Archive for the ‘Drugs’ Category

by Daniel Oberhaus

Amanda Feilding used to take lysergic acid diethylamide every day to boost creativity and productivity at work before LSD, known as acid, was made illegal in 1968. During her downtime, Feilding, who now runs the Beckley Foundation for psychedelic research, would get together with her friends to play the ancient Chinese game of Go, and came to notice something curious about her winning streaks.

“I found that if I was on LSD and my opponent wasn’t, I won more games,” Feilding told me over Skype. “For me that was a very clear indication that it improves cognitive function, particularly a kind of intuitive pattern recognition.”

An interesting observation to be sure. But was LSD actually helping Feilding in creative problem solving?

A half-century ban on psychedelic research has made answering this question in a scientific manner impossible. In recent years, however, psychedelic research has been experiencing something of a “renaissance” and now Feilding wants to put her intuition to the test by running a study in which participants will “microdose” while playing Go—a strategy game that is like chess on steroids—against an artificial intelligence.

Microdosing LSD is one of the hallmarks of the so-called “Psychedelic Renaissance.” It’s a regimen that involves regularly taking doses of acid that are so low they don’t impart any of the drug’s psychedelic effects. Microdosers claim the practice results in heightened creativity, lowered depression, and even relief from chronic somatic pain.

But so far, all evidence in favor of microdosing LSD has been based on self-reports, raising the possibility that these reported positive effects could all be placebo. So the microdosing community is going to have to do some science to settle the debate. That means clinical trials with quantifiable results like the one proposed by Feilding.

As the first scientific trial to investigate the effects of microdosing, Feilding’s study will consist of 20 participants who will be given low doses—10, 20 and 50 micrograms of LSD—or a placebo on four different occasions. After taking the acid, the brains of these subjects will be imaged using MRI and MEG while they engage in a variety of cognitive tasks, such as the neuropsychology staples the Wisconsin Card Sorting test and the Tower of London test. Importantly, the participants will also be playing Go against an AI, which will assess the players’ performance during the match.

By imaging the brain while it’s under the influence of small amounts of LSD, Feilding hopes to learn how the substance changes connectivity in the brain to enhance creativity and problem solving. If the study goes forward, this will only be the second time that subjects on LSD have had their brain imaged while tripping. (That 2016 study at Imperial College London was also funded by the Beckley Foundation, which found that there was a significant uptick in neural activity in areas of the brain associated with vision during acid trips.)

Before Feilding can go ahead with her planned research, a number of obstacles remain in her way, starting with funding. She estimates she’ll need to raise about $350,000 to fund the study.

“It’s frightening how expensive this kind of research is,” Feilding said. “I’m very keen on trying to alter how drug policy categorizes these compounds because the research is much more costly simply because LSD is a controlled substance.”

To tackle this problem, Feilding has partnered with Rodrigo Niño, a New York entrepreneur who recently launched Fundamental, a platform for donations to support psychedelic research at institutions like the Beckley Foundation, Johns Hopkins University, and New York University.

The study is using smaller doses of LSD than Feilding’s previous LSD study, so she says she doesn’t anticipate problems getting ethical clearance to pursue this. A far more difficult challenge will be procuring the acid to use in her research. In 2016, she was able to use LSD that had been synthesized for research purposes by a government certified lab, but she suspects that this stash has long since been used up.

But if there’s anyone who can make the impossible possible, it would be Feilding, a psychedelic science pioneer known as much for drilling a hole in her own head (https://www.vice.com/en_us/article/drilling-a-hole-in-your-head-for-a-higher-state-of-consciousness) to explore consciousness as for the dozens of peer-reviewed scientific studies on psychedelic use she has authored in her lifetime. And according to Feilding, the potential benefits of microdosing are too great to be ignored and may even come to replace selective serotonin reuptake inhibitors, or SSRIs as a common antidepressant.

“I think the microdose is a very delicate and sensitive way of treating people,” said Feilding. “We need to continue to research it and make it available to people.”

https://motherboard.vice.com/en_us/article/first-ever-lsd-microdosing-study-will-pit-the-human-brain-against-ai

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mdma

By DAVE PHILIPPS

After three tours in Iraq and Afghanistan, C. J. Hardin wound up hiding from the world in a backwoods cabin in North Carolina. Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications.

