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Tranq Dope: Animal Sedative Mixed With Fentanyl Brings Fresh Horror to U.S. Drug Zones

By Jan Hoffman PHILADELPHIA — Over a matter of weeks, Tracey McCann watched in horror as the bruises she was accustomed to getting from injecting fentanyl began hardening into an armor of crusty, blackened tissue. Something must have gotten into the supply. Switching corner dealers didn’t help. People were saying that everyone’s dope was being cut with something that was causing gruesome, painful wounds. “I’d wake up in the morning crying because my arms were dying,” Ms. McCann, 39, said. In her shattered Philadelphia neighborhood, and increasingly in drug hot zones around the country, an animal tranquilizer called xylazine — known by street names like “tranq,” “tranq dope” and “zombie drug” — is being used to bulk up illicit fentanyl, making its impact even more devastating. Xylazine causes wounds that erupt with a scaly dead tissue called eschar; untreated, they can lead to amputation. It induces a blackout stupor for hours, rendering users vulnerable to rape and robbery. When people come to, the high from the fentanyl has long since faded and they immediately crave more. Because xylazine is a sedative and not an opioid, it resists standard opioid overdose reversal treatments. More than 90 percent of Philadelphia’s lab-tested dope samples were positive for xylazine, according to the most recent data. “It’s too late for Philly,” said Shawn Westfahl, an outreach worker with Prevention Point Philadelphia, a 30-year-old health services center in Kensington, the neighborhood at the epicenter of the city’s drug trade. “Philly’s supply is saturated. If other places around the country have a choice to avoid it, they need to hear our story.” A study published in June detected xylazine in the drug supply in 36 states and the District of Columbia. In New York City, xylazine has been found in 25 percent of drug samples, though health officials say the actual saturation is certainly greater. In November, the Food and Drug Administration issued a nationwide four-page xylazine alert to clinicians. © 2023 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 28630 - Posted: 01.14.2023

Legal Use of Hallucinogenic Mushrooms Begins in Oregon

By Andrew Jacobs PORTLAND, Ore. — The curriculum was set, the students were enrolled and Oregon officials had signed off on nearly every detail of training for the first class of “magic” mushroom facilitators seeking state certification. But as the four-day session got underway inside a hotel conference room in early December, an important pedagogical tool was missing: the mushrooms themselves. That’s because state officials, two years after Oregon voters narrowly approved the adult use of psilocybin, were still hammering out the regulatory framework for the production and sale of the tawny hallucinogenic fungi. Instead, the students, most of them seasoned mental health professionals, would have to role play with one another using meditation or intensive breathing practices that could lead to altered states of consciousness — the next best thing to the kind of psychedelic trip they would encounter as licensed guides. Not that anyone was complaining. Like many of the two dozen students who paid nearly $10,000 for the course, Jason Wright, 48, a hospital psychiatric nurse in Portland, said he was thrilled to be part of a bold experiment with national implications. “It’s incredible to be on the front lines of something that has the potential to change our relationship with drugs that should never have been criminalized in the first place,” he said. On Jan. 1, Oregon became the first state in the nation to legalize the adult use of psilocybin, a naturally occurring psychedelic that has shown significant promise for treating severe depression, post-traumatic stress disorder and end-of-life anxiety among the terminally ill, among other mental health conditions. © 2023 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 28617 - Posted: 01.04.2023

How Can Tainted Spinach Cause Hallucinations?

