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This section explains how using drugs and alcohol can affect your mental health. It also explains how you can get help to stop using drugs and alcohol. This information is for people affected by mental illness in England who are 18 or over. See this 46 second video for why this is important. People use drugs and drink alcohol for lots of different reasons. Whatever your reason, using drugs or alcohol may have a long-term negative effect on you. The possible long-term effects include the following. If you use alcohol or drugs for a long time it can cause serious issues for your mental well-being. Drugs can make you more unwell and more likely to try and harm yourself or take your own life. There is also some evidence that using some drugs may cause mental illness for the first time. For example, research has shown that cannabis can increase your chances of developing psychosis or a psychotic disorder. Psychosis is a medical term. If you have psychosis you will process the world around you differently to other people. This can include how you experience, believe or view things. You might see or hear things that others do not. Or believe things other people do not. Some people describe it as a 'break from reality'. There are different terms use to describe psychosis. You can find more information about 'Psychosis' by clicking here. In this section we have listed some of the different types of substances that could have an impact on your mental health. Please be aware that this list is not a list of all substances. Taking any substances can be dangerous. They can also have bad interactions with any medications or other substances you might use. They are a specialist charity that provides information on drugs. You can find their website here: www. Cannabis is one of the most commonly used drugs in England. According to one study, 1 in 13 people aged had used it in the last year. Young people aged are more likely to use cannabis. The same study shows that just under 1 in 5 young people had used cannabis between and Some people take cannabis because it makes them feel relaxed or happy, but It can also make you feel anxious or feel paranoid. Some people may experience things that aren't real. This is a sign of drug-induced psychosis. Some studies have shown that the risk of psychosis may be higher if you:. If you have been using cannabis and you feel that it is affecting your health, make an appointment to see your GP as soon as you can. Your doctor should not judge you and should not tell other people you use drugs. Some people with a mental illness have problems using alcohol. Alcohol is legal, which means it is easier to get. It can make the feelings of some mental health issues feel worse. The long-term effects of alcohol also depend on how much you drink, and how regularly you drink it. If you drink too much on a regular basis then you could cause yourself serious physical and mental harm. Drinking can make you do something you would not normally do. This can include self-harm and suicide. Very high levels of alcohol can cause psychosis. These are drugs that contain one or more chemical substance. They produce effects that are similar to cocaine, cannabis and ecstasy. This is a common term that people use. It is used because some NPS were legal before However, the name is now wrong, because since they have been made illegal. Some new psychoactive drugs can cause confusion and a feeling of panic. You can also have hallucinations. Hallucinations can affect the way you behave. Your behaviour can become erratic and can put your own safety at serious risk. Some NPS can be very dangerous. They can kill you or hurt you very badly. There is a higher risk of this if taken with alcohol or other psychoactive drugs. In the short-term, these drugs can make you feel wide awake and alert. This can make it difficult for you to relax or get to sleep. They might cause you to have a drug-induced psychosis. In the long-term, amphetamines might make you anxious and depressed. They can also be addictive. Benzodiazepines are a type of tranquilisers. They are used to treat anxiety. They are also used as a muscle relaxant. Sometimes a doctor will tell you to take benzodiazepines to help you with anxiety. But people also buy them illegally because of their relaxing effects. They can be addictive, and so doctors only give them for a short time. In the short-term, these drugs can make you feel calmer. Depending on the type you take, they could make you feel confused or overly sleepy. Taking benzodiazepines with other drugs or alcohol can be dangerous. It can affect your breathing. It can also increase the risk of overdose and death. In the long-term, some people become addicted. This can have a big effect on their day-to-day life. In the short-term, cocaine can make you feel awake, talkative and confident. After this wears off, you can feel tired and depressed after taking it. In the long-term, cocaine use can affect how you feel. It can affect your relationships with friends and family. Cocaine is also addictive and over time you are more likely to have ongoing problems with depression, paranoia or anxiety. Cocaine can cause fits, heart attacks and strokes. If you mix it with some other drugs you are more likely to overdose or die. In the short-term, ecstasy may make you feel energetic, very happy, chatty and confident. It can also sometimes make you feel anxious, confused or trigger drug-induced psychosis. In the long-term, ecstasy use can lead to memory problems. You may also develop depression and anxiety. In the short-term, heroin can make you feel relaxed and happy. It takes away pain and can make you feel sleepy. But there is a higher risk that you could take too much or overdose with heroin than some other drugs. Heroin can be taken in lots of different ways, including by injection. However, there is a high risk of getting an infection if you inject heroin, particularly if you share needles with someone else. Heroin is very addictive. It can have serious long-term effects. You may feel