Recent changes in the pattern of drug abuse in the United Kingdom

Abstract

Until recently, most types of drug dependence were uncommon in Great Britain. The little dependence recorded was found in a few professional people, or patients who had become addicted accidentally in the course of medical treatment. There was very little addiction among those who had obtained drugs from any illicit source.

Details

Author: Thomas BEWLEY ,
Pages: 1 to 14
Creation Date: 1966/01/01

Recent changes in the pattern of drug abuse in the United Kingdom

M.A. M.D., F.R.C.P.I. Thomas BEWLEY ,
Consultant Psychiatrist, Tooting Bec Hospital, London

Until recently, most types of drug dependence were uncommon in Great Britain. The little dependence recorded was found in a few professional people, or patients who had become addicted accidentally in the course of medical treatment. There was very little addiction among those who had obtained drugs from any illicit source.

This situation has now changed. There has been a marked increase in opiate addiction among young people. There has also been a similar increase in the misuse of amphetamines by young people and the third noticeable change is that cannabis has also been introduced into the country. Until a few years ago, misuse of cannabis was almost non-existent.

These three types of drugs have mostly been used by adolescents and it was concern over this rapidly increasing misuse of drugs illicitly obtained by this age group that led to the recall of an Inter-departmental Committee, under the chairmanship of Lord Brain, to review the situation. Owing to the rate at which the situation was changing, the Committee had to be convened again within five years of making its first report.

Originally, the misuse of illicitly obtained drugs was confined to London, but this has been changing, and in the past two years there has been a spread of this type of misuse to other parts of the country.

There have been other changes in the patterns of drug abuse in the United Kingdom. There has been an increase in the misuse of amphetamines and barbiturates originally prescribed for medical reasons. This change has not been confined to the London area, but has been found in all parts of the United Kingdom. There has also probably been a slow change in the incidence of alcoholism.

In this article, the changes in incidence of dependence on various drugs are examined separately.

Changes in the incidence of dependence on opiates

There has been a marked change in the pattern of addiction to opiates in the United Kingdom in the last twenty years. Most addicts recorded before that time had become addicted accidentally in the course of treatment, or belonged to professions with easy access to drugs; for example, doctors, nurses or pharmacists. Since then there has been an increase in the number of younger addicts. These have become addicted from contact with other addicts and most of these have been addicted to either heroin alone, or both heroin and cocaine.

Home Office figures

The index or register kept by the Home Office is commonly misunderstood. There appears to be a widespread belief outside the United Kingdom that it is possible to be a "registered" addict and that there is an index or register of addicts kept by the Home Office and that any person who is "registered" is entitled to obtain drugs. There has also been a lot of fruitless argument as to whether this is a good method for dealing with opiate addiction, and this system, the so-called "British System ", has been quoted much more widely than it has been understood. In fact, there has never been any such thing as a "British System ". A series of administrative practices grew up at a time when there were very few addicts and those mostly in professions with easy access to opiates. This was described at a later date as the "British System ". It probably developed because there was virtually no opiate addiction in the country, and was in no way a cause of the small numbers of addicts. In the last few years, there has been an increase in the amount of addiction, particularly heroin addiction, and since then it has been seen that the British practices have not been entirely satisfactory.

The Home Office index or register is a list of people who are known to be addicted to opiates, which is kept by the Home Office in order to make returns to the United Nations, and also to have information available about the numbers of addicts at any time in the United Kingdom. The fact that a person's name is on the Home Office register does not entitle him to more or different drugs than any other person. There have never been limitations, up to the present, on doctors prescribing opiates to addicts in order to sustain their addiction. This system worked well at the time there were very few addicts. Any doctor was entitled to prescribe opiates for an addict but in practice very few did so (until recently virtually none, as there were so few addicts).

The Home Office register or index itself is compiled from various sources. The most important are the routine inspections of retail pharmacists records. These inspections are carried out by the police and when they show regular or unusual supplies of drugs to particular individuals, this is reported to the Home Office. Further enquiry is made usually by a Regional Medical Officer of the Ministry of Health or Scottish Home and Health Department to discover whether the case is one of addiction or of genuine medical necessity. The police also report cases of addiction encountered in the course of other enquiries. Further cases may be reported to the Home Office by doctors, hospitals, social workers or similar sources. Addiction is not at present notifiable and doctors have no statutory duty to report such cases. However, if a doctor prescribes narcotic drugs for an addict, the addict's name will eventually reach the index after inspection of the records of the pharmacist dispensing the drugs. The annual statistics published by the Home Office show only those addicts known to have been taking drugs during the previous year; they exclude those who are not known to be currently taking drugs, for example addicts in prison or abroad, and those obtaining all their drugs from illicit sources as well as those permanently or temporarily cured. These figures do not give an accurate estimate of the total number of addicts as three groups will escape notice:

  1. Those in the early stages who obtain all their drugs from addict friends, or from a black market source.

  2. Those who do this permanently who will never be known to the Home Office unless they come to the notice of the police.

