Due to the controversial nature of this topic and the target audience (young people) it is important that the reader reads the complete answer and not
simply one paragraph or a few sentences. Taking one part of the answer out of context can lead to a misinterpretation of the intended message.
Paul Dillon speaks to thousands of students across Australia providing information on alcohol and drugs, particularly in relation to looking after
themselves and their friends. Some young people make contact with him to ask questions that they did not feel comfortable asking in front of their peers.
The Real Deal on Drugs allows young people to ask questions about drugs and provides them with access to accurate and up-to-date information.

Why didn't my ecstasy work? Could taking medications have an effect?

I recently took ecstasy but felt no effects whatsoever. Is this normal or is this a dangerous sign of some kind? Could it have affected me without me being aware of it? I also take 150mg of Zoloft everyday for depression, could this have something to do with me not having any effect.

There are really two issues that need to be covered here - firstly, why would someone who has taken ecstasy not get the effect they were expecting, and secondly, a discussion on using drugs like ecstasy if you are on medications, particularly those used to treat mental health conditions.

There are a number of things to remember when taking an illegal drug that could result in someone not experiencing the desired effect:
  • There may not have been any active substance in your pill or capsule. Analysis of pills, capsules and powders sold as ecstasy shows that some contain no active substance at all and may in fact contain household products like Epsom salts and bicarbonate of soda! Sometimes they just contain caffeine. As much as we warn about poisonous substances being in ecstasy (and that may certainly be the case), sometimes there's nothing in them!

  • If others with you took a pill from the same batch and they got an effect remember that different people will be affected differently by exactly the same drug. Just because someone had a very strong effect after taking a pill, it doesn't necessarily mean that others will too. This is why one person may die or get extremely sick after taking a pill, while all the others around them who took exactly the same thing had no problems at all – this is called 'individual difference' and is incredibly important to remember in regards to drugs!

  • There are many other things that could impact on the effect the drug has on the user – what you ate beforehand, how much you ate, your mood when you took the drug and who you were with and so many others. Would this account for getting no effect whatsoever? Most probably not but sometimes people's expectations of what a drug experience is going to be like may exceed what actually happens …

Most importantly, you have been diagnosed with depression and are being treated … taking a drug like ecstasy when you're on medication for a mental health issue is simply not a good idea and can possibly make your condition even worse. There is a great little article on mixing ecstasy with Zoloft at the following link: http://goaskalice.columbia.edu/answered-questions/zoloft-and-mdma - take a look at it and think very carefully about ever using the drug again. Although many people regard ecstasy as a 'low-risk' drug, things can still go wrong - your mental health is so important and when you have a pre-existing condition, using a drug like ecstasy that plays around with your brain chemistry could be even more dangerous.
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How do I know when I can safely put a drunk person to bed?

I have a question that I have thought of about taking care of a drunk friend. One of the things I recall you saying is to try to make sure they don't fall unconscious and try to keep them awake if you possibly can. Some of the people I have looked after have wanted to go to bed, so I was wondering when is it a safe time for a drunk person to be put to bed and go to sleep without me watching them anymore?

The practice of putting someone to bed to 'sleep it off' has been around for as long as alcohol has been consumed and most times the worst thing that happens is that the person wakes up the next morning feeling a little worse for wear or covered in their own vomit. That is not always the case, however, with some drunk people being sick through the night and ending up choking on their own vomit, or others simply stopping breathing due to the depressant effects of alcohol.

The reality is that many drunk people will want to go to bed, particularly if they have been feeling unwell for a while. There are three simple tests that a person looking after a drunk friend can use to see whether you are able to put them to bed and be reasonably sure that they will be safe:

  • Can the person walk? Just a few steps, not a marathon - if they can't walk, they still need to be monitored closely. Putting them to bed at this time is not advised
  • Can they talk? They don't need to have a quality conversation but you need to know that can speak and let you know where they are, preferably in a language you can understand!
  • Can they answer a question? The best question to ask them is something like "What is your full name?" If they don't know what their name is, once again, it is not a good idea to put them to bed!
If they can pass these simple tests, you should be able to put them to bed. It is important, however, that you make sure you put them into bed in the recovery position (you can look at this YouTube video from St John Ambulance if you don't know how to do this), and then put a folded pillow behind their back to ensure that they don't roll back over through the night. Once you have, it is still important to monitor them for at least 30mins to an hour, ensuring that they are breathing steadily, that they haven't vomited or rolled over onto their back.

The major issue with looking after drunk people is that you can never be sure when they actually had their last drink, so you can't know with any certainty that this is as 'drunk' as they'll get. With that in mind, if you are considering put a drunk friend to bed, another good trick is to quickly take their pulse and then wait 10-15 minutes and take it again, making sure that it is now either steady or getting stronger (faster). If it is dropping that means there is still alcohol making its ways to the brain and putting them to bed is potentially very dangerous.

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What is 'Special K' and what is the 'K hole'?

Some of my friends have started using something called 'Special K'. It's a white powder and they snort it. What is it and what is the 'K hole' that they keep talking about?

'Special K' is a street term for ketamine, a powerful anaesthetic used in both human and veterinary surgery.  It is a dissociative drug, which means that when used, the mind leaves the body causing the user to experience quite intense hallucinations. Ketamine was first used extensively during the Vietnam War during battlefield surgery.  When soldiers returned home, those who had been given the drug talked about the experiences that they had had whilst under the effect of the drug and not surprisingly it started to be used recreationally. Its popularity increased quite dramatically in the 1990s, this time amongst the nightclub scene, with people reporting that the drug enhanced the clubbing experience (e.g., the music sounded different and the lights were more intense). 
Doctors and vets use ketamine in an injectable liquid form but 'Special K' users buy the drug in a fine crystal or powder form that is then snorted. Use too much of the drug and users can find themselves in a dissociated state, or as it is now called a 'k-hole'.  As a result, smaller, measured doses (called 'bumps') are taken, increasing the chance of having a more 'pleasurable' experience with the drug. So what exactly is a 'k-hole' and is it dangerous?
A 'k-hole' is difficult to define as it appears to mean different things to different people, but essentially there appears to be two types of 'k-holes'. Some users regard it as the state of dissociation (i.e., when your mind leaves your body) and in these cases it is definitely regarded as a 'positive' experience. Often the initial events may feel like they are happening at a high speed, with people reporting feeling as though they are zooming through tunnels or computer networks, traveling on rollercoasters or being swept through a sewer. However, there is another place you can go when you have one 'bump' too many – a black place which many users believe they will never return from. Some compare this to a 'near-death experience' (NDE) and see it as a dark and frightening place and somewhere that they never want to go to again! There is a real sense that what is being experienced is real and that one is actually dead or dying, and that what is happening is inexpressible in words.
We really don't know very much about the long-term use of ketamine as most of the research conducted in the area has been looking at its use by medical professionals for surgery. There is certainly growing evidence that regular use of ketamine can cause serious bladder and urinary tract problems. This can lead to difficulty urinating and there have now been documented cases of regular users of 'Special K' needing to have surgery in an attempt to fix these problems. It also needs to be remembered that the potential for ketamine users to do harm to themselves while in the 'k-hole' is great and there are many stories of users burning or cutting themselves unknowingly whilst using the drug. 
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