that heroin becomes more important than other things in your life. This might make it harder to keep a job and affect your relationships. In the short-term, LSD may make you experience things that aren't real. Sometimes the experience will be enjoyable, and sometimes it will be frightening. This is known as a bad trip. If you have a history of mental health problems taking LSD can make it worse. If you panic during a trip on LSD it can be scary. Your local NHS trust may have a policy that says how they will help people with dual diagnosis. Check on their website to see if you can find out more about what to expect locally. If you are not already getting help with your mental health from your local mental health team, a good first step is to make an appointment to see your GP. Your GP may offer you medication and therapy to treat your mental illness. They may refer you to a drug and alcohol service to help you with your drug use. If your needs are too complicated for your GP to deal with alone, you might need more specialist support. They should offer this support and work with drug and alcohol services to give you all the help you need. The Department of Health and Social Care says that people with dual diagnosis are a key group of people who should get help from mental health services. You should not be stopped from getting help if you have drug or alcohol problems and severe mental illness. They say that people who have a severe mental illness and drug or alcohol problem should get help under the Care Programme Approach CPA. Under the CPA you will have a care co-ordinator to plan your care. They will help to write a care plan. This should account for all the different needs you might have such as:. NICE also say that you should be able to give your views on the care plan to make sure that it meets your needs. And the care plan should be shared with your carers or family if you agree. You can read the NICE guidance online here: www. There may be a team in your area which helps people with dual diagnosis. It is sometimes called the dual diagnosis team. However, not all areas of the country have them, and it may have a different name. If there isn't one in your area, you could try contacting your local community mental health team CMHT for help. As well as NHS services, you could try contacting local charities. Many charities have support services or support groups for people struggling with substance misuse. You can find some national charities listed in the Useful Contacts section below. Some people with dual diagnosis have told us that it has been difficult to get the help they need. For example, you may have been told that mental health services cannot help you because of your drink or drugs problem. But the Department of Health and Social Care is very clear that mental health services should try to help you if you have dual diagnosis. The National Institute for Health and Care Excellence NICE also say that you should not be turned away from mental health services because you have a drug or alcohol problem. You can ask for a copy of their policy for eligibility criteria. You may then be able to use this to show you are eligible for their support. If you are not happy with the services you get, talk to the person in charge of your care. This might be your GP or your 'care coordinator'. They might be able to change things for you. An 'advocate' may be able to help you to get your point of view across. You might need to make a complaint to the NHS if you do not get the help you need. Supporting someone struggling with dual diagnosis can be difficult. It might help to speak to the person you are helping, to see what support they want. For example, some people might just want someone to talk with. Other people might want more practical help, such as with booking appointments or helping them speak to professionals. We Are With You and Adfam are two charities that offer support and advice to relatives, friends and carers of those struggling with substance misuse. You can find their contact details in the Useful Contacts section below. You might also feel that you need support for yourself. You may be able to get practical support to help you with your caring responsibilities. But this can only happen if the person who you care for wants you to be involved. Speak to the mental health team if you have ideas about what services should be available or how things could work better. Drinkline This is the national alcohol helpline. They provide information and selfhelp materials for callers worried about their own drinking, and to support the family and friends of people who are drinking. They are confidential, you do not have to give your name and they can provide advice on where to get help. Telephone : Open weekdays 9am — 8pm, weekends 11am — 4pm. Webchat Drinkchat : www. Adfam This is a national charity for families and friends of drug users. It offers confidential support and information. Frank Frank provides information and advice on drugs to anyone concerned about drugs and solvent misuse, including people misusing drugs, their families, friends and carers. Open 24 hours a day, every day Text : Email : Online form here: www. Website : www. Alcohol Change UK Alcohol concern is the national organisation for alcohol misuse. It does not provide services, but they do produce information on alcohol. We Are With You This is a drug and alcohol treatment agency. Their services deal primarily with drug and alcohol problems including support for families. Al-Anon Family Groups This is a service for families and friends of alcoholics. Al-Anon family groups provide understanding, strength and hope to anyone whose life is, or has been, affected by someone else's drinking. They are recovering addicts who meet regularly to help each other stay clean. They have groups around the country. Helpline : 10am — midnight Website : www. Alcoholics Anonymous AA AA provides an opportunity for people to get together to solve their problem with alcohol and help others to recover. Cocaine Anonymous CA CA is a fellowship of men and women who use