  3. Those who have temporarily had their names removed from the register for one of the reasons given earlier in this paragraph. Most of the addicts on the index have been addicted for about a year when first noted, so that the numbers recorded will always be a year behind the true figure.

If the numbers of cases known to the Home Office are studied over a number of years since 1921, when the Dangerous Drugs Acts were first passed, it can be seen that there was a slow steady decline in the number of cases known to the Home Office. In 1955, however, this appeared to change (fig. 1). In 1945 the method of compiling the register was altered, and a number of names were taken off the list; before 1945 a name was not taken off the list unless the person had not been known to be taking drugs for a period of ten years. It can be seen that the decline in the total number of narcotic addicts in the country decreased from the year 1935 to 1955, and then started to rise again.

FIGURE 1

Number of addicts recorded by the Home Office (1935-1965)

Full size image: 7 kB, Number of addicts recorded by the Home Office (1935-1965)

Method of compiling register altered.

There has been a similar increase in the number of convictions for offences concerned with manufactured drugs (fig. 2). This does not include raw opium or cannabis. The majority of these offences were committed by heroin addicts.

The increase in the total number of addicts is almost entirely accounted for by an increase in the number of addicts who have started their addiction by obtaining drugs from another addict (fig. 3). There has arisen a small black market for the sale of heroin, which is supplied by some addicts who have more drugs prescribed for them than they use, thus enabling them to sell the surplus. The black market price has remained at ? 1 for 1 grain (60 mg) of heroin for the past five years. A close examination of the figures published by the Home Office (fig. 4 and table 1) show that there has been a marked increase in adolescent addiction with a very considerable increase in the numbers known to be taking heroin alone or heroin and cocaine.

In view of this striking change in the last five years, all the heroin addicts whose names had been recorded in the past ten years were separately reviewed (Bewley, 1965). The majority of the new addicts were British born (table 2) and the rate at which new names of heroin addicts had been added to the register had increased rapidly (fig. 5). In 1954, there was not a striking difference between the number of heroin addicts who had become addicted in the course of treatment and those who had acquired their addiction from some other source. By 1964, this had completely changed and most of the addicts had started from some non-therapeutic source (fig. 6).

FIGURE 2

Manufactured drugs

Full size image: 16 kB, FIGURE 2

FIGURE 3

Source of addiction

Full size image: 11 kB, FIGURE 3

When these addicts were followed up, noting whether or not they were known to be taking heroin in any succeeding year, it was found that the majority were continuously taking heroin; 80% had either continued to take heroin or had died. Where those continuously taking heroin were compared with those not known to be taking heroin, and excluding those who had died or left the country or were untraced, it was found that four times as many continued to take heroin continuously as remained off drugs.

A further development in the past twelve months has been an outbreak of infective hepatitis among heroin addicts. Dr. O. Ben-Arie and I have traced 40 cases so far. This is not surprising in that about a third of all heroin addicts admitted to hospital admit to sharing syringes with other addicts. Dr. Vincent Marks found abnormalities when empirical "liver function tests" were carried out on an unselected group of 89 heroin and cocaine users. Six of these were jaundiced and showed laboratory findings compatible with but not typical of infective hepatitis. He thought that among heroin addicts seen in London, while some cases of jaundice were viral in origin, transient liver damage was more often the result of either a direct hepatotoxic effect of the large doses of heroin and cocaine used, pyrogens or other contaminants injected unwittingly, or subclinical bacteraemias due to the use of septic materials.

Dr. I. Pierce James made a follow-up study of all the heroin addicts who had died between 1954 and 1965. He found the mortality among heroin addicts in the United Kingdom first addicted from illicit sources to be 22 per 1000 per year (a figure 20 times the expected rate and approximately higher than among narcotic addicts in the United States).

FIGURE 4

Full size image: 61 kB, FIGURE 4

Addicts known to the Home Office according to age

TABLE 1

Numbers of addicts known to be using particular drugs

Year
Morphine alone
Pethidine alone
Heroin alone
Heroin and cocaine
1958 174 99 42 12
1959 172 97 40 18
1960 150 81 42 44
1961 145 82 49 74
1962 140 89 63 104
1961 49 94 62 166
1964 145 109 125 201
1965 143 93 209 294

TABLE 2

Nationality of heroin addicts in the United Kingdom first known to be addicted, 1955-1965

British born
587
Canadian
72
United States
19
Jamaican
10
Australian
7
Nine other nationalities
14
Total
709

Heroin addiction of this type was almost entirely confined to the London area, as was pointed out in the Second Report of the Inter-departmental Committee (1965). However, there has been a change since the publishing of this report, and in the last year there has been a striking increase in the numbers of heroin addicts outside London.