“Nothing worked for me, so I put aside the idea that I could get better,” said Mr. Hardin, 37. “I just pretty much became a hermit in my cabin and never went out.”

Then, in 2013, he joined a small drug trial testing whether PTSD could be treated with MDMA, the illegal party drug better known as Ecstasy.

“It changed my life,” he said in a recent interview in the bright, airy living room of the suburban ranch house here, where he now lives while going to college and working as an airplane mechanic. “It allowed me to see my trauma without fear or hesitation and finally process things and move forward.”

Based on promising results like Mr. Hardin’s, the Food and Drug Administration gave permission Tuesday for large-scale, Phase 3 clinical trials of the drug — a final step before the possible approval of Ecstasy as a prescription drug.

If successful, the trials could turn an illicit street substance into a potent treatment for PTSD.

Through a spokeswoman, the F.D.A. declined to comment, citing regulations that prohibit disclosing information about drugs that are being developed.

“I’m cautious but hopeful,” said Dr. Charles R. Marmar, the head of psychiatry at New York University’s Langone School of Medicine, a leading PTSD researcher who was not involved in the study. “If they can keep getting good results, it will be of great use. PTSD can be very hard to treat. Our best therapies right now don’t help 30 to 40 percent of people. So we need more options.”

But he expressed concern about the potential for abuse. “It’s a feel-good drug, and we know people are prone to abuse it,” he said. “Prolonged use can lead to serious damage to the brain.”

The Multidisciplinary Association for Psychedelic Studies, a small nonprofit created in 1985 to advocate the legal medical use of MDMA, LSD, marijuana and other banned drugs, sponsored six Phase 2 studies treating a total of 130 PTSD patients with the stimulant. It will also fund the Phase 3 research, which will include at least 230 patients.

Two trials here in Charleston focused on treating combat veterans, sexual assault victims, and police and firefighters with PTSD who had not responded to traditional prescription drugs or psychotherapy. Patients had, on average, struggled with symptoms for 17 years.

After three doses of MDMA administered under a psychiatrist’s guidance, the patients reported a 56 percent decrease of severity of symptoms on average, one study found. By the end of the study, two-thirds no longer met the criteria for having PTSD. Follow-up examinations found that improvements lasted more than a year after therapy.

“We can sometimes see this kind of remarkable improvement in traditional psychotherapy, but it can take years, if it happens at all,” said Dr. Michael C. Mithoefer, the psychiatrist who conducted the trials here. “We think it works as a catalyst that speeds the natural healing process.”

The researchers are so optimistic that they have applied for so-called breakthrough therapy status with the Food and Drug Administration, which would speed the approval process. If approved, the drug could be available by 2021.

Under the researchers’ proposal for approval, the drug would be used a limited number of times in the presence of trained psychotherapists as part of a broader course of therapy. But even in those controlled circumstances, some scientists worry that approval as a therapy could encourage more illegal recreational use.

“It sends the message that this drug will help you solve your problems, when often it just creates problems,” said Andrew Parrott, a psychologist at Swansea University in Wales who has studied the brains of chronic Ecstasy users. “This is a messy drug we know can do damage.”

Allowing doctors to administer the drug to treat a disorder, he warned, could inadvertently lead to a wave of abuse similar to the current opioid crisis.

During initial studies, patients went through 12 weeks of psychotherapy, including three eight-hour sessions in which they took MDMA. During the sessions, they lay on a futon amid candles and fresh flowers, listening to soothing music.

Dr. Mithoefer and his wife, Ann Mithoefer, and often their portly terrier mix, Flynn, sat with each patient, guiding them through traumatic memories.

“The medicine allows them to look at things from a different place and reclassify them,” said Ms. Mithoefer, a psychiatric nurse. “Honestly, we don’t have to do much. Each person has an innate ability to heal. We just create the right conditions.”

Research has shown that the drug causes the brain to release a flood of hormones and neurotransmitters that evoke feelings of trust, love and well-being, while also muting fear and negative emotional memories that can be overpowering in patients with post-traumatic stress disorder. Patients say the drug gave them heightened clarity and ability to address their problems.

