26-year-old Londoner Sara found herself in that situation whilst at university four years ago. A regular weekend would see her out Friday and Saturday without fail, with nothing more than a few drinks and a gramme of speed to see her through. "I'd have my breakfast on the Friday morning," she says, "then go out that night and do a gramme, maybe more, of speed, be awake all Saturday and do it all over again Saturday night. I'd not eat from Friday morning to Monday lunchtime. I noticed I was losing weight - you would be if you were dancing that long but especially if you didn't eat for three days - and I thought it was great. You didn't want to have dinner on the night you were going out anyway because you'd get a bit of a tummy, so even if I hadn't have been doing any drugs I still wouldn't have eaten. But by the time Monday came around I felt fucking awful. "We used to laugh about it then, but when I think about it now I don't know how we stood it. The turning point for me was when I started work and I realised I couldn't go on like that all weekend then come into work shaking on a Monday and not even be able to answer the phone, so I just stopped doing it." Sara's best mate carried on caning it and was eventually diagnosed as suffering from the eating disorder bulimia. "It took her a long time to get over it," says Sara, "but I probably wouldn't have noticed how ill she was if I had carried on as well. Luckily I was so busy at work that I had more important things to do than worry about whether I looked fat or not." "These people probably don't realise that their health is deteriorating," warns Haughton. "Like long-term heroin users, we find they don't realise that the wear and tear on their looks, the weight loss and the teeth rotting is gradual. But if you showed them a picture of how they looked before they went on H they'd be very shocked. Likewise regular users of speed."

MOST clubbers aren't that bothered about the long term effects of drugs on their health (and if they are, they're more likely to be worried about long-term psychological problems). We accept that the price we pay for being caned on a Saturday night is the comedown on Sunday. So you miss your Sunday lunch - big deal, that's not going to stop us taking drugs. But by not recharging your body in the week by catching up on missed sleep and eating a well balanced diet, you'll end up suffering badly. "Any club drug is a stimulant," explains Haughton, "whether it be E, coke or speed - and they all involve a certain loss of appetite. When it is taken to extreme, especially with speed and cocaine users, they quite often not only look ill but can end up anorexic. Some women may find that when their weight loss reaches a certain level their periods become heavier or irregular and can even stop completely. If something keeps you up for two days and you're not eating in that time your health will deteriorate pretty rapidly. And if you spend a lot of time doing speed or coke the bridge of your nose will eventually collapse, which isn't exactly pretty." Haughton is aware that the majority of drug users do not phone Lifeline - most of us don't give a second thought to what we're doing to ourselves because we're all doing it and it doesn't seem abnormal behaviour. But of those who do call for advice, women outnumber men by three to one. "There are a whole series of reasons for that," explains Haughton. "Lifeline's success is partly due to the fact that we target young female drug users and are trained to discuss issues relating specifically to them. We get a lot of calls from young girls who are worried about their looks and who feel pressured into conforming to this certain image. Insecurity and a lack of confidence mixed with club drugs can lead to all sorts of problems. We listen to their concerns and if they're not ready to give up, we'll try and persuade them to be careful. After learning of the effects that the drugs, and in particular speed, have on their health, I think a few of them stop doing it." Clare Chapman, from Bath-based counselling service Off The Record, has seen a number of young women fall into the trap of amphetamine abuse. They may not start out specifically to lose weight, but - even if that was not their initial intention - it is inevitable that many users will feel if they stop doing speed or cocaine then they'll put weight on. "We see very young girls, some as young as eleven or 12 who start smoking cigarettes because they know it suppresses their appetite," says Chapman. "As they get older, they're likely to find other substances which will do the same job. This is when the problems start and if they're already worried about their weight they may turn to something else such as speed. It's worrying and it can be very dangerous. That's where counsellors can help."

"AT the time I didn't think about what I was doing to myself," says Julia, a 20-year-old clubber from Nottingham. "It wasn't important. Going out and getting off my head was all I cared about, and although I used to look rough, I just thought, 'Fuck it', because everyone else did and I didn't care as long as I was out. We all wore tiny outfits and caned the sunbeds and that but in the end we just got a bit bored with it all. "Basically it used to take us all day to get ready, we wouldn't eat all day so our stomachs didn't stick out and then we'd get to a club and most of the blokes would be fat and ugly anyway! I still go out and have a good laugh but I don't give a toss what people think of me anymore and I can't be bothered with dieting. I suppose I've grown out of wanting to be off my head all the time and I'm not so insecure that I feel I need to be dead skinny, I know I look alright as I am." In Andrew Tyler's book Street Drugs, he describes how a friend of his had a half-a-gramme-a-week speed habit which left him drifting in and out of sleep and no-sleep patterns. His habit took 18 months to develop. Two months down the line after deciding to quit because he couldn't stand it anymore he was finally able to fall into some sort of sleeping pattern. Soon he was managing to get up at 9am and go to work. But it was a whole 18 months before he felt like a proper person again. Alan Haughton again: "When Lifeline first started in 1989 amphetamines were a lot more prevalent as drugs go than ecstasy, but we find that a lot of women who call Lifeline do admit to using amphetamines not just to have a good time but to help them lose weight - not just speed, but cocaine as well."

AMPHETAMINE is an appetite suppressant, and aside from the associated depressive, exhausting comedowns, it can cause people to fall into eating disorders such as bulimia or anorexia. Most clubbers who do speed or coke don't take it for any other reason than to stay up all night and enhance their weekend - but others, whose main reason for taking drugs is to keep their weight down, will eventually pay the price. Long term regular users will not only suffer chronic sleeping problems, ill-tempered outbursts and paranoia, but also skin rashes, dark circles under the eyes from the lack of sleep and a handful of other problems - hardly what anyone would call attractive attributes. And there are other dangers. "Speed, when taken with alcohol," says Haughton, "can be particularly dangerous. Someone who would normally crash out after drinking a large amount may have retained so much energy that they could easily act on drunken impulses." Apart from the possibility that you might end up in a cell for thumping someone, you may also find yourself laying in bed next to a total stranger with no recollection of the events that took place and nothing but a trip to the doctors to get yourself checked over to look forward to. Anyone who has done coke or speed - even once - will be aware of the side effects, but how far are regular users like Caroline prepared to go for the sake of a few pounds? Is it really worth the paranoia, the restlessness, the depression, the skin complaints, the risk of developing a serious eating disorder not to mention the danger of heart failure - all for a flat stomach? Think beyond next weekend. Think about the rest of your life. The choice about taking drugs is, as ever, up to you - but using them to lose weight is going to cost a lot more than a few pounds. If you're really that bothered, why not try aerobics or a gym?
(Thanks to Annie Ryan at DAWN. Users names have been changed.)

LONG-TERM SPEED ABUSE - THE EFFECTS