Misuse of cannabis (marihuana)

In the United Kingdom cannabis or marihuana is known by a number of names, for example "Charash", "Charge", "Gauge", "Gear", "Grass", "Hash", "Hashish", "Hemp", "Indian Hemp", "Rope", "Pot", "Stuff", "Tea", and "Weed". These are all terms that are also in use in other parts of the world. Marihuana has reached the United Kingdom by a Roundabout route from India, through Africa, the West Indies and the United States. In the United Kingdom, Marihuana is generally used in the form of a cigarette, And this is known as a "Joint", a "Reefer", a "Sausage", a "Smoke", a "Spliff", or a "Stick", all terms Known in the United States [see glossary in Appendix, p. 10].

FIGURE 5

Numbers of heroin addicts added to the Home Office Register each year

Full size image: 13 kB, FIGURE 5

FIGURE 6

Source of addiction of heroin addicts in the United Kingdom

Full size image: 10 kB, FIGURE 6

Until 1945 there was very little misuse of cannabis in the United Kingdom, but between 1945 and 1960, there was a slow increase, and between 1960 and 1965, a marked increase in this misuse. It is difficult to estimate accurately the number of people who use cannabis. People who use it do not normally come to the attention of a doctor unless they have some other illness. Some idea of the trend can be gained from studying the number of prosecutions and convictions for misuse of cannabis, and also from studying the amounts and the number of seizures of cannabis recorded by H. M. Customs each year. There has been an increase both in the number of seizures and in the total weight of the drug seized, though this varies widely from year to year. Until two years ago most of the convictions for misuse of cannabis were among recent immigrants to the United Kingdom, chiefly West Indians and West Africans, but, in the last two years, such convictions have not been confined entirely to this group, and at present probably half of them are of British-born users of cannabis. The majority of the offences has been committed in the London area, though it is not entirely confined to the metropolis. It can be seen that there has been an apparent decline in the number of cannabis offences in Liverpool.

Cannabis offences are compared with offences where other drugs were concerned in figure 7 over the period 1921-1964. Following the coming into force of the Dangerous Drugs Act, in 1921 there were a number of prosecutions for technical offences, such as the failure by a pharmacist to keep proper records. There was an increase in opium offences during the war, but this was probably due to a re-routing of the international smuggling of opium, and most of these cases concerned offences in ports by seamen. The graph shows that there has been a marked change since 1959, with an increase in offences of all types, but most markedly so in the case of cannabis offences.

If it is assumed that for every conviction there are possibly ten or twenty people who are not convicted, it would give a figure for regular cannabis users in the United Kingdom of about 30 per 100,000 population. Also, if it were assumed that for every person who takes marihuana with some degree of regularity, there are as many people who might occasionally try it, then one would get a figure of about 60 per 100,000 population.

Users of cannabis are generally either recent immigrants or belong to a "beatnik" sub-culture. Probably more use of drugs of this type would be found among jazz musicians than other professions.

The taking of cannabis may be associated also with the taking of other drugs. The majority of younger heroin users described by me (1965) had taken this drug before taking heroin. There is still an argument among British psychiatrists as to whether cannabis misuse of this type leads to heroin addiction.

FIGURE 7

Drug offences in the United Kingdom (1921-1964)

Full size image: 30 kB, FIGURE 7

Misuse of amphetamines

In the past ten years there have been changes in the incidence of misuse of amphetamines in the United Kingdom. Attention was first drawn to this by Dr. P. H. Connell, who found a number of patients with amphetamine psychoses who were admitted to an observation ward in London. At that time a number of patients had taken amphetamines in very large amounts, having ingested the contents of nasal inhalers. (Other drugs have now been substituted for the amphetamine inthese inhalers.) Later there was an increase in misuse of amphetamines taken in the form of tablets or pills. These were mainly amphetamines combined with a barbiturate. This was originally something that was localised in the London area, and mostly to a particular part of the West End of London, specifically Soho. At this time the drug most frequently misused was drinanyl, in the form of tablets known as "Purple Hearts ", owing to their colour and shape. Since that date a number of other amphetamine and amphetamine/barbiturate combinations have been misused, and these have been sold widely on the black market. The name "Purple Heart" has been succeeded by a number of other names: "Blues ", "French Blues ", "Minstrels ", "Nigger Minstrels ", "Black and Whites ", "Black and Greens ", "Black and Tans ", "Black Bombers" and so forth, each one being derived from the appearance of the tablet.

These drugs appear to be stolen from legal stocks, often in large quantities, and they are then retailed in cafés and coffee bars. At present they are sold at about 1/6d to 2/6d per tablet, the higher prices being charged at week-ends. It would appear that the people who take these drugs are not all grossly abnormal. Many of them would appear to be adolescents who a few years ago would have been getting drunk on a Saturday night, and who now merely take a number of amphetamines in order to remain "high" while at parties, or in groups with other users. It is probable that large numbers of adolescents experiment with these drugs and, at a later date, abandon taking them and settle down to a more stable, better adjusted adult life. A small proportion of these users, however, does become at least psychologically dependent on them. Instead of taking them occasionally at week-ends, the pattern changes, and the drugs may be taken regularly through the week. Instead of 10 tablets over the week-end, now 20, 30, 40 or 60 tablets may be ingested daily, throughout the week. At this stage the users may develop paranoid psychoses, and they may come to the attention of psychiatrists, being admitted to an observation ward or mental hospital.