For years after his combat deployments, Mr. Hardin said he was sleepless and on edge. His dreams were marked with explosions and death. The Army gave him sleeping pills and antidepressants. When they didn’t work, he turned to alcohol and began withdrawing from the world.

“I just felt hopeless and in the dark,” he said. “But the MDMA sessions showed me a light I could move toward. Now I’m out of the darkness and the world is all around me.”

Since the trial, he has gone back to school and remarried.

The chemist Alexander Shulgin first realized the euphoria-inducing traits of MDMA in the 1970s, and introduced it to psychologists he knew. Under the nickname Adam, thousands of psychologists began to use it as an aid for therapy sessions. Some researchers at the time thought the drug could be helpful for anxiety disorders, including PTSD, but before formal clinical trails could start, Adam spread to dance clubs and college campuses under the name Ecstasy, and in 1985, the Drug Enforcement Administration made it a Schedule 1 drug, barring all legal use.

Since then, the number of people seeking treatment for PTSD has exploded and psychiatry has struggled to keep pace. Two drugs approved for treating the disorder worked only mildly better than placebos in trials. Current psychotherapy approaches are often slow and many patients drop out when they don’t see results. Studies have shown combat veterans are particularly hard to treat.

In interviews, study participants said MDMA therapy had not only helped them with painful memories, but also had helped them stop abusing alcohol and other drugs and put their lives back together.

On a recent evening, Edward Thompson, a former firefighter, tucked his twin 4-year-old girls into bed, turned on their night light, then joined his wife at a backyard fire.

“If it weren’t for MDMA … ” he said.

“He’d be dead,” his wife, Laura, finished.

They both nodded.

Years of responding to gory accidents left Mr. Thompson, 30, in a near constant state of panic that he had tried to numb with alcohol and prescription opiates and benzodiazepines.

By 2015, efforts at therapy had failed, and so had several family interventions. His wife had left with their children, and he was considering jumping in front of a bus.

A member of a conservative Anglican church, Mr. Thompson had never used illegal drugs. But he was struggling with addiction from his prescription drugs, so he at first rejected a suggestion by his therapist that he enter the study. “In the end, I was out of choices,” he said.

Three sessions with the drug gave him the clarity, he said, to identify his problems and begin to work through them. He does not wish to take the drug again.

“It gave me my life back, but it wasn’t a party drug,” he said. “It was a lot of work.”

http://mobile.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html

by Philip Perry

Hitler’s charisma, demagoguery, and ability to mobilize Germany behind him have been much written about and discussed. His failed attempt to fight a war on two fronts, and making the same mistake as Napoleon—invading Russia, have also been topics exhausted by scholars and armchair historians alike. But new revelations, such as the fact that the Fuhrer had a micropenis, are changing completely how we view the Second World War.

A 47-page dossier reveals that the rise of Nazi Germany was fueled by drug use. Hitler himself was taking 74 separate drugs, including a powerful opioid, and what we would consider today methamphetamine (crystal meth). The US military report, developed over the course of the war, outlines a number of different substances ingested by the Fuhrer including morphine, barbiturates, tranquilizers, and even bull’s semen.

The bull’s semen was supposed to restore the Fuhrer’s libido in to keep up with his much younger girlfriend, and to make him appear energetic and masculine before the populace. The other drugs were to help alleviate a range of issues from stomach cramps to perhaps, what some historians believe were the symptoms of bipolar disorder.

German writer Norman Ohler covers drug use in Nazi Germany in his new book, The Total Rush (Der Totale Rausch). In America, its entitled Blitzed. The book was a huge success in Germany and has since been translated into 18 languages. According to Ohler, though drugs played a pivotal role, historians overlooked it due to little interest in Hitler’s personal physician, Dr. Theodor Morell.


Injections of bull semen supposedly helped Hitler keep up with girlfriend Eva Braun, pictured here.

Ohler’s friend Alexander Kramer, who owns a vast collection of books and memorabilia from the war period and earlier, was the first to tell Ohler about the role narcotics played. Ohler said he knew immediately it would be the subject of his next book. Though he is not an historian, Third Reich expert Hans Mommsen, now deceased, aided the author in his quest. Ohler spent years in archives to piece the story together.