By Yan Zhuang Delirium. Fever. Hallucinations. Not what you expect when adding baby spinach to a salad, but these are among the alarming symptoms dozens of Australians have experienced after consuming what are thought to be contaminated batches of the leafy greens. More than 100 people reported symptoms, including at least 54 who have sought medical help, after eating baby spinach that the authorities believe to be tainted. Four major supermarket chains have recalled products containing the suspect spinach. The authorities said that the spinach had caused “possible food-related toxic reactions” with those affected experiencing symptoms including delirium, hallucinations, blurred vision, rapid heartbeat and fever. Some Australians took to social media to jokingly ask how they could obtain hallucinogenic spinach. “Never have I been so interested in salad,” one Twitter user said. But the authorities have stressed that the symptoms are far from pleasant. “They’re unable to see properly, they’re confused, they’re having hallucinations,” Darren Roberts, the medical director of New South Wales’s Poisons Information Center, said of the victims in an interview on local television. “And we’re talking about scary hallucinations; it’s nothing that’s fun.” Its producer, Riviera Farms in the state of Victoria, said it believed its product had been “contaminated with a weed.” What weed could make spinach hallucinogenic? The health department of the state of Victoria has said that the symptoms suggested “anticholinergic syndrome,” a type of poisoning mainly caused by plants in the Solanaceae family, which includes nightshade, jimson weed and mandrake root. Anticholinergic plants and drugs inhibit the production of a brain chemical called acetylcholine, which is linked to memory, thinking and the visual system, according to Dominic ffytche, a professor of visual psychiatry at King’s College London, who specializes in visual hallucinations (and who really does lowercase his last name). Acetylcholine can also be lost naturally and is linked to Alzheimer’s, some type of dementias and other neurodegenerative diseases, he said. © 2022 The New York Times Company

We thought our dog was having a stroke. She was stoned.

By Susan Coll Last summer, my husband had gone hiking with our two dogs when one of them — a year-old rescue who weighs in at over 50 pounds, can scale steep inclines like a mountain goat and has the speed and grace of an Olympic athlete — suddenly collapsed. Unable to stand, Dafna was disoriented and had also become incontinent. Was it a seizure? A stroke? A snake bite? We piled into our car and headed to an emergency veterinary clinic. I held Dafna’s head in my lap, convinced the end was near. This puppy had destroyed two pairs of my prescription eyeglasses, a new leather wallet, and had torn gashes in my clothes. She’d chewed through my daughter’s internet cords. Still, I loved her like no other. At the clinic, the staff rushed Dafna to a back room with the professionalism expected in a life-or-death situation. But we thought we also noticed a hint of amusement? Even a smirk? A few moments later, we learned why. The vet explained that while they were running a urine test to confirm their suspicions, they were pretty sure Dafna had ingested THC, maybe from a marijuana plant growing wild along the trail, or perhaps she’d eaten a discarded pot roach. Basically, our dog was stoned. It turns out that’s not so unusual these days. In Vermont, where we were and where possession and use of marijuana was legalized in 2018, the vet said she now sees as many as 10 cases per week of pot intoxication. According to ASPCApro and local vets, that’s happening across the country. © 1996-2022 The Washington Post

Largest-ever analysis finds genetic links to smoking and drinking

Miryam Naddaf More than 3,500 genetic variations that potentially affect smoking and drinking behaviour have been identified in a study involving almost 3.4 million people with African, American, East Asian and European ancestry. The findings, published in Nature on 7 December1, highlight how increasing the sample size and ethnic diversity improves the power of such genome-screening analyses — called genome-wide association studies (GWASs) — to reveal how various traits are linked to genes, combinations of genes or mutations. Smoking and drinking are important risk factors for several physical and mental illnesses, including cardiovascular diseases and psychiatric disorders. Although both behaviours are influenced by environmental and social factors, there is evidence that genetics can affect tobacco and alcohol consumption. “We’re at a stage where genetic discoveries are being translated into clinical [applications],” says study co-author Dajiang Liu, a statistical geneticist at Penn State College of Medicine in Hershey, Pennsylvania. “If we can forecast someone's risk of developing nicotine or alcohol dependence using this information, we can intervene early and potentially prevent a lot of deaths.” Scientists use GWASs to find genetic ties to diseases or behaviours by comparing genetic sequences in large numbers of people. But so far, most of these studies have focused on European populations. Liu and his colleagues constructed a model that incorporated the genomic data of 3,383,199 people, 21% of whom had non-European ancestry. They identified 3,823 genetic variants that were associated with smoking or drinking behaviours. Thirty-nine of these were linked with the age at which individuals started smoking, 243 with the number of cigarettes smoked per day and 849 with the number of alcoholic drinks consumed per week.

The final puff?