In February 1964 a series of articles appeared in the Evening Standard of London, describing the adolescent "Purple Heart culture" in Soho, London. This was followed by an increase in public concern over drugtaking by adolescents. This culminated in the passing of the Drugs (Prevention of Misuse) Act, 1964, which made it an offence to possess without "authority" drugs of the amphetamine type, or to import them except under licence. The penalties on summary conviction were a ? 200 fine and/or 6 months' imprisonment and, on indictment, an unlimited fine and/or 2 years' imprisonment. There has been controversy since the passage of this Act as to its effectiveness. If a café where there is trafficking in amphetamines is raided now by the police, vast numbers of tablets may be found on the floor, but not in anyone's possession.

A recent study in a London remand home by Dr. Peter Scott showed that one-fifth of boys on remand had been taking amphetamine substances shortly prior to their arrival at the remand home, as shown by urine tests. Many of these were not suspected to have been taking amphetamines and when they were compared with a similar group of boys who are not taking amphetamines they in no way differed from them in the types of crime committed or their types of personality. The author concluded that in this group there was probably no direct link between taking of amphetamines and committing of crime.

A further group of people also may become dependent on amphetamines and these are people for whom they are originally prescribed, usually by their own general practitioner. A survey by Kiloh and Brandon in Newcastle-on-Tyne showed that probably 500 people in a town with a population of 250,000 were psychologically dependent on amphetamines. The majority of these were middle-aged, many of them women, for whom amphetamines had first been prescribed as a treatment for depression. If these figures were extended to cover the rest of the country, it would appear that possibly somewhere in the region of 100-200 per 100,000 population are, at any rate to some slight degree, psychologically dependent on amphetamines.

To estimate the incidence of misuse of amphetamines that are obtained illegally, and not on prescription, is very much more difficult. It is difficult to decide whether to endeavour to include every one who has once taken an amphetamine tablet illicitly or only those who take them regularly (for example, at week-ends) or only those who have become dependent on them to some extent. A recent article in The Times of London estimated that at least some 10,000 adolescents probably misused amphetamines regularly in the London area. This was an estimate based on the pooled impressions of a number of people who had some experience of this particular type of misuse of drugs. There are no accurate figures and no careful studies have been done. It is possible that between 100-200 per 100,000 of the population of the United Kingdom might have taken these drugs illicitly.

It is perhaps easier to make a guess as to the number of people who have become seriously dependent on amphetamines, if one takes the number of people who are either spending long periods of time in a mental hospital or in prison because of their addiction. There are possibly about the same number of people in this cate- gory as there are addicts to heroin and cocaine, perhaps somewhere between 2 and 4 per 100,000 population.

Misuses of barbiturates

There have also been changes in the pattern of misuse of barbiturates, as pointed out by Dr. M. M. Glatt.

It is possible to get some idea of the extent of this misuse by studying a number of different phenomena: for example, deaths from overdoses of barbiturates, both suicidal and accidental; admission to hospital for barbiturate poisoning (overdose); admission to hospital because of barbiturate dependence, and surveys among samples of the general population to ascertain the incidence of use of barbiturates and incidence of dependence on them. There have also, of course, been changes in the amount of use of other sedatives as well as barbiturates, but the latter are still the most widely used sedative in the United Kingdom. Thirty years ago a far greater amount of bromides were prescribed, and bromide intoxication was not an uncommon illness. Bromide intoxication is now rare, since bromides are seldom prescribed, and have been superseded by barbiturates.

In the United Kingdom there has not been any striking change in the over-all suicide rate in the past 10 years, but there has been a change in the methods used. There has been an increase in the suicide rate from poisoning by analgesics and soporific substances, the most important members of this group being barbiturates. The suicide rate from barbiturate poisoning among men and women in three age groups has been shown by Glatt and Brooke (figs. 8 and 9). It can be seen there has been a sharp recent increase in the rates in both sexes and at all ages.

FIGURE 8

Suicide rate from barbiturate poisoning per million living

Full size image: 9 kB, FIGURE 8

FIGURE 9

Suicide rate from barbiturate poisoning per million living

Full size image: 9 kB, FIGURE 9

There have also been striking changes in the amount of non-fatal poisonings which require hospital treatment. The latest available figures show that admission rates for poisoning to National Health Service hospitals in England and Wales have increased markedly, and there has been a steady increase also in admissions for barbiturate poisoning. Total increase in admissions because of poisoning have probably been largely due to an increase in admissions for barbiturate poisoning. This is well illustrated in a table in an article by Professor Kessel, giving admissions to the poisons unit in the Royal Infirmary in Edinburgh. As he pointed out, the majority of these self-poisonings are not necessarily with suicidal intent, and many of them are due to seeking a temporary period of oblivion or escape from stress. From this it can be assumed that there has been an increase in the total amount of barbiturates consumed in the United Kingdom, and this is confirmed by studying the estimated amounts of barbiturates prescribed by general practitioners in the National Health Service (fig. 10).