the 12 step, self-help programme to stop cocaine and all other mind-altering substances. Telephone : Open 10am — 10pm every day. DrugWise DrugWise provides information and publications on a wide range of drug related topics. PostScript A charity committed to supporting individuals to reduce the harms caused by prescribed drugs that are associated with dependence and withdrawal. They do this through a wrap-around service of one to one therapy, group therapy and a telephone support service. Release They offer advice and information on drug problems. They have expertise in legal matters surrounding drugs. Email : ask release. Turning Point This is an organisation that works with people affected by drug and alcohol misuse, mental health problems and learning disabilities. Advice and information About mental illness Learn more about conditions Drugs, alcohol and mental health. Drugs, alcohol and mental health This section explains how using drugs and alcohol can affect your mental health. Download Drugs, alcohol and mental health factsheet. Share: Contact us:. Overview There are many reasons why you might use drugs and alcohol. Some people use them to try and deal with their symptoms of their mental illness. This is called 'self-medication'. Drugs and alcohol can make the symptoms of your mental illness worse. Some drugs may make it more likely for you to get a mental illness, and they may make it harder to treat. Mental health, and drug and alcohol services should work together to give you the support you need. If you have any problems getting help, you could make a complaint. Need more advice? If you need more advice or information you can contact our Advice and Information Service. Contact us Contact us. About How can drugs and alcohol affect my mental health? Needing to take more to get the same effect. High blood pressure and strokes. Problems with your liver and pancreas. Development of certain cancers e. Difficulty obtaining or maintaining an erection. Problems with orgasms. Difficulties becoming pregnant. Feeling like you must use the drug or alcohol. This is known as being dependent. Having sudden mood changes. Having a negative outlook on life. Loss of motivation. Problems with relationships. Being secretive. Having episodes of drug-induced psychosis. What is psychosis? Drugs and effects Which substances can affect my mental health? Alcohol Also known as: bevvies, booze Some people with a mental illness have problems using alcohol. The short-term effects of an NPS depend on what you take. These drugs can also affect your judgement, which could put you at risk. When you stop taking the drug, you may feel depressed and you might find it hard to sleep. Getting help How can I get help? This should account for all the different needs you might have such as: social care, housing, and physical health. Worried about your mental health? Care Programme Approach by clicking here. Problems What can I do if I have problems trying to get help? You can find more information about: Advocacy by clicking here. Complaints by clicking here. Carer's, friends and relatives What if I am a carer, friend or relative? NICE also says that if you are caring for someone with a dual diagnosis you can: be involved in their care planning, and work with services to help those services improve. You can find more information about: Supporting someone with a mental illness by clicking here. Confidentiality — for carers, friends and relatives by clicking here. Useful contacts Drinkline This is the national alcohol helpline.

‘Tuned Out or Tuned In’: Spirituality and Youth Drug Use in Global Times

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Official websites use. Share sensitive information only on official, secure websites. Everything I saw was beautiful. That was weird…. Man, Chinese male in Hong Kong, age The first time I tried ecstasy… I just really wanted to dance and after awhile, I danced quicker to the beat. I was with friends chilling… I became more loose and wanted to hug people… I was really awake. Kitty, Chinese female in HK, age And then not having the effects of alcohol. Leticia, Hispanic female in San Francisco, age It just makes you wanna do all those things anyway. James, white male in SF, age At first glance, one might interpret these youth narratives as a form of youthful abandonment to a good night out—the fun and pleasure derived from being with friends and dancing to high energy music, all enhanced by psychoactive drugs. However, the fact that these young persons living in two very different cultural locales—Hong Kong and San Francisco—share similar emotions and understandings from their night out suggests that there are deeper issues at hand. On the one hand, these accounts attest to, what has become in modern times, a global youth cultural phenomenon—the dance drug scene. Starting in London and New York in the s, a distinctive youth dance drug culture emerged center stage as a global phenomena. While observers might interpret this as part of a globalizing, homogenizing youth consumer culture, the dance drug culture developed beyond the rave, diversifying and moving in many different cultural directions within and across societies. On the other hand, while this global youth cultural form appears to be distinctive to modern times, it has a connection to other times and places through intoxication. Pleasurable descriptions of altered states—happiness, freedom, euphoria—from psychoactive drugs have been recorded since prehistoric times. The recent history of psychedelics is an example of this tension between the desire for altered states and the modern governance dictates of rationality and responsibility. The altered states associated with psychedelics have long been revered for their religious, medical and social associations in Aztec, Toltec, Navajo and many other native cultures. Here psychedelic intoxication was more than just about pleasure; it was also about the spiritual awakening of the self and society. They provide unspeakable pleasure and revelation. Current models of social adjustment—mechanized, socialized, televised—make