ByDennis Normile Smoking kills. Ayesha Verrall has seen it up close. As a young resident physician in New Zealand’s public hospitals in the 2000s, Verrall watched smokers come into the emergency ward every night, struggling to breathe with their damaged lungs. Later, as an infectious disease specialist, she saw how smoking exacerbated illness in individuals diagnosed with tuberculosis and HIV/AIDS. She would tell them: “The best thing you can do to promote your health, other than take the pills, is to quit smoking.” Verrall is still urging citizens to give up cigarettes—no longer just one by one, but by the thousands. As New Zealand’s associate minister for health, she has led the development of the Smokefree Aotearoa 2025 Action Plan, which could make New Zealand the first country in the world to achieve smoke-free status—typically defined as an adult smoking rate of no more than 5%. (Aotearoa, loosely “Land of the Long White Cloud,” is a traditional Māori name for the country.) New Zealand’s Parliament is about to vote on the plan, which Chris Bostic, Washington, D.C.–based policy director at Action on Smoking & Health (ASH), calls “a huge deal. This will be the most comprehensive antitobacco policy in history.” Unveiled in December 2021, the plan features three radical interventions. One, called the smoke-free generation strategy, will make it illegal to ever sell combustible tobacco products to those born in 2009 or later. The goal is to create an ever-growing cohort that never picks up the smoking habit. A second provision calls for reducing the number of tobacco retailers by as much as 95%, to make cigarettes harder to get. The boldest proposal in the eyes of experts is reducing cigarettes’ nicotine content to below addictive levels. This “cuts right at the heart of why people smoke in the first place,” says Geoffrey Fong, head of the International Tobacco Control Policy Evaluation Project at the University of Waterloo. It’s potentially a “true game changer in the battle against smoking.”

Deaths From Substance Abuse Rose Sharply Among Older Americans in 2020

By Roni Caryn Rabin Deaths due to substance abuse, particularly of alcohol and opioids, rose sharply among older Americans in 2020, the first year of the coronavirus pandemic, as lockdowns disrupted routines and isolation and fear spread, federal health researchers reported on Wednesday. Alcohol and opioid deaths remained far less common among older people than among those middled-aged and younger, and rates had been rising in all groups for years. But the pronounced uptick — another data point in the long list of pandemic miseries — surprised government researchers. Deaths from opioids increased among Americans aged 65 and older by 53 percent in 2020 over the previous year, the National Center for Health Statistics found. Alcohol-related deaths, which had already been rising for a decade in this age group, rose by 18 percent. “The rate of alcohol deaths in older people is much lower than for younger adults, but the change caught our eye,” said Ellen Kramarow, a health statistician at the center and the lead author of the report, which analyzed death certificate data. Overdose deaths from synthetic opioids account for fewer than 1 percent of deaths in people over 65, Dr. Kramarow noted. “But the shape of the curve jumped out at us,” she said. Physiological changes that occur with aging leave older adults more vulnerable to the ill effects of alcohol and drugs, as metabolism and excretion of substances slow down, increasing the risk of toxicity. Smaller amounts have bigger effects, researchers have found. Alcohol and opioids can interact poorly with prescription medications that many older adults take for common conditions like hypertension, diabetes and mood disorders. Misuse can lead to falls and injuries, exacerbate underlying medical conditions and worsen declines in cognition. © 2022 The New York Times Company

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 11: Emotions, Aggression, and Stress
Link ID: 28581 - Posted: 12.06.2022

New U.S. law promises to light up marijuana research

By Meredith Wadman It just got easier for U.S. scientists to get their hands on some pot—for research, that is. President Joe Biden today signed into law a bill that streamlines access to marijuana for medical research. The new law is expected to speed the issuance of government permits to scientists who want to study cannabis, whose medicinal promise has been widely touted but remains, with a few exceptions, unproven. It will also expedite applications from producers—including universities—that want to grow and distribute the drug for research. It also obliges the federal government to make sure an adequate, uninterrupted supply of marijuana is available to scientists. “We will now be able to treat marijuana like we treat any other substance or pharmaceutical for which we hope there is potential benefit. We will be able to subject it to rigorous scientific trial,” says Representative Andy Harris (R–MD), a physician and former National Institutes of Health (NIH)–funded researcher who helped usher the bipartisan legislation through Congress. “This is exciting,” says Ziva Cooper, the director of the Center for Cannabis and Cannabinoids at the University of California (UC), Los Angeles. “The bill is a significant step forward with respect to chipping away at the barriers” for research. Scientists are eager to study cannabis and its derivatives as potential treatments for cancer, chronic pain, post-traumatic stress disorder, and other conditions. Other cannabis researchers welcomed the new law but said it doesn’t go far enough. In particular, they are disappointed it does not include a provision from an earlier draft of the legislation that would have allowed scientists to buy and study the marijuana available to consumers in the 37 states that have legalized its recreational or medical use.