As there has been an increase in the total amounts of barbiturates prescribed and consumed, it is likely that there has also been an increase in the amount of dependence on the drug. Recently Oswald and Priest have shown by EEG studies that even small amounts of barbiturates can cause physical dependence. Minor degrees of psychological dependence are also often found in that patients who regularly take barbiturates have difficulty in stopping. They find that they are restless and wakeful when they try to omit their accustomed doses. A recent survey was carried out in North London by Dr. B. G. Adams, which showed that 407 patients in a group practice of 10,000 had been given barbiturates over a long period of time. Though most of them continued to receive the drug without obvious addiction, there was evidence of increasing dosage in 47.

FIGURE 10

Estimated total quantities of barbiturates prescribed by general practitioners in National Health Service

Full size image: 7 kB, FIGURE 10

It is more difficult to estimate the extent of dependence on, or misuse of, barbiturates than the other drugs mentioned so far, but it is likely that the figure for the United Kingdom might be of the order of 150-250 per 100,000 population. Dr. Adams' figures suggest that 2 per cent of the population might be taking barbiturates regularly in small amounts.

Other types of misuse of drugs

Some misuse of lysergic acid has been noticed recently, and occasional cases are reported of misuse of other hallucinogens, these abuses occurring mostly in London. There has been public concern about misuse of LSD, though at present the persons affected probably only number a few hundreds. Because of this, however, LSD has been added to the amphetamines as a drug covered by the Drugs (Prevention of Misuse) Act.

Incidence of alcoholism

The largest problem of addiction in the United Kingdom is addiction to alcohol, or alcoholism. Several estimates of the extent of this have been made ranging from a total number of 35,000 to 350,000 alcoholics. The earlier estimates from surveys of general practice are generally considered to be too low in that many alcoholics may not have been diagnosed by their doctor, and indeed they may not even have seen him. A recent and more accurate survey by G. Prys Williams estimated that there were 300,000 alcoholics in the country, of whom 70,000 were assumed to have evidence of physical or mental deterioration.

The incidence of alcoholism will not necessarily remain unchanged. There has been an increase in the amount of alcohol consumed in the United Kingdom and there has been an increase in the number of convictions for drunkenness in the past ten years. Drunkenness among the young, however, has shown a relative improvement, though this may be because more young people who might otherwise get drunk are taking other drugs. The likelihood of developing alcoholism partly depends on the amount of alcohol consumed, and when there has been a general increase in this, it is likely that there will also be an increase in the incidence of alcoholism.

Summary

There have been very marked changes in the patterns of drug misuse in the United Kingdom in the past decade. There used to be very little dependence of any type, apart from alcoholism, and almost no illicit use of drugs. This has changed and there is now a small amount of illicit use of lysergic acid, and a markedly increased rate of appearance of heroin addicts who first obtained the drug illicitly. There has also been a large increase in the amount of illicitly used amphetamines and amphetamine-barbiturate combinations. Illicit use of drugs was confined to London at first, but it is now spreading to other parts of the country. There has been an increase in amphetamine dependence and barbiturate dependence from legitimate use also. It is likely too that there has been, and will continue to be, slow increase in the rate of alcoholism. It is difficult to make an exact estimate of the incidence of drug misuse in the United Kingdom at present, but table 3 attempts an evaluation.

TABLE 3

Estimate of incidence of drug misuse in the United Kingdom (1966)

Type of misuse
Comment
Rate per 100,000 population
Hallucinogens
A small amount illicit use of LSD
<1
Cocaine
Almost entirely used in combination with heroin
1-3
Morphine
The majority heroin addicts addicted from some non-therapeutic source
4-5
Cannabis
Illicit use without dependence
30-60
Amphetamines
a) Slight dependence on prescribed amphetamines
100-200
 
b) Illicit use of amphetamines
100-200
Barbiturates
a) Regular use with dependence
150-250
 
b) Regular use without dependence
800-1200
Alcohol
a) Obvious and chronic alcoholics
140
 
b) Alcoholics with early deterioration
400

Acknowledgements

I would like to thank the Home Office for much help in preparing this survey, also Mr. H. B. Spear, Dr. M. M. Glatt and Dr. I. P. James.

References

001

1, Adams B. G. et al., J. Coll. Gen. Practit., 1966, 12: 24.

002

Bewley T. H., Brit. Med. J. , 1965, 2: 1284.

003

Bewley T. H., Lancet, 1965, 1: 808.

004

Ben-Arie O. & Bewley, T. H. (in preparation).