It all begins during the Weimar Republic, and the rise of Hitler. His inner circle lionized him, portraying him as a superior man in mind and body, who never ate meat, never touched drugs or alcohol, or even women. In 1933 when he rose to power, all intoxicating drugs were banned. Addicts were soon executed by the state or sent off to the camps.

Dr. Fritz Hauschild in Berlin developed what was first known in Germany as methyl-amphetamine. In 1937 the company he worked for expressed the hopes of using it to become a rival of Coca Cola. By 1938, the drug became pervasive and available without a prescription. Soon, almost everyone in Germany was using the drug, known as Pervitin, to boost confidence, energy, and attitude.

As ubiquitously as coffee today, it was regarded in much the same way. Housewives ate Pervitin-laced chocolates which allow them to get housework done in a jiffy and even helped them lose weight. Though health and fitness were upheld as a supreme cultural value, the populace and their leader were all in actuality, smashed on drugs.

It was Dr. Otto Ranke, the director of the Institute for General and Defense Physiology, who decided Pervitin was a good way to help soldiers avoid exhaustion. It allowed them to remain awake for long periods, march for miles, and fight in terrifying conditions fearlessly. Before invading France in 1940, Nazi soldiers were instructed to take tablets of Pervitin throughout the day and night. The invasion of Poland was also fueled by meth.

Although Ohler said his mentor told him never to rely on just one cause, the author says the blitzkrieg was utterly dependent on Pervitin. Otherwise, Hitler’s forces could have never swept through Europe as quickly as they did. Records indicate that 35 million tablets were distributed in 1940 over a span of four months, to fuel the western offensive. The idea was to turn ordinary men into superhuman machines.

There is still argument today over whether or not certain drugs improve or impede a soldier’s performance. The side effects of Pervitin were irrational behavior, hallucinations, and enraged outbursts. The Nazis weren’t alone. Many other armies used amphetamines to fight off fatigue. Dexedrine was used by the British and Americans, while the Japanese had their own form of speed.

As the war raged on, Hitler began relying on his doctor more and more, whom was distrusted and loathed by the rest of his inner circle. Dr. Morell meanwhile relied on the Fuhrer for his position. In 1941 Hitler came down with a terrible illness. Though Morell had been famous for vitamin injections, it was clear that these were not going to cut it.

Animal hormones and a series of medications were attempted. Finally, the physician settled on Eukodal, a wonder drug which we would call Oxycodone today. Soon, one of the world’s most famous villains was receiving several injections of Eukodal per day, and combining them with a host of other drugs, including cocaine, which had been prescribed to help with an ear condition endured on the eastern front. The drug cocktail, particularly Eukodal, made Hitler feel invincible, even when it became clear, by 1944, that Germany was losing. His generals frantically appealed to him to change tactics. But Eukodal made him feel powerful, euphoric, and in control, and so he decide to plod along, undeterred.

Late in the war, the factories that made Germany’s drugs were bombed out by the Allies. By early 1945, the Fuhrer was in a state of fevered withdrawal. According to Ohler, the world’s most infamous fascist spent his final days in his bunker, drowning in a hellish state of withdrawal.

Ohler doesn’t think Hitler’s personal physician purposely turned him into an addict, though it is possible. But it’s just as likely that the Fuhrer himself was the driving force, imbued with an addictive personality. Either way, in the fall of 1944, Hitler removed Morell. But by then, it was too late. The Fuhrer took his own life. Morell meanwhile died not too long after the war a sad and broken figure, discarded by history. Ohler portrays him as a tragic figure, a mere opportunist caught up in the forces of his time, while others see him as an out-and-out scoundrel. Regardless of his intentions, his methods seem to have contributed to the downfall of the Third Reich.

by Tori Rodriguez, MA, LPC

Individuals with major depressive disorder (MDD) have double the risk of alcohol use disorders (AUDs) and vice versa, and it has previously been proposed that some people with MDD may use alcohol to self-medicate. Though alcohol can become depressant if used chronically, alcohol initially has an antidepressant effect, though the underlying mechanisms have not been identified. Findings reported in September 2016 in Nature Communications begin to elucidate the basis of this action.