no sense to the new LSD generation, who see clearly that American society is becoming an air-conditioned anthill. In every generation of human history, thoughtful men have turned on and dropped out of the tribal game, and thus stimulated the larger society to lurch ahead. Timothy Leary, Leary on Drugs 9. This diversification is partly in reaction to governmental restrictions and ordinances but it is also related to the rise of corporate opportunities with a homogenized and domesticated dance music experience, featuring a sleek postmodern feel with chrome furnishings, sophisticated sound systems, and well accessorized attendees. Recently the UK witnessed a repeat of the late s second summer of love as underground ravers rallied at abandoned buildings in London and observers pointed to the increasing disenchantment with the state, amidst rising tuition fees and economic recession. Generally speaking, this diversification has meant that the dance drug scene has become accessible to a larger and broader youth audience. But along with this diversity has come social distinctions. These cultural distinctions and divisions have been further reinforced through constraining social access through spatial segregation of venues, doormen and security, and costly entrance and beverage fees. The end result is layers of class and cultural distinctions within and across the scene. Although many youth and cultural studies scholars focus on the process of social exclusion emerging in youth cultures within a comparative framework, 16 drug researchers, with few exceptions, have restricted their enquiries on drug use patterns and the dance scene to single cultures and locales, and have not examined the role of pleasure and its connection to intoxication. Yet as we have noted, there are many other settings like the commercialized club scene which attract young people. Does the commercialized club scene offer more than the immediate pleasure of intoxication? Can spirituality play a role within the commercialized club scene? Drawing from these different frames of reference on the emergent dance drug culture, the following discussion is inspired by a curious issue raised by party goers in two cosmopolitan locales, that of San Francisco and Hong Kong. Are these two competing narratives of young people who engage in similar cultural practices? If so, how do we explain this? Are they solely related to pharmacological differences in ecstasy and ketamine? Are these different narratives connected to glocalization—where global movements are articulated with differential effects locally? To examine this paradox, we draw from in-depth interviews conducted in two parallel studies on club drug use, one in San Francisco from —04, and the other in Hong Kong from — The pleasure derived from intoxication involves more than simply a physiological reaction, but an opportunity to lose oneself momentarily from the normal routine of everyday life. In this process of stepping outside of oneself, one may develop a spiritual awareness—a heightened sense of self, of others, and of oneness with the collective. Spirituality lies at the core of the experiences of young people in both locales, and thus, at another level, raises questions about why young people in different locales, most of whom have limited religious backgrounds, are seeking a different spiritual journey. What do these journeys mean in the broader context of being a young person in modern times? We begin with a brief sketch of the development of the scene in both locales and then turn to the meaning of drug use in different cultural settings. San Francisco and Hong Kong share a similar vibrant nightlife, and the rise of the dance drug culture in each locale presents an insightful comparison on intoxication and space. While some observers describe these distinct scenes as uncontained youthful hedonism, others have noted the spiritual connections to a collective and to the disc jockeys. With the exception of heroin, other intoxicants were not readily available or in demand in Hong Kong. Although marijuana use occurred among young people in throughout the s and s, its use was relatively limited. Heroin use has been culturally understood as part of a male older generational experience, for which young people have distanced themselves from. Although these two locales offered different intoxicants and nightlife settings, the intoxicant, ecstasy, became one key link in the dance drug scene that emerged in San Francisco and Hong Kong. In both locales, British rave culture had a hand in shaping the distinctive spaces for youth intoxication. The rave scene in San Francisco emerged in the early s, later than in other US cities, and was at least initially in the form of underground parties held in warehouses, clubs and lofts where ecstasy was part of the experience and alcohol was banned. Rave promoters and organizers regularized these nights out at various clubs and rented locations in the city. Wicked, the British music collective, with their nature worshipping through neo-Pagan rituals attracted thousands of youth to the legendary Full Moon Raves at the beach. Noted for their techno-sophisticated psychedelic lighting and shaman-like disc jockeys, they attracted thousands of San Francisco ravers keen on a sensory experience of ecstasy and dance at underground raves. This British style was popularized, spreading to other nightlife events and mainstream clubs. But by the mid s, this period slowly waned with internal conflict among promoters and supporters, diversification of musical tastes and styles, and police raids on unlicensed events, and led to fewer events or moving to the suburbs. Although underground raves had diminished by the late s, massive commercial raves took their place, attended by increasing numbers of young people from the surrounding Bay Area. So while grass roots underground parties symbolized the early rave years in the city, the later years saw the increased popularity of commercialized mass scale raves, which were highly publicized, expensive, and involved big-production