005

Brooke E. M. & Glatt M. M., Med. Sci. & Law , 1964, 277.

006

Connell P. H., Brit. J. Addict ., 1964, 60: 9.

007

Drugs (Prevention of Misuse) Act, 1964 , H.M.S.O., London.

008

Glatt M. M., Bull. Narcot., 1962, 14: 19.

009

James I. P. (awaiting publication).

010

Kessel N., Brit. Med. J ., 1965, 2. 1265-1270, 1336-1340.

011

Kiloh L. G. & Brandon S., Brit. Med. J ., 1962, 2: 40.

012

Marks V. & Chapple P. A. L. (awaiting publication).

013

Oswald I. & Priest R. G., Brit. Med. J ., 1965, 2: 1093.

014

Registrar General Statistical Reviews, England & Wales, H.M.S.O., London.

015

Reports to the United Nations on the Working of the International Treaties on Narcotic Drugs , 1954-1964, Home Office, London (1954-1964).

016

16- Scott P. & Wilcox D. R. C., Brit. J. Addict ., 61: 9.

017

Second Report of the Inter-departmental Committee, 1965, H.M.S.O., London.

018

The Times , December 20th, 1965

019

Williams G. P., Chronic alcoholics: Rowntree Social Service Trust.

Slang terms associated with drugs in the United Kingdom (1966)

African Woodbine
Marihuana (cannabis) cigarette
Amphetamines and amphetamine / barbiturate combinations
Benny (Benzedrine). Black and Tan. Black and White. Black and White Minstrel. Black Bomber. Blue. Bluey. Brown Bomber. Christmas Tree. Dex (dexedrine). Dominoes. Double Blue. French Blue. Jolly Beans. Minstrel. Meth (Methedrine). Nigger Minstrel. Purple Heart. Sweets.
Amyl
Amyl nitrate.
Bang
The sensation experienced after injecting a narcotic intravenously
Back (at the back)
Where one drug is taken after another.
Barbiturates
Goof balls. Sleepers.
Benny
Benzedrine.
Bhang
Cannabis: in this form taken by mouth (India).
Black Bomber
Amphetamine (" Durophet ") 20-mg capsules.
Black and Tan
Amphetamine (" Durophet-M. ")
Black and White
Amphetamine (" Durophet ") 12.5-mg capsule.
Black and White Minstrel
Amphetamine (" Durophet ") 12.5-mg/dl capsule.
Block
Black market term for ounce of hashish (resin).
Blocked
Being under the influence of a drug (particularly drinamyl)
Blow
Smoke marihuana (cannabis) (U.S.).
Blue (Double Blue)
Amphetamine/barbiturate compound. Also used to describe sodium amytal, phenergan and other blue tablets.
Blue Velvet
Paregoric and an antihistamine.
Bluey
Drinamyl.
Boy
Heroin (U.S.)
Brought down
To be elated (from drugs) and then suddenly unexpectedly depressed.
Brown Bomber
Amphetamine. (" Durophet-M. ")
Bugged
Covered with sores or abscesses from septic injection of a narcotic.
Bullet
A capsule.
Burn (v)
a) To take someone else's narcotic and not return it.
Burn (n)
b) A solitary minor smoking of marihuana (cannabis).
Burned out
Recovered from drug dependence.
Bush Tea
Concoction of herbs (containing cannabis).
Business
Apparatus for injection of a drug.
Buzz
Feeling of exhilaration produced by a drug (U.S.)
C.
Cocaine (U.S.)
Canapa
Term used for cannabis in Italy.
Cannabis indica
See Marihuana.
Caps
Capsules of heroin (Canadian).
Carry (n)
A load of drugs.
Charas (charash)
Black Indian cannabis (possibly mixed with opium). Cannabis in block.
Charge
Cannabis.
Charlie
Cocaine (U.S.).
Christmas Tree
Drinamyl (U.S.).
To chuck
To eat excessively when being withdrawn narcotics (Noun: "chuck horrors ") (U.S.).
Cocaine
C. Charlie. Coke. Girl. Snow.
Coke
Cocaine (U.S.)
Cold Turkey
Stopping narcotics suddenly. Derived from the appearance of "goose skin ". (U.S.)
Come down(v)
To lose drug-induced exhilaration as it wears off.
Congo Mataby
The term used for cannabis in the Congo. Cannabis in seed or natural state.
Connection
Person from whom drugs are obtained.
Cook up
To prepare an injection (dissolving heroin in spoon).
Corporation Cocktail
Coal gas bubbled through milk.
Crank Up
To inject a narcotic.
Croaker
A doctor who provides narcotics for an addict (Canadian, U.S.).
Crutch
Two matches; a split match used to completely smoke marihuana (cannabis) cigarette.
Cut
To adulterate drugs.
Dagga
South African term for cannabis (from Dagha) (soft guttural gh).
Deal
Small amount of cannabis. May refer to an ounce of hashish.
Deck
Shot, injection, e.g. a deck of horse, an injection of heroin (Canadian U.S.).
Dex (dexes)
Dexamphetamine sulphate tablets.
Drag
Marihuana (cannabis) cigarette (inhalation of its smoke).
Drying out
Slow withdrawal from narcotics. Also recovering from alcoholic bout.
Double Blue
Amphetamine / barbitttrate compound.
Dominoes
Durophet 12.5-mg capsules.
Dope
Drugs (U.S.).
Experience
LSD or mescaline experience.
Fix
(n) An injection of a narcotic drug (U.S.).
 