Behavioral and molecular evidence of the rapid antidepressant activity of NMDA receptor (NMDAR) antagonists, which have been found to be effective within 2 hours of administration and remain so for 2 weeks, represents a significant advance in depression treatment. Antidepressant efficacy involves the induction phase and the sustained phase.

The sustained phase of rapid antidepressants requires “both new protein synthesis and an increase in protein stability… for the GABABR shift in function necessary to increase” the activity of mTORC1, a mechanistic target of rapamycin complex 1, the authors explained in their paper. Rapamycin (mTOR) is a “serine/threonine kinase essential for messenger RNA translation” and is required for the sustained impact of rapid antidepressants.

Citing previous findings that ethanol (EtOH) also blocks NMDARs in the hippocampus, scientists at the University of Texas at Austin and Wake Forest University School of Medicine in Winston-Salem, North Carolina, aimed to determine whether EtOH and NMDAR antagonists exert rapid antidepressant effects via the same synaptic pathways in rodents. They hypothesized that EtOH “has lasting antidepressant efficacy, shares the same downstream molecular signaling events as rapid antidepressants, and requires de novo protein synthesis.”

First, they found that acute exposure to EtOH led to antidepressant and anxiolytic behaviors in rodents for up to 24 hours. They then discovered that, like NMDAR antagonists, EtOH alters the expression and signaling of GABABR, increases dendritic calcium, and leads to the synthesis of new GABABRs. This synthesis requires fragile-X mental retardation protein (FMRP), an RNA-binding protein of which precise levels are needed for normal neuronal functioning.

The antidepressant effects and the changes in GABABR expression and dendritic calcium were not observed in in Fmr1-knockout (KO) mice, supporting the concept that FMRP has in important role in regulating protein synthesis after EtOH exposure, and thereby facilitating its antidepressant efficacy.

These results point to a shared molecular pathway for the antidepressant activity of EtOH and rapid antidepressants, and highlight a mechanism involved in the initial antidepressant action of alcohol. “A shift in GABABR signaling is observed with both rapid antidepressants and acute EtOH treatment, which may provide insight into the molecular basis for the high comorbidity between major depressive disorder and AUD,” the authors concluded.

http://www.psychiatryadvisor.com/addiction/rapid-antidepressant-effect-of-alcohol/article/567335/?DCMP=EMC-PA_Update_RD&cpn=psych_md%2cpsych_all&hmSubId=&NID=1710903786&dl=0&spMailingID=15723696&spUserID=MTQ4MTYyNjcyNzk2S0&spJobID=881842067&spReportId=ODgxODQyMDY3S0

Professor David Nutt. Neuropsychopharmacology.

Professor David Nutt. Neuropsychopharmacology.

by Katie Forster

A new type of synthetic alcohol has been discovered which could allow people to enjoy the sociable effects of a few pints, but skip the hangover that usually follows.

The new drink, known as ‘alcosynth’, is designed to mimic the positive effects of alcohol but doesn’t cause a dry mouth, nausea and a throbbing head, according to its creator Professor David Nutt.

The Imperial College Professor and former government drugs advisor told The Independent he has patented around 90 different alcosynth compounds.

Two of them are now being rigorously tested for widespread use, he said – and by 2050, he hopes alcosynth could completely replace normal alcohol.

“It will be there alongside the scotch and the gin, they’ll dispense the alcosynth into your cocktail and then you’ll have the pleasure without damaging your liver and your heart,” he said.

“They go very nicely into mojitos. They even go into something as clear as a Tom Collins. One is pretty tasteless, the other has a bitter taste.”

By researching substances that work on the brain in a similar way to alcohol, Professor Nutt and his team have been able to design a drug which they say is non-toxic and replicates the positive effects of alcohol.

“We know a lot about the brain science of alcohol; it’s become very well understood in the last 30 years,” said Professor Nutt.

“So we know where the good effects of alcohol are mediated in the brain, and can mimic them. And by not touching the bad areas, we don’t have the bad effects.”

Advocates of alcosynth believe it could revolutionise public health by relieving the burden of alcohol on the health service.

According to Alcohol Concern, drinking is the third biggest risk factor for disease and death in the UK, after smoking and obesity.

“People want healthier drinks,” said Professor Nutt. “The drinks industry knows that by 2050 alcohol will be gone.”

