Crash on the sofa and chat with your friends. Chill out.

Look after yourself

If you enjoy clubbing and want to continue doing it, be good to yourself. Don’t drink or do drugs throughout the week. Get plenty of rest and sleep. Eat well. A healthy, balanced diet throughout the week is like putting money in the bank to spend at the weekend. Stay fit. Working out, walking, swimming, or any sport will strengthen your heart and lungs and improve your mental wellbeing.

Keep clubbing as a special weekend treat; don’t let it take over your life. The more varied social life you have outside the club nights will make those sessions all the more enjoyable. Clubbing can be fun, but it’s not the top and bottom of everything. Enjoy life. The more you have going on in your life, the more special your night’s clubbing will become.

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OVERDOSE

Using any drug carries risk. These risks increase if you are mixing drugs or combining them with alcohol, and can result in an overdose. This can still happen even sometime after you have taken the drugs.

The symptoms for people who are overdosing on uppers or downers are different but some people can display symptoms of both.

Overdose symptoms can include

• Uppers - Chest pain or tightness, shortness of breath, hot to the touch and red in the face, sudden collapse.
• Downers - Looks pale, blue lips, shortness of breath, sudden collapse, not waking in response to stimuli, snoring deeply (this is a sign of difficulty breathing, not deep sleep).

If this happens in a club, take them to a cool quiet place and get help straight away, most clubs will have a designated first aider who will help them until an ambulance arrives.

If it happens away from the club, put them in the recovery position and call an ambulance, you do not have to give your name, and the police have a policy of not attending overdose calls, unless there is any danger to the medical staff, a death, or child safety issues.

Always tell the medical staff who attend what drugs they have taken, and if possible give samples to the medical staff this could save someone's life.

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You can buy printed versions of this information in the Substance shop

Go to shop

These organisations and websites can provide further drug information and advice.

Talk to Frank

National drugs awareness site for young people and parents/carers.
www.talktofrank.com

Helpline 0800 77 66 00

talktofrank.com

RELEASE

Release is the national centre of expertise on drugs and drugs law - providing free and confidential specialist advice to the public and professionals.

www.release.org.uk

WEDINOS

WEDINOS is a harm reduction project, providing an anonymous drug-checking service,

wedinos.org

The Loop

The Loop develops and delivers innovative health interventions through its drug checking services and related harm reduction advice and support.

wearetheloop.org

What is Cocaethylene?

Cocaine and alcohol are increasingly being used together as a 'straightener' to keep the night going, allowing people to drink more alcohol and lessen the 'comedown' from cocaine. When you use these substances together, your liver automatically creates a third drug called cocaethylene. This new compound affects your body differently than cocaine or alcohol alone, creating both stronger effects and greater risks. The information in this guide will help you understand and minimise these risks.

Cocaethylene Effects

Cocaethylene increases both the duration and intensity of cocaine's effects. It stays active in your body 3–5 times longer than cocaine alone, creating a more powerful high. But the downside (yes, there always is one!) is that cocaethylene is also more toxic than cocaine by itself, causing both short-term and long-term physical and mental health problems.

Cocaethylene Risks

Health

Cocaethylene causes more severe increases in heart rate and blood pressure than cocaine alone. Even for perfectly healthy people, this increases the chance of seizures, heart attacks and strokes. For anyone with an underlying heart condition, this is extremely risky. Cocaethylene is more toxic than cocaine and stays in your system much longer, putting greater strain on your liver and other organs. Over time, this can cause serious damage.

Violence

Alcohol reduces your inhibitions, cocaine increases confidence, and cocaethylene amplifies both effects. This combination significantly increases the risk of impulsive or reckless behaviour, including violence.

Sex

The combined effect of cocaine and alcohol can significantly impact sexual performance. It increases sexual desire but makes it harder to achieve an erection and lubrication, and more difficult to reach orgasm. Prolonged attempts to climax can cause physical damage and increase the risk of sexually transmitted infections (STIs).

Important: Using sexual stimulants like Viagra with cocaine and alcohol puts massive strain on your heart and is not recommended.

Warning Signs

Cocaethylene itself doesn't increase addiction risk beyond what cocaine and alcohol carry individually. However, you can become accustomed to using both substances together, so that using one triggers cravings for the other. This can lead to dependency on both substances.

Some warning signs include:

• Using larger amounts of alcohol and cocaine to get the same effect, or to cancel out the negative effects of either substance
• Spending time thinking about when you are going to use next
• Having problems at home, work or university because of your behaviour or neglecting responsibilities
• Getting involved in violence or injuring yourself or others after a session

Taking Control

If you want to cut down or stop using alcohol and cocaine, the following advice may help:

• Use smaller amounts at each session and give yourself more time to recover between sessions
• Think about the negatives – financial problems, feeling rough all the time, relationship issues. Remind yourself of these when you feel the urge to use
• Avoid triggers like places or people you use with
• Take a break from certain friends, avoid specific pubs and clubs, and find alternative activities
• Tell someone what you're doing or ask a friend to support you. Having someone to talk to during difficult moments can make all the difference
• Don't give up. Breaking the habit is possible. If you don't succeed the first time, don't be hard on yourself – you've taken the first step. Try again!

Order the cocaethylene resource

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On this page

• What are street benzos?
• What are MSJs?
• Types of benzodiazepines
• Effects of diazepam
• Side effects
• Mixing benzodiazepines with other drugs
• Overdose and withdrawal
• How are illicit benzodiazepines supplied?
• Reducing risk: harm reduction advice
• The law (UK)
• Share this information
• Help and support

What are street benzos?

Street benzos—also called MSJs, blues, vallies, scoobies, and street Valium—refer to benzodiazepines bought online or obtained without a prescription. They can be real, fake, or novel drugs that imitate legitimate medicines.