(v) To inject a drug.
Flake out
To lose consciousness
Flash
Effect of cocaine, and to a lesser extent of methedrine.
Flushing
Drawing blood back into syringe
Freddy
Ephedrine tablet.
French Blue
Amphetamine/barbiturate pill (sometimes spelled French Blu). New type Drinamyl.
Front(at the front)
When one drug is taken before another.
Full
Full of drugs.
Gage
(As in greengage) Cannabis (U.S.).
Ganga
(Pron. Ganja) Cannabis (West Indies)
Gear
Belongings, including supplies of drugs, syringes, etc. Sometimes refers to marihuana (cannabis).
Get through
To obtain drugs (U.S. term).
Girl
Cocaine (U.S.).
Goof(v)
To spoil an injection of a narcotic, either when making it up or when injecting it.
Goof balls
Barbiturates.
Goofed up
Intoxicated with barbiturates.
Grass
Cannabis.
Green and Blacks
Librium capsules
Groovy
Effect of amphetamine.
Guide
Someone familiar with a drug and relatively sober while others try it for the first time.
Gun
Syringe (U.S.)
H.
Heroin (U.S.).
Habit (a habit)
a) Addiction to drugs with physical dependence (U.S.).
 
b) Dosage commonly taken.
Hard drugs
Opiates and cocaine (term not often used by addicts).
Hash
Hashish (cannabis).
Hashish
Cannabis - usually refers to drug in resin form.
Head
User of marihuana (cannabis) or LSD 25 (U.S.).
Hemp
Cannabis.
Herb
Cannabis.
Heroin
H. Boy. Horse. Jack. Shmee. Shmeck. Shit.
High
Feeling good, in a state of euphoria (" High as a kite ").
Hooked
To become hooked = to become addicted to (or dependent on) narcotics.
Horros
a) Acute psychosis caused by amphetamines.
 
b) Depression after stopping taking amphetamines.
 