values. When the dot com bubble burst in , so too did the nighttime economy, as fewer could afford expensive entrance covers and ten-dollar drinks. British expatriates, along with their North American counterparts, were the first to organize and promote raves as occasional events in Hong Kong in Ecstasy first appeared in these early s raves attended by British expatriates, and not coincidentally were the first arrestees for ecstasy possession in the then colony. Although expatriates and local Chinese returnees were among the first rave attendees, these organized events in large open spaces like convention halls grew in popularity in the mid s, and local middle-class and later working-class youth joined the party. Raves and organized dance parties were differentiated by the sophistication of lighting and sound, and music, however, this scene was relatively short-lived compared to other cities including San Francisco. While the music at raves and organized parties was typically from the UK and North America, and without lyrics, more permanent local venues tended to include local Cantonese pop music. Raves were also recognized as sites with a high degree of anonymity, providing patrons with more opportunity to be liberated and experimental than in discos and clubs where space is more constrained and the risk of being under the watchful eye of others is greater. The emergence and expansion of discos and clubs resulted in a range of dance venues catering to different types of participants and experiences but united by the theme of commercialism. Licensed and unlicensed dance sites in the form of clubs, discos, and lounges flourished, catering to a range of local social groupings from the exclusive membership clubs featuring local celebrities to large scale discos with private VIP rooms to no frills dance rooms operating without liquor licenses, and spilling over to Shenzhen, a short train ride across to the Chinese border. But within a short time of ecstasy gaining popularity in Hong Kong, a new drug emerged as the preferred drug of choice. However, the use of ketamine to supplement ecstasy soon began to change and our recent research has found that many are using ketamine for its own sake. In addition, unlike ecstasy, the use of which is primarily confined to nightlife and dance venues, among Hong Kong youth ketamine gained popularity in wider leisure and recreational contexts ibid. The rapid rise in and popularity of ketamine use among young people in Hong Kong is possibly unmatched internationally. At the end of the s, ketamine use among young people in Hong Kong grew so quickly that within three years of its introduction to the local illicit drug market, it became the primary drug of choice among those under 21 years of age, surpassing that of ecstasy, and it has remained so since then. So although ecstasy use in the dance scene was, at least initially, a common link between San Francisco and Hong Kong, ketamine became a distinctive marker of difference. From the interviews in our two study sites, with the exception of marijuana and ecstasy, which were nearly universally used by respondents in both locales, ketamine was by far the most popular drug in Hong Kong but far less so in San Francisco. While the rates of ecstasy use in both locales are comparable, the use of most other intoxicants like cocaine, methamphetamines, mushrooms and GHB are relatively rare in Hong Kong. Correspondingly, Hong Kong respondents reported significantly lower rates of drug experimentation; more than half of Hong Kong respondents had used three or fewer drugs in their lifetimes versus less than a quarter of San Francisco respondents. While there were relatively few differences in the ages at which club drug users tended to start using drugs, Hong Kong respondents tended to start using cocaine, LSD and mushrooms later than respondents from San Francisco, but started using ketamine at a significantly earlier age. While San Francisco and Hong Kong seem miles apart, these two urban locales share a comparable youth dance drug culture. Several points of comparison bear mentioning. First the role of British rave culture has also played a significant role in San Francisco and Hong Kong, but in different ways. So too did British promoters come to Hong Kong with the hope of developing a similar kind of grass roots underground scene, however, this cultural form was short-lived, overshadowed by policing and ordinance restrictions and the rise of an locally driven and highly commercialized enterprise. Second, in both locales, although grass roots efforts among young people were central to the initial scene, their efforts were largely transformed through regulatory and prohibitive controls over venues and intoxication, and simultaneously, the mainstreaming and commercialization of the scene. Third, ecstasy has played an integral role in the emergence of the dance drug culture in both locales, although ketamine has come to the forefront in Hong Kong. As elsewhere, Hong Kong witnessed the emergence of a distinctive youthful and trendy dance scene where ecstasy had very much been embedded in the scene until the use of ketamine began to make in-roads. But why did ketamine come to dominate the youth dance drug scene in Hong Kong and spill over into use in other recreational settings? What is it that young people in Hong Kong seek in using ketamine and are their experiences similar or different to the experiences of young people in San Francisco? As an intoxicant, why is ketamine distinctive for Hong Kong youth? Does ketamine provide a way to tune in or tune out? We turn to look at the possible differences that exist between our two samples not just in terms of their personal characteristics but also in relation to their cultural notions of drug use and the meanings that young people in both places attribute to using drugs. Although our study was never designed to be representative and consequently the personal characteristics of our samples cannot be taken to represent all dance attendees in San Francisco or Hong Kong, there nevertheless exist some