“They know that and have been planning for this for at least 10 years. But they don’t want to rush into it, because they’re making so much money from conventional alcohol.”

Early experiments into alcosynth, such as those reported on by BBC’s Horizon in 2011, used a derivative of benzodiazepine – the same class of drugs as Valium.

Mr Nutt said his new drinks did not contain benzodiazepine, and their formulas would remain a closely guarded, patented secret.

However, the huge cost of funding research into the drug and regulatory concerns mean it could be a long time before people can order an alcosynth cocktail at their local pub.

Professor Nutt, who was sacked from his position as the government drugs tsar in 2009 after he claimed taking ecstasy was less dangerous than riding a horse, said he was unsure if the use of synthetic alcohol would be restricted by the new Psychoactive Substances Act, which came into force in May.

“It’s an interesting idea, but too much in its infancy at the moment for us to comment on,” a Department of Health spokesperson told The Independent.

“I don’t think we’d give money to it until it was a little further along,” said the spokesperson. “If [Professor Nutt] were to apply for funding, it would go through the process of everything else and would be judged on its merits.”

“It would be great for producing better workforce efficiency if no one was hungover,” they added.

According to Professor Nutt, the effects of alcosynth last around a couple of hours – the same as traditional alcohol.

He said he and his team have also managed to limit the effects of drinking a lot of alcosynth, so in theory it would be impossible to ever feel too ‘drunk’.

“We think the effects round out at about four or five ‘drinks’, then the effect would max out,” he said.

“We haven’t tested it to destruction yet, but it’s safer than drinking too much alcohol. With clever pharmacology, you can limit and put a ceiling on the effects, so you can’t ever get as ill or kill yourself, unlike with drinking a lot of vodka.”

Researcher Guy Bentley worked with Professor Nutt on a new report by the liberal think tank the Adam Smith Institute into alcosynth regulation.

Mr Bentley told The Independent he hoped to persuade the government to accept the drug as a way of reducing the harm caused by alcohol.

“[The report] is trying to spark what happened with e-cigarettes and tobacco, but with alcohol,” he said. “Professor Nutt has been experimenting on this for a long time, but I thought to myself – ‘where is it?’ I wanted my hangover-free booze.”

However, not everyone was as keen on the new discovery.

Neil Williams, from the British Beer and Pub Association, said alcosynth was not necessary, as “there are other ways of avoiding a hangover”.

“There are plenty of low-strength drinks, particularly beers,” he told The Independent. “We should all drink in moderation so we shouldn’t need to have a hangover anyway.”

“I’d want to know more about it before I tried it myself,” he said.

http://www.independent.co.uk/life-style/health-and-families/health-news/hangover-free-alcohol-david-nutt-alcosynth-nhs-postive-effects-benzodiazepine-guy-bentley-a7324076.html?cmpid=facebook-post

By Christopher Ingraham

As acceptance of and usage of marijuana have become more widespread, a whole lot of interesting questions for public health researchers have been raised: How will legal marijuana affect our children? Our jobs? Our relationships?

Or how about our sex lives?

That latter question inspired a research project by Joseph Palamar and his colleagues at New York University. “Since the landscape is changing, and marijuana continues to increase in popularity, research is needed to continue to examine if and how marijuana use may influence risk for unsafe sexual behavior,” they write in the July issue of the journal Archives of Sexual Behavior.

To that end, Mr. Palamar and his colleagues recruited 24 heterosexual adults to take part in a series of in-depth interviews about prior sexual experiences that happened under the influence of either alcohol or marijuana. This was not meant to be a national sample. Rather, the purpose was to obtain a rigorous qualitative assessment of the different effects of alcohol and marijuana on people’s sexual behaviors and to use this as a jumping-off point for future quantitative research.

Here are a few of the observations the researchers drew from the interviews.

1. Beer goggles are real.

Respondents “overwhelmingly reported that alcohol use was more likely to [negatively] affect the partners they chose,” the study found. Both men and women were fairly likely to say that alcohol had the effect of lowering their standards for whom they slept with, in terms of character and appearance. With marijuana, this seemed to be much less of an issue.

“With weed I know who I’m waking up with. With drinking, you don’t know. Once you start drinking, everybody looks good,” a 34-year-old female said.

