Posts Tagged ‘drug abuse’

Psychedelics were highly popular hallucinogenic substances used for recreational purposes back in the 1950s and 1960s. They were also widely used for medical research looking into their beneficial impact on several psychiatric disorders, including anxiety and depression. In 1967, however, they were classified as a Class A, Schedule I substance and considered to be among the most dangerous drugs with no recognized clinical importance. The use of psychedelics has since been prohibited.

Psychiatrist and honorary lecturer at the Institute of Psychiatry, Psychology and Neuroscience, at Psychiatrist and honorary lecturer at the Institute of Psychiatry, Psychology and Neuroscience, at King’s College London, James Rucker, MRCPsych, is proposing to reclassify and improve access to psychedelics in order to conduct more research on their therapeutic benefits. He believes in the potential of psychedelics so much that late last month he took to the pages of the prestigious journal the BMJ to make his case. He wrote that psychedelics should instead be considered Schedule II substances which would allow a “comprehensive, evidence based assessment of their therapeutic potential.”

“The Western world is facing an epidemic of mental health problems with few novel therapeutic prospects on the horizon,” Rucker told Psychiatry Advisor, justifying why studying psychedelics for treating psychiatric illnesses is so important.

Rucker recognizes that the illicit substance may be harmful to some people, especially when used in a recreational and uncontrolled context. He cited anecdotal reports of the substance’s disabling symptoms, such as long-term emotionally charged flashbacks. However, he also believes that psychedelic drugs can have positive outcomes in other respects.

“The problem at the moment,” he argued, “is that we don’t know who would benefit and who wouldn’t. The law does a good job of preventing us from finding out.”

From a biological perspective, psychedelics act as an agonist, a substance that combines with a receptor and initiates a physiological response to a subtype of serotonin known as 5HT2a. According to Rucker, this process influences the balance between inhibitory and excitatory neurotransmitters.

“The psychedelics may invoke a temporary state of neural plasticity within the brain, as a result of which the person may experience changes in sensory perception, thought processing and self-awareness,” Rucker speculated. He added that psychedelic drugs can act as a catalyst that stirs up the mind to elicit insights into unwanted cycles of feelings, thoughts and behaviors.

“These cycles can then be faced, expressed, explored, interpreted, accepted and finally integrated back into the person’s psyche with the therapist’s help,” he explained. Reclassifying psychedelics could mean that the mechanism by which these substances can help with anxiety, depression and psychiatric symptoms could be studied and understood better.

Several experts in the field of drug misuse have disagreed strongly with Rucker’s proposals in this area, and are quick to refute his findings and recommendations. Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), emphasized the fact that psychedelics can distort a person’s perception of time, motion, colors, sounds and self. “These drugs can disrupt a person’s ability to think and communicate rationally, or even to recognize reality, sometimes resulting in bizarre or dangerous behavior,” she wrote on a NIDA webpage dealing with hallucinogens and dissociative drugs.

“Hallucinogenic drugs are associated with psychotic-like episodes that can occur long after a person has taken the drug,” she added. Volkow also says that, despite being classified as a Schedule I substance, the development of new hallucinogens for recreational purposes remains of particular concern.

Rucker has several suggestions to help mediate the therapeutic action of the drug during medical trials, and thereby sets out to rebut the concerns of experts such as Volkow. When a person is administered a hallucinogen, they experience a changed mental state. During that changed state, Rucker points out, it is possible to control what he describes as a “context,” and thereby make use of the drug more safe.

According to Rucker, the term “context” is divided into the “set” and the “setting” of the drug experience. “By ‘set,’ I mean the mindset of the individual and by ‘setting’ I mean the environment surrounding the individual,” he explained.

To prepare the mindset of the person, Rucker said that a high level of trust between patient and therapist is essential. “A good therapeutic relationship should be established beforehand, and the patient should be prepared for the nature of the psychedelic experience,” he suggested. The ‘setting’ of the drug experience should also be kept closely controlled — safe, comfortable and low in stress.

It is also necessary to screen participants who undergo the drug experience in order to minimize the risk of adverse effects. Rucker suggested screening patients with an established history of severe mental illness, as well as those at high risk of such problems developing. It is also important to screen the medical and drug history of participants.

“The action of psychedelics is changed by many antidepressant and antipsychotic drugs and some medications that are available over the counter, so a full medical assessment prior to their use is essential,” he said.