interesting differences. Overall the sample was well-educated, with 60 per cent of them either currently or previously having pursued a post-high school education, ranging from vocational training to graduate school. Few respondents had dropped out of high school. Sixty percent of respondents were employed at the time of the interview, mostly in white-collar business or clerical jobs, education or non-profit fields, or in retail and service. Few worked in skilled trade or labor jobs. Of those working, 59 per cent of them worked part-time, but over 65 per cent of the part-time workers were also students. In contrast with the middle-class characteristics of San Francisco respondents, about 75 per cent of Hong Kong respondents came from lower-class or working-class families. This characteristic was also reflected in the majority of the employed respondents who worked in the service industry or in trade occupations. While 33 per cent of them were employed in trade jobs or at the lower end of the service industry, and less than 30 per cent earned the equivalent of more than USD 1, per month. The most common occupations were hair stylists, cosmetologists, sales clerks, decorators, tele-marketers, servers at restaurants and discos, and construction workers. Thirty-three percent of the respondents were unemployed at the time of the interview, some of whom were students. Ten percent of them supplemented their income through various illegal activities such as selling or delivering pirated videodiscs and selling drugs. Such behavior, though, is not acceptable at upscale dance clubs by the professionals in our sample. While ketamine, like ecstasy, is highly accessible, easily purchased on or near the dance venue, ketamine is much less expensive. Moreover, unlike ecstasy, ketamine tends to have considerably higher levels of purity in Hong Kong. While an ecstasy tablet may be halved with one other person, depending on purity levels and length of use, ketamine is more likely to be shared with a small group of friends. Although such social class differences may go some way to explaining why ketamine is so popular in Hong Kong in comparison with those in San Francisco, it is also important to compare cultural notions of intoxicants used in dance drug settings in the two locales. Although miles apart, respondents in both locales report strikingly similar motivations for intoxication in the dance setting, whether ecstasy or ketamine As we noted from the outset, pleasure, although a feature often absent in drug scholarship, is fundamental to intoxication, and our respondents are no exception in reporting this as a main attraction in consuming drugs in a distinctly youthful scene. But what is pleasure in this youthful context? The pleasure of ecstasy is defined in relation to fun, happiness, energy, and the ability to let go, and momentarily lose oneself. Fun features prominently among San Francisco youth. And like the high was great. The young people frequently described how ecstasy, especially when used within the dance-event setting, allowed them not just to have a good time but also to experience a uniquely superlative level of fun. Fun is therefore a central feature of these discussions of pleasure and their motivations for drug consumption. For some, the pleasures centered around enjoying an exciting night out and the immediate physical effects of an increase in energy and a heightening of the senses, while for others the pleasures of ecstasy were described as life-changing, leading them to become more open, sociable, or even spiritual in their daily lives, even when not on the drug. For example, because many participants used ecstasy at dance events, they noted a connection between the drug and their enjoyment of music and dancing. You wanna meet people. Lights… trance music. The fact that this effect was communal, shared by hundreds of others dancing on ecstasy at the rave, further intensified the pleasure of the experience. Other participants focused on other sensory effects of ecstasy: the pleasures of visual effects and their heightened sense of touch while on ecstasy. All your inhibitions are free, and you just like…all of a sudden you feel like you can do anything. And then, I guess your self-esteem somehow rises. Ling, Asian American female, age According to their narratives, ecstasy helped them open up, trust others, and achieve emotional connections that were difficult or impossible otherwise. After that experience, my view in seeing the world changed. Getting high on ecstasy is also like drinking. The meaning of pleasure in this context—the euphoria, the energy, the emotional, the liberation to lose oneself—cuts across cultures, and, as other studies in different locales have shown, may represent a common global experience. In San Francisco and Hong Kong, some occasional users experiment not with different drugs, but with different settings in which to consume ecstasy, hoping that new venues with alternative music and social groups will enhance their sense of pleasure. For many others, however, after a few experiences, the pursuit of pleasure is redefined as they combine different drugs to extend, prolong or alter the pleasures from ecstasy. In cases such as this, respondents use one drug to extend the effects of another. In other cases, certain drugs were used to intensify the effects of others, particularly ecstasy, a point noted by other researchers. For example, according to a young male, combining marijuana and mushrooms had the effect of making the experience more intense. Whatever it is, it all intensifies the situation. Or as another respondent noted:. I used to smoke marijuana more for the effects it would give you on E. It brought it back a little bit. Made you feel better. Other drug combinations were believed to intensify not merely the ecstasy experience, but transform the experience completely. In Hong Kong, however, ketamine became a booster to speed up and heighten the liberating sensations from ecstasy and dancing. With one or two lines, most users were able to continue to enjoy the dance environment. After