Marijuana use also was more associated with sex with people the respondents already knew — girlfriends and boyfriends, for instance. But alcohol “was commonly discussed in terms of having sex with strangers [or someone new],” the study found.

2. Drunk sex often leads to regret. Stoned sex typically doesn’t.

“The most commonly reported feeling after sex on alcohol was regret,” the study found. “Both males and females commonly reported that regret, shame, and embarrassment were associated with alcohol use, but this was rarely reported for marijuana.”

“I want to cook the person something to eat [after sex] when I’m high,” one male respondent said. “When I’m drunk, it’s like, ‘I’m out of here.’ Or get away from me.”

These negative emotions are seen as at least partly due to drunk sex being associated more with strangers.

3. Drunk sex can make you sick. Stoned sex can make you distracted.

“Nausea, dizziness, feeling sick [and vomiting], and blacking out were commonly reported to be associated with alcohol use,” the study found. One male said he accidentally fell asleep during sex while drunk. Another told of multiple instances where sex had to be interrupted because “I’ve had to stop and go hurl.”

There were fewer adverse effects reported with marijuana, and these tended to be more mental. One respondent said that marijuana use lessened his motivation to have sex. Another reported that being high distracted her from the experience.

“You’re so high [on marijuana] … you start thinking sex is weird. ‘What is sex?’ ” a female respondent reported.

4. The pleasure is usually better on marijuana.

The study found that “alcohol tended to numb sensations and marijuana tended to enhance sensations.”

“Alcohol tends to be a lot more numb,” a male respondent said. “Everything is sort of blunted and muted, whereas with marijuana it’s intensified.”

This “numbness” was associated with a longer duration of sex while drunk. But that wasn’t necessarily a good thing.

It “sometimes lasts too long,” one female respondent said. “Compared to when you’re high — it feels so great and it might be a little shorter.”

The study found that both men and women reported longer and more intense orgasms on marijuana, with one woman reporting hers were “magnified at least by five times.”

Also, marijuana led to “more tender, slow, and compassionate sexual acts, and to involve more sensation and sensuality than alcohol,” the report found.

5. Drunk sex is riskier overall.

“With regard to sexual risk behavior, the majority of participants felt that alcohol was riskier, sexually, than marijuana,” Mr. Palamar and his colleagues found. People typically said they exercised poorer judgment when drunk than when stoned, and were more likely to black out and forget whom they were with, what they were doing or whether they used protection.

Participants generally didn’t note this type of behavior with marijuana and said that while under its effects, they felt more in control overall. “One participant interestingly pointed out that marijuana use decreased his likelihood of engaging in risk behavior because while high he was too paranoid to give in,” the study found.

There were some take-homes viewed as useful from a public health perspective. First, the findings confirm one thing that numerous other studies have shown: Alcohol use seems to be closely associated with high-risk sexual behavior.

Aside from the link with unprotected sex and the corresponding risk of unexpected pregnancy or sexually transmitted diseases, studies have also drawn disturbing parallels between alcohol use and sexual assault. That link appeared even in the very small sample in Mr. Palamar’s study: One out of the 12 women interviewed reported an instance of sexual assault while under the effects of alcohol.

These negative consequences appear to be less pronounced with marijuana. Research found significantly lower incidences of domestic violence among couples who smoke marijuana, for instance.

http://www.post-gazette.com/news/health/2016/08/08/Serious-researchers-studied-how-sex-is-different-when-you-re-high-vs-when-you-re-drunk/stories/201608080044

Thanks to Michael Moore for bringing this to the It’s Interesting community.

By Christopher Ingraham

There’s a body of research showing that painkiller abuse and overdose are lower in states with medical marijuana laws. These studies have generally assumed that when medical marijuana is available, pain patients are increasingly choosing pot over powerful and deadly prescription narcotics. But that’s always been just an assumption.

Now a new study, released in the journal Health Affairs, validates these findings by providing clear evidence of a missing link in the causal chain running from medical marijuana to falling overdoses. Ashley and W. David Bradford, a daughter-father pair of researchers at the University of Georgia, scoured the database of all prescription drugs paid for under Medicare Part D from 2010 to 2013.