In order to avoid the danger of addiction, psychedelics should be given at most on a weekly basis. Indeed, for many patients, very few treatments should be required. “The patient may need only one or two sessions to experience lasting benefits, so the course should always be tailored to the individual,” Rucker advised.

If there are any adverse effects during the psychedelic experience, a pharmacological antagonist or antidote to the drug can be administered to immediately terminate the experience. “This underlines the importance of medical supervision being available at all times,” Rucker noted.

Psychedelics are heavily influenced by the environment surrounding the drug experience. Rucker is proposing they be administered under a controlled setting and with a trusted therapist’s supervision. Together with a reclassification of the drug, medical research could generate a better understanding and application of the benefits of psychedelics to mental health.

1.Rucker JJH. Psychedelic drugs should be legally reclassified so that researchers can investigate their therapeutic potential. BMJ. 2015; 350:h2902.

http://www.bmj.com/content/350/bmj.h2902/related

“I grew up in the hood in Miami in a poor neighborhood. I came from a community in which drug use was prevalent. I kept a gun in my car. I engaged in petty crime. I used and sold drugs. But I stand before you today also — emphasis on also — a professor at Columbia University who studies drug addiction.”

That’s how Dr. Carl Hart, a neuroscientist and professor of psychology and psychiatry, opened a recent TED talk he gave about his research into addiction. After his difficult youth, Hart said he toed the drug war line for a number of years: “I fully believed that the crime and poverty in my community was a direct result of crack cocaine.” He bought into the notion, pushed by policymakers in the 1980s and 1990s, that you could get hooked on crack and other drugs after just one hit.

But his research has disabused him of these notions. He recruited cocaine and meth users into his lab, and over a period of several days offered them some options: they could either receive hits of their drug of choice, or they could take payments of five dollars instead. Crucially, the payments offered were less than the value of the drugs they could consume.

Contrary to the notion of the craven drug fiend who will do literally anything for one more hit, Hart found that half of cocaine and meth users opted for the money over the drugs. And when he increased the payments to 20 dollars, closer to 80 percent of meth users chose the money. The lesson? “Attractive alternatives dramatically decrease drug use,” he said in his talk.

This speaks to another point Hart made, which is worth quoting at length:

80 to 90 percent of people who use illegal drugs are not addicts. They don’t have a drug problem. Most are responsible members of our society. They are employed. They pay their taxes. They take care of their families. And in some cases they even become president of the United States.

He’s right, of course. Among people who have ever used marijuana, only 9 percent become addicted. That rate is 11 percent for cocaine and 17 percent for stimulants like meth. Even the vast majority of people who use heroin — 77 percent of them — never get addicted to the drug.

When it comes to his own kids, Hart, who is black, is less worried about drugs and more worried about the people who enforce drug laws. He says that the effects of drugs at the individual-level are predictable and easy to understand: you smoke some weed, you will experience X effects after Y amount of time. But interactions with the police are a different story. “I don’t know how to keep my children safe with the police because, particularly when it comes to Black folks, interactions with police are not predictable,” he said in a recent Q&A hosted by the Drug Policy Alliance and reported in Ebony magazine.

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

A new drug that gives people superhuman strength, but leads to violent delusions, is gaining attention.

The drug, which has the street name of Flakka, is a synthetic stimulant that is chemically similar to bath salts. Flakka is fast developing a reputation for what seem to be its nasty side effects, including a tendency to give people enormous rage and strength, along with intense hallucinations.”

Even though addicted, users tell us they are literally afraid of this drug,” said James Hall, an epidemiologist at the Center for Applied Research on Substance Use and Health Disparities at Nova Southeastern University in Florida. “As one user recently reported, it’s $5 insanity.”

From what it is to how it may work, here are five facts about Flakka.

1. What is it?

Flakka, which is also called gravel in some parts of the country, is the street name for a chemical called alpha-PVP, or alpha-pyrrolidinovalerophenone. The chemical is a synthetic cathinone, a category that includes the mild natural stimulant khat, which people in Somalia and the Middle East have chewed for centuries. Chemically, Flakka is a next-generation, more powerful version of bath salts. Flakka was banned by the Drug Enforcement Administration in early 2014.

2. What are its effects?

At low doses, Flakka is a stimulant with mild hallucinatory effects.