c) Heroin withdrawal symptoms
Horse
Heroin.
Hung up
Unable to get drugs, depressed, let down, disappointed.
Hype (hypo)
Addict (from hypodermic) (U.S.).
India
Cannabis.
Indian hemp
Cannabis.
Jack
A heroin tablet.
Jack up
Take an injection of a narcotic.
Jag
Injection (go on a jag, go on a bout of drug taking).
Jimmy
An injection of a narcotic (Canadian).
Job (a job)
A batch of drugs.
Joint
Marihuana (cannabis) cigarette (U.S.).
Jolly
Beans Benzedrine (U.S.).
Joy Pop
Subcutaneous injection of a drug (U.S.).
Junk
Narcotic drugs (U.S.).
Junkie (Junky)
One who is addicted to narcotics (U.S.).
Kick (n)
Thrill
Going on a kick
An intensive period of drug taking.
Kicking (the habit)
Stopping drugs.
Kif
Cannabis (N. Africa).
Lamb (lamb chop)
An injection of a narcotic.
Lit up
Intoxicated.
Loaded
Full of drug.
Load (a load)
Stock of illegal drugs.
M.
Morphine (U.S.).
Machine
Syringe.
Main-line (v)
To inject intravenously.
Main-liner
An addict who injects his drugs intravenously (U.S.).
Marihuana
Canapa.Charas (h). Charge. Congo Mataby. Dagga. Gage. Ganga. Gear. Grass. Hashish. Hemp. Indian Hemp. Kif. Mary-Jane. Muggles. Pot. Rope. Stuff. Tampi. Tea. Weed.
Marihuana cigarette
Drag. Joint. Rainy-day woman. Reefer. Sausage. Smoke. Sploff. Stick.
Mary-Jane
Marihuana (cannabis) (U.S.).
Meth
Methedrine.
Meths
Methylated spirits.
Minstrel
Amphetamine (" Durophet ") 12.5-mg capsule.
Morphine
M.
Mud
Crude opium (Marihuana (cannabis)) (In U.S. opium for smoking.)
Muggles
American term for marihuana (cannabis).
Nigger Minstrel
Amphetamine (" Durophet ") l2.5-mg capsule.
Nod-(to nod; on the nod)
Drowsy state following injection of a narcotic).
O.
Opium (U.K.).
Opium
O. Mud
Okay Scene
Enjoyable drug party.
Paranatural
Derealisation, depersonalisation or dissociation caused by drugs.
Pellet
Tablet.
Pep Pills
Amphetamines or similar stimulant drugs.
Per
Prescription (Canadian).
Phy
Physeptone.
Pills (" taking pills ")
Amphetamine/barbiturate tablets.
Point
Needle.
Pop
Inject (generally intramuscularly or subcutaneously).
Popping or Skin Popping
Subcutaneous injection of a drug.
Pot
Marihuana (U.S.).
Pothead
Marihuana user.
Purple Heart
Drinamyl.
Push
To sell narcotic drugs.
Pusher
A pedlar of narcotic drugs.
Rainy-Day Woman
Marihuana cigarette.
Rangoon
Cannabis in natural form.
Raver
Person under influence of excessive amount of amphetamine.
Reefer
Marihuana cigarette (not a term used by users) (U.S.).
Red Biddy
Methylated or surgical spirits in wine (N. Ireland).
Roach
End of marihuana cigarette (cannabis).
Rolling up
Making a marihuana cigarette (cannabis).
Rope
Marihuana (cannabis).
Sausage
Marihuana cigarette (musicians).
Send (v)
To be intoxicated by a drug.
Scene (the scene)
The group of users; the place drugs are taken in common.
To Score
To obtain drugs. Sometimes getting heroin over one's requirements (U.S.).
Scratching
Searching for drugs.
Script
A prescription for drugs (U.S.).
Shirash
See Charas.
Shit
Heroin (U.S.). Sometimes refers to cannabis in block form.
Shmee or Shmeck
Heroin (U.S. and Canadian).
Shot
An injection of drugs (U.S.).
Shoot up
Inject intravenously.
Sick
Refers to opiate withdrawal symptoms.
Skin Popping
Giving subcutaneous injection of a drug (U.S.).
Sleepers
Barbiturates.
Smoke (or to smoke)
Marihuana cigarette (cannabis).
Sniff
Take drug nasally.
Snort
Take drug nasally by sniffing (U.S.).
Snow
Cocaine (sometimes morphine). Term not often used by addicts.
Speedball
Combination of cocaine with heroin or other opiates (U.S.).
Spike
Hypodermic needle (U.S.).
Spliff
Marihuana cigarette (cannabis).
Stick
Marihuana cigarette (cannabis) (U.S.).
Stoned (Stoned out of your mind)
Marihuana (cannabis effect (U.S.) under influence of drugs).
Stoved
Under the influence of a drug.
Straight
Ordinary cigarette (tobacco)
Strung out
Feeling ill from lack of narcotics and other hard drugs.
Stuff
Cannabis or other drugs.
Sugar (sugar lump)
LSD 25. Lysergic acid.
Sweets
Amphetamines.
Tampi
Cannabis.
Taste (a taste of)
Taking a small amount of a drug and only just feeling it.
Tea
Marihuana (cannabis) (U.S.).
Teahead
User of cannabis.
Tom (Tom Mix: Fix)
An injection of a narcotic.
Trip (take a trip)
a) Experience effects of LSD
 
b) Single (cube of sugar) measure of LSD.
Turkey (cold turkey)
Immediate complete withdrawal of all narcotic drugs
Turn on
a) To smoke a marihuana cigarette
 
b) To give a non-addict his first shot.
 
c) "A turn on ", "a turning on" a single particular drug occasion.
User
Taker of narcotics.
Weed
Marihuana (cannabis) (U.S.).
Weed heads
Cannabis users.
White drugs
Cocaine (" snow "). Term not used by addicts.
Works
Syringe, spoon, etc.
Wrap up
Brown paper packet containing cannabis.
Yen
A strong desire or yearning (originally referred to opium smokers' desire for drug during withdrawal distress).
Zen (Instant Zen)
Lysergic acid diethylamide (LSD 25) (U.S.).

Other slang terms (not associated with drugs) used by addicts

Bird (" doing bird ")
Serving a prison sentence.
Blue
Policeman.
Blow
Masturbate.
Bogey
Policeman.
Bread
Money.
Bull
A detective (Canadian, also U.K.).
Bum
Tramp.
Bust (busted)
To arrest (to be arrested).
Carrier
Person who sells for supplier (middle- man) (U.S.).
Cat
Man.
Chick
Girl.
Crazy
Very good.
D.
Detective.
Derry
Derelict house.
Fuzz
Police (U.S.)
Gas
Terrific, marvellous
Goof (v)
To give oneself away to the police.
Kip (v, n) (to kip, to have a kip)
Sleep especially but not necessarily sleep rough.
The Man
Police. Authority (U.S.).
Nicked
Arrested.
Pad
Room or apartment.
Rat
To go back on a bargain or inform on someone.
Road
On the road; vagabond existence.
Shrink
Psychiatrist (" Head shrinker ").
Skippering
Travelling about with all one's belonging, sleeping rough. Bedding down with others.
Sleep Rough
Sleep anywhere
Turn Over
To rob.
Uncle
Policeman or informer.