They’re usually cheap, easy to get, and may be sold in blister packs or pill containers designed to look safe and official. Common markings include ‘DAN 5620’, ‘10’, ‘T-20’, ‘TEM 20’, ‘Bensedin’, and ‘MSJ’.

Street benzos are unpredictable in both content and strength. Some contain novel psychoactive substances (NPS) like etizolam, flualprazolam, or phenazepam, which are not licensed in the UK and can be much stronger than diazepam.

In 2024, the UK classified 15 more novel benzodiazepines as Class C drugs. Some of these, like bromazolam, have been found in tablets marked ‘MSJ’ or sold as diazepam. These substances may be stronger than expected and increase the risk of overdose—especially when mixed with alcohol, opioids or GHB. Read more on GOV.UK.

What are MSJs?

MSJs are blue diazepam tablets stamped with 'MSJ' on one side and a break line on the other. They're produced by MSJ Industries, a subsidiary of Sri Lankan manufacturer J.L. Morison Son & Jones (Ceylon) PLC. Though legitimate, they're being diverted into the illicit market.

• Small, blue, professionally pressed pills (approx. 6mm x 1.5mm)
• Often referred to as MSJs, vallies, blues
• Available online through unauthorised sources
• Illicitly sourced from manufacturers in Sri Lanka, India, China, Thailand, and elsewhere

Due to illicit production and lack of quality control, MSJ tablets sold on the street can contain anywhere from 8mg to 30mg of diazepam despite being marketed as 10mg, making dosing unpredictable and dangerous.

Types of benzodiazepines

Different benzodiazepines vary in strength, duration and effect. Common types include:

• Diazepam (Valium)
• Temazepam (Restoril)
• Alprazolam (Xanax)
• Lorazepam (Ativan)
• Chlordiazepoxide (Librium)
• Flubromazolam
• Flurazepam (Dalmane)
• Phenazepam

Not all benzos are equal—10mg of one type may not be equivalent to 10mg of another.

Effects of diazepam

Diazepam is a long-acting benzodiazepine used for anxiety, muscle spasms, and insomnia. Its effects can include:

• Drowsiness and sedation
• Muscle relaxation
• Confusion and memory loss
• Dizziness and impaired coordination

Effects may last into the next day, especially when combined with alcohol. Long-term use increases the risk of dependence and withdrawal.

Side effects

Common side effects:

• Drowsiness, confusion, dizziness
• Light-headedness, blurred vision
• Muscle weakness, slurred speech

Less common side effects:

• Skin rashes, tremors, headaches
• Sexual dysfunction
• Low blood pressure, digestive problems
• Difficulty urinating or incontinence

Rarely, paradoxical effects like aggression or disinhibition may occur—especially when mixed with alcohol or other drugs.

Mixing benzodiazepines with other drugs

Combining benzos with other depressant drugs increases overdose risk:

• Alcohol: Increases sedation and impairs judgement. Risk of blackout and poor decision-making.
• Opioids (heroin, methadone): Strongly suppresses breathing—leading cause of overdose deaths.
• GHB/GBL: Even hours apart, the combined sedative effects can be fatal.
• Gabapentinoids (pregabalin, gabapentin): Reduce opiate tolerance, increasing overdose potential.

Overdose and withdrawal

Overdose signs

• Unconsciousness
• Slow or irregular breathing
• Pale lips or skin, vomiting
• Cold, clammy skin

If someone has also taken opioids, use naloxone if available—but call 999 in all cases.

Withdrawal symptoms

Stopping suddenly can cause:

• Severe anxiety and panic
• Shaking, sweating, confusion
• Seizures and hallucinations

Withdrawal should be medically supervised. Symptoms can start within hours and last several days.

How are illicit benzodiazepines supplied?

Most legal benzos are prescribed and dispensed by pharmacists. Street benzos may be:

• Diverted from legal prescriptions
• Bought online, including the dark web
• Distributed via social media apps (Snapchat, WhatsApp, Telegram, etc.)

Some are made to look legitimate, but contain unknown or highly potent substances. Public Health England has warned about pills with markings like ‘DAN 5620’, ‘10’, ‘T-20’, ‘MSJ’, and ‘TEM 20’ due to hospitalisations and deaths.

Reducing risk: harm reduction advice

• Start low, go slow – dosage varies.
• Don’t mix with alcohol or other sedatives.
• Don’t use alone – have someone nearby.
• Avoid daily use to reduce dependence.
• Don’t inject. If you do, don’t share or reuse.
• Never stop abruptly—seek medical advice to taper safely.
• Don’t drive or operate machinery while affected.

The law (UK)

In the UK, benzodiazepines without a prescription are Class C drugs.

• Possession: Up to 2 years in prison, a fine, or both
• Supply: Up to 14 years in prison, a fine, or both

If prescribed, you can legally possess and use them—but selling or sharing your supply is still illegal.

Share this information

Raising awareness and sharing accurate information is one of the best ways to reduce harm. Services can order our benzodiazepine information and awareness booklet here, or use this guide to support people who use benzos—or anyone who needs to understand the risks and effects more clearly.

Help and support

For more information, advice, or support with benzodiazepine use, visit:

• Talk to Frank – 24/7 national drug information
• Release – Legal advice for people who use drugs
• GOV.UK: take‑home naloxone – Guidance on naloxone supply and overdose prevention
• WEDINOS – UK-wide drug‑checking data, including benzodiazepine substitutions
• Mind – Mental health support during withdrawal or medication use

Buy printed copies of our Benzos resource

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Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

DRD Co-ordinator (Aberdeenshire)

Life+