taking E, you can dance more and it last longer. For K, it comes into effect very fast, it just takes about five minutes. And then I become dizzy so I may not always be able to dance. People call this the K eye, and I feel higher. The first time was at a disco with my friend, after we had some ecstasy. We snorted it in the toilet. I saw people snorting heavy doses, but I told myself try only a little first… I had one line. It was very bitter and felt strange. It made me feel faint, confused, like floating in the air. I will only use K after ecstasy because once I had only K at a rave and the feeling was just faint. In this way, ketamine was used in conjunction with ecstasy and was oriented around improving or transforming the ecstasy experience. While ecstasy provided energy and disinhibition for dancing and socializing, ketamine moved the high in a different direction. The above respondents highlight some of the unique experiences of ketamine, especially its ability to produce a feeling of, first dizziness, followed by floating and release. This floating sensation is reported without the use of ecstasy. All around me things are inclined this way and that.. From this discussion it is clear that participants in both sites used drugs for similar reasons. Like many young people attending dance events in different parts of the globe, using intoxicants like ecstasy intensified their feelings of pleasure. Furthermore, in order to extend or heighten the pleasurable effects, our participants used a combination of drugs. However, while in San Francisco the preferred drug of choice to use while intoxicated on ecstasy was either marijuana or GHB, in Hong Kong it was ketamine. Nevertheless, although cultural similarities in why our participants used club drugs existed in both samples, their narratives also revealed cultural differences in how our participants described their experiences. While the pleasure of ecstasy in the dance drug setting lies in its ability to lose oneself, their narratives also point to a sense of humanistic spirituality—a self awakening and recognition of the role as an individual and as part of a collective. An ability to lose control was an important attractive feature of ketamine that emerged from the narrative accounts of the Hong Kong sample. The loss of control, the loss of the ability to move, is paradoxically connected by our respondents to a sense of freedom. What they emphasize here are the physical experiences of ketamine which they found to be particularly attractive. Within this state, ketamine enabled respondents to relax and transcend the stress, conflict and boredom of everyday life. As scholars have observed, boredom, in its modern articulation, is associated with a number of major transformations in life ways including individualism, belief in the right to personal happiness, secularization, the resulting capitalist division between work and leisure. These effects are described in both positive and negative ways, relating to the physical state—confusion, numbness, dizziness—as well as the metaphysical being—feeling out of control, moving out of the body to fly. My greatest experience with K was when I nearly found myself dying…On that night, I had some money and took some ketamine and ecstasy. I got a pack of ketamine and people around me kept spooning it to me so I snorted a lot. While I was snorting the ketamine, I remembered I still had a packet in my pocket. I took it out and gave it to my friends, and they spooned to me again… After that, I went out to the stage and dance. I just stopped there with my opened eyes. I saw many people in stripes. When the music was low in sound, I saw everything shaking. Then I asked my friends to take me back to sit down… I could not control myself and I thought I would probably die. How could this be? I was definitely afraid of that… I called to my friend, and my eyes had already turned over. At the time, I dimly saw people dancing in a slow pace with slow actions.. I felt hard and the effect came again. I did not know whether it belonged to me or not. Yes, maybe my soul did come back. I found myself becoming clearer. I came back to the world, came back to Hong Kong. I felt I was awake… I was very afraid. At least I understand the feeling which was nearly death. This state could be achieved in a variety of social spaces including leisure, school, and even work. Experiencing the moment was also noted by our respondents in the San Francisco sample. Nevertheless while ecstasy was particularly attractive for our participants to experience the moment, ketamine was much less attractive. This suggests that particular drugs invoke meaning specific to their social economic, cultural and spiritual context. Although the San Francisco respondents described the effects of ketamine, for example the floating sensation, in similar ways, many of them did not like the specific physical experiences that were so attractive for young people in Hong Kong. I just wanted to like lie there, and get over the dizziness. These physical experiences convinced some respondents that taking ketamine was not fun. I like ones that make me either like happy, singing, dancing, or something like that. Moreover, the loss of control which was attractive for young people in Hong Kong was described by our respondents in San Francisco as too debilitating. Losing control while on drugs was most commonly described as a state, or even the state, to be most carefully avoided while on drugs. This may reflect an overall characteristic of our San Francisco respondents, narratives which emphasized the social element of drug use, especially related to taking ecstasy. But an interest in the transitory and immediate effects of drug intoxication was not the only characteristic identified by our participants in San Francisco, they also emphasized the more enduring and even permanent benefits in using club drugs, and especially ecstasy—a feature that did not figure in the Hong Kong accounts. Participants in San Francisco described how the longer-term positive effects produced changes both in their