They found that, in the 17 states with a medical-marijuana law in place by 2013, prescriptions for painkillers and other classes of drugs fell sharply compared with states that did not have a medical-marijuana law. The drops were quite significant: In medical-marijuana states, the average doctor prescribed 265 fewer doses of antidepressants each year, 486 fewer doses of seizure medication, 541 fewer anti-nausea doses and 562 fewer doses of anti-anxiety medication.

But most strikingly, the typical physician in a medical-marijuana state prescribed 1,826 fewer doses of painkillers in a given year.

These conditions are among those for which medical marijuana is most often approved under state laws. So as a sanity check, the Bradfords ran a similar analysis on drug categories that pot typically is not recommended for — blood thinners, anti-viral drugs and antibiotics. And on those drugs, they found no changes in prescribing patterns after the passage of marijuana laws.

“This provides strong evidence that the observed shifts in prescribing patterns were in fact due to the passage of the medical marijuana laws,” they write.

In a news release, lead author Ashley Bradford wrote, “The results suggest people are really using marijuana as medicine and not just using it for recreational purposes.”

One interesting wrinkle in the data is glaucoma, for which there was a small increase in demand for traditional drugs in medical-marijuana states. It’s routinely listed as an approved condition under medical-marijuana laws, and studies have shown that marijuana provides some degree of temporary relief for its symptoms.

The Bradfords hypothesize that the short duration of the glaucoma relief provided by marijuana — roughly an hour or so — may actually stimulate more demand in traditional glaucoma medications. Glaucoma patients may experience some short-term relief from marijuana, which may prompt them to seek other, robust treatment options from their doctors.

The tanking numbers for painkiller prescriptions in medical marijuana states are likely to cause some concern among pharmaceutical companies. These companies have long been at the forefront of opposition to marijuana reform, funding research by anti-pot academics and funneling dollars to groups, such as the Community Anti-Drug Coalitions of America, that oppose marijuana legalization.

Pharmaceutical companies have also lobbied federal agencies directly to prevent the liberalization of marijuana laws. In one case, recently uncovered by the office of Sen. Kirsten Gillibrand (D-N.Y.), the Department of Health and Human Services recommended that naturally derived THC, the main psychoactive component of marijuana, be moved from Schedule 1 to Schedule 3 of the Controlled Substances Act — a less restrictive category that would acknowledge the drug’s medical use and make it easier to research and prescribe. Several months after HHS submitted its recommendation, at least one drug company that manufactures a synthetic version of THC — which would presumably have to compete with any natural derivatives — wrote to the Drug Enforcement Administration to express opposition to rescheduling natural THC, citing “the abuse potential in terms of the need to grow and cultivate substantial crops of marijuana in the United States.”

The DEA ultimately rejected the HHS recommendation without explanation.

In what may be the most concerning finding for the pharmaceutical industry, the Bradfords took their analysis a step further by estimating the cost savings to Medicare from the decreased prescribing. They found that about $165 million was saved in the 17 medical marijuana states in 2013. In a back-of-the-envelope calculation, the estimated annual Medicare prescription savings would be nearly half a billion dollars if all 50 states were to implement similar programs.

“That amount would have represented just under 0.5 percent of all Medicare Part D spending in 2013,” they calculate.

Cost-savings alone are not a sufficient justification for implementing a medical-marijuana program. The bottom line is better health, and the Bradfords’ research shows promising evidence that medical-marijuana users are finding plant-based relief for conditions that otherwise would have required a pill to treat.

“Our findings and existing clinical literature imply that patients respond to medical marijuana legislation as if there are clinical benefits to the drug, which adds to the growing body of evidence suggesting that the Schedule 1 status of marijuana is outdated,” the study concludes.

One limitation of the study is that it only looks at Medicare Part D spending, which applies only to seniors. Previous studies have shown that seniors are among the most reluctant medical-marijuana users, so the net effect of medical marijuana for all prescription patients may be even greater.

The Bradfords will next look at whether similar patterns hold for Medicaid.

https://www.washingtonpost.com/news/wonk/wp/2016/07/13/one-striking-chart-shows-why-pharma-companies-are-fighting-legal-marijuana/

Thanks to Kebmodee for bringing this to the It’s Interesting community.