Like cocaine and methamphetamine, Flakka stimulates the release of feel-good brain chemicals such as dopamine and norepinephrine, Hall said. The drug also prevents neurons, or brain cells, from reabsorbing these brain chemicals, meaning the effects of the drug may linger in the system longer than people anticipate.

3. What are the dangers?

The danger comes from the drug’s incredible potency. A typical dose is just 0.003 ounces (0.1 grams), but “just a little bit more will trigger very severe adverse effects,” Hall told Live Science. “Even a mild overdose can cause heart-related problems, or agitation, or severe aggression and psychosis.”

Because of the drug’s addictive properties, users may take the drug again shortly after taking their first dose, but that can lead to an overdose, Hall said. Then, users report, “they can’t think,” and will experience what’s known as the excited delirium syndrome: Their bodies overheat, often reaching 105 degrees Fahrenheit, they will strip off their clothes and become violent and delusional, he said. The drug also triggers the adrenaline-fueled fight-or-flight response, leading to the extreme strength described in news reports.

“Police are generally called, but it might take four or five or six officers to restrain the individual,” Hall said.

At that point, emergency responders will try to counteract the effects of the drug in the person’s system by injecting a sedative such as the benzodiazepine Ativan, and if they can’t, the person can die, Hall said.

In the last several months, 10 people have died from Flakka overdoses, he said. (Users of PCP, Ecstasy, cocaine and methamphetamine can also experience the excited delirium syndrome.)

4. How is it sold?

According to Hall’s research, alpha-PVP is often purchased online in bulk from locations such as China, typically at $1,500 per kilogram. Doses typically sell on the street for $4 or $5, and because each dose is so tiny, that means dealers can net about $50,000 from their initial investment, as long as they have the networks to distribute the drug.

5. Why are we only hearing about it now?

Evidence suggests the illegal drug has only recently come on the scene. Crime lab reports from seized drugs reveal that seizures of alpha-PVP have soared, from 699 samples testing positive for the drug in 2010, to 16,500 in 2013, according to the Drug Enforcement Administration’s National Forensic Laboratory Information System.

About 22 percent of the drug seizures that tested positive for alpha-PVP came from South Florida, according to the data.

http://www.livescience.com/50502-what-is-flakka.html

Last year, newly published letters written by Nobel prize winner Heinrich Böll appeared to confirm that Nazi troops took crystal methamphetamines in order to stay awake and motivated, despite the desperate conditions they faced on the front line.

Now, new research has revealed that Adolf Hitler was himself a regular user of the drug, now a Class A, prized among addicts for its feeling of euphoria but feared for its mental destructiveness.

According to a 47-page wartime dossier compiled by American Military Intelligence, the Fuhrer was a famous hypochondriac and took over 74 different medications, including methamphetamines.

It claims that Hitler took the drug before his final meeting with Italian fascist leader Mussolini in July of 1943, during which he apparently ranted non-stop for two hours.

Hitler eased the pain of his final days in his bunker with nine injections of a drug called Vitamultin, too, which contained among its ingredients meth-amphetamine.

The dossier – which is the subject of a new documentary Hitler’s Hidden Drug Habit – goes on to claim that the Fuhrer became addicted to drugs after seeking the medical advice of Berlin-based Dr Morell in 1936.

He was initially prescribed a drug called Mutaflor in order to relieve the pain of his stomach cramps.

He was then prescribed Brom-Nervacit, a barbiturate, Eukodal, a morphine-based sedative, bulls’ semen to boost his testosterone, stimulants Coramine and Cardiazol, and Pervitin, an ‘alertness pill’ made with crystal meth-amphetamine.

His reliance on medication became costly, and by the end of 1943, Hitler was dependant on a mentally debilitating cocktail of uppers and downers.

“Morell was a quack and a fraud and a snake oil salesman,” Bill Panagopoulos, an American collector who discovered the dossier, said.

“He should not have been practising medicine anywhere outside a veterinary clinic.”

“Some [of the drugs] were innocuous, some not so innocuous, some poisonous. Did he develop a dependence on any of these drugs? Which of these drugs, if any, were addictive? And did he become addicted to them? I’d be interested to know what the combination of these medications would do to someone who’s otherwise in good health.”

http://www.independent.co.uk/news/people/hitler-was-a-regular-user-of-crystal-meth-american-military-intelligence-dossier-reveals-9789711.html