sense of themselves and in their subsequent social behavior and interactions with others. Far from evoking the enjoyment of temporarily losing control, participants in San Francisco looked to the long-term benefits of using drugs. While they may also wish to transcend the mundane at least for an evening they also sought more. Some ecstasy users contended that its effects were ephemeral and confined to its intoxicating influence. Other users, though, sought to build on and draw from their ecstasy experiences by integrating their newfound spiritual sentiments, blurring of boundaries, and sociability into their everyday lives. The pleasures of ecstasy are thus associated with a longer-lasting positive experience. Many San Francisco participants believed that they could re-create some of the positive and pleasurable experiences of ecstasy on the dance floor—previously unexplored means of relating to others and the world in general— into daily life. For others this took on a metaphysical or spiritual undertone in which ecstasy was seen to have opened them to understanding a greater purpose or meaning in life. While most had started using ecstasy for more mundane reasons, primarily for fun, some said this shifted over time, as ecstasy enabled a transformation in how they perceived themselves. An emphasis on these more lasting changes—the self awareness, the prospect of a new emergent self, the forging of communal relations beyond the dance-drug setting—may be one reason why ketamine has very limited attraction to our San Francisco respondents. Although 37 per cent of them had tried ketamine, less than 25 per cent had used in the last year, and only two percent had used it in the last month. For those who had used in a measured and controlled manner, the ketamine experience was novel—watery legs and arms, walking in a dreamy and cloudy state and slight numbness. But most San Francisco respondents were aware from friends and reading up on ketamine of potential negative effects—confusion, numbness, sense of being out of control—ketamine was generally not seen as a pleasurable substance nor consistent with the forging of a new self. While we are not suggesting that our Hong Kong respondents did not experience any of these life-changing experiences, their accounts of ketamine use tended to omit any such discussions. It was precisely this ability to lose control and become immediately and momentarily immobile that attracted young Hong Kongers. But beyond this immediacy is the pursuit and longing for freedom and liberation from the everyday to experience a spiritual connection to the self. Contemporary research in many locales around the world suggests that intoxicants have become embedded, in what appears to be, a global youth dance drug culture. Ecstasy, in particular, has been integral to the scene even as users around the world experiment and make cocktails with other drugs associated with the dance scene, including non-prescription drugs, hallucinogens, cocaine, and crystal methamphetamine, in the pursuit of new heights of pleasure and altered consciousness. Ecstasy and other intoxicants are also important dimensions in this shared global youth culture even in the face of its shift from grass roots efforts at staging raves to the expansion and range of commercialized settings scattered in cities across the world. With the emergence of a highly commercialized and segmented dance drug scene, researchers have been left wondering if the original motives of intoxication and raves—that of emotionality and spirituality—have been lost in the transition. Largely absent in discussions about the local and global youth dance drug culture is the comparative dimension, that is, the possible different meanings associated with drug use in different social cultural locales. And that has been our objective here, to take a tentative first step to examining different meanings associated with drug use in two specific social cultural contexts. In doing so, we have tried to make sense of the growing interest among scholars from different frames of reference—criminological, sociological, anthropological, historical, and religious—to try to understand the micro level of emergent cultural and class distinctions and negotiated youth identities in the context of broader conditions of modern times. Intoxication, a notion of much value but understudied, provides a useful framework for this comparison of the meanings of drug use in different cultural locales. Because intoxication and the pursuit of pleasure provides a link between the present and the past. Intoxication tells us about the meaning derived by individuals from using particular substances as well as the social, economic and cultural conditions in which they seek an altered consciousness. So what does intoxication and pleasure mean in modern times for young people? Although each scene is defined in culturally and class specific ways, young people in both locales give meaning to their respective drugs of choice in their settings with similar motivations. On the one hand, they share similar experiences of pleasure through intoxication in rave and other dance settings. Yet the experience, described by San Francisco ravers and Hong Kong disco and club goers, of not just the losing of self, but the finding and awakening of the self, or what we could broadly describe in humanistic terms, a spiritual self. This awakening of the self, however, differs for young people in San Francisco who prefer ecstasy and those in Hong Kong who prefer ketamine. Intoxication and a sense of spiritual connection, albeit transitory and momentary, provide a tonic for the boredom and routine of everyday life. As a library, NLM provides access to scientific literature. Past Present. Published in final edited form as: Past Present. Find articles by Karen Joe-Laidler. Find articles by Geoffrey Hunt. Find articles by Molly Moloney. PMC Copyright notice. The publisher's version of this article is available at Past Present. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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