Why aren’t there more ways to treat alcoholism?

By Katherine Ellison News organizations were quick to trumpet the recent findings of a small study suggesting that “magic mushrooms” could be part of a breakthrough treatment for alcoholism. It’s no wonder. Every year, alcohol abuse kills more than 140,000 Americans and affects millions more, with a steep increase in deaths in recent years, according to data published by the Centers for Disease Control and Prevention on Nov. 4. But excitement about the psilocybin study also raises a question: Why aren’t there more medical treatments for such an obviously devastating problem? “There is a desperate need for new medications, and there are many good avenues that we’re pursuing,” said Dorit Ron, a neurology professor at the University of California at San Francisco Medical Center, who has been studying potential treatments that include rapamycin, a drug designed to help transplant patients tolerate new organs. But getting promising new medications into the hands of doctors and their patients has proved difficult, said George Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), adding “it doesn’t go for lack of trying.” Lack of awareness by doctors, funding decisions by the pharmaceutical industry and the stigma surrounding alcoholism have all held up progress, he said. Can pills help? Ron and other researchers say medication can play a vital role in combating alcohol use disorder, the medical condition commonly known as alcoholism. But fewer than 2 percent of people with an alcohol addiction take medication for the condition, national surveys show, compared with 13.4 percent of those dealing with opioid addiction.

The U.S.’s alcohol-induced death rate rose sharply in the pandemic’s first year

By Aimee Cunningham The death rate from alcohol use rose sharply in the United States in the first year of the pandemic. From 2019 to 2020, the rate of alcohol-induced deaths climbed 26 percent, from 10.4 per 100,000 people to 13.1 per 100,000, researchers report in a National Center for Health Statistics data brief published November 4. The rate of alcohol-induced deaths has generally increased yearly for the last two decades, but the annual uptick tended to be 7 percent or less. Deaths from alcoholic liver disease, which includes hepatitis and cirrhosis, were the most common driver of the increased rate. Deaths from mental and behavioral disorders due to alcohol use — mortality from dependence syndrome or withdrawal, for example — were the second most frequent contributor. The death rate from alcohol use jumped 26 percent overall from 2019 to 2020, a marked increase from previous years. Other researchers have reported that adults were drinking more frequently, and more heavily, early in the pandemic compared with the year before. There is also evidence of an increase in cases of alcoholic liver disease. A study at Johns Hopkins Hospital in Baltimore reported that 2.3 times as many patients with severe alcoholic liver disease and with recent unhealthy drinking were referred to their liver transplant center from July to December of 2020 compared with those months in 2019. © Society for Science & the Public 2000–2022.

The One Where Matthew Perry Writes an Addiction Memoir

By Elisabeth Egan BEVERLY HILLS, Calif. — When I pictured Matthew Perry, the actor frequently known as Chandler Bing, I saw him on the tangerine couch at Central Perk or seated on one of the twin recliners in the apartment he shared with Joey Tribbiani. In September, after arriving at his 6,300-square-foot rental house and being ushered through a driveway gate by his sober companion, I sat across from Perry, who perched on a white couch in a white living room, a world away from “Friends,” the NBC sitcom that aired for 10 seasons and catapulted all six of its stars into fame, fortune and infinite memes. Instead of the foosball table where Chandler, Joey, Monica, Phoebe, Rachel and Ross gathered, nudging each other through the first chapters of adulthood, Perry, 53, had a red felt pool table that looked untouched. There was plenty of light in the house, but not a lot of warmth. I have watched every episode of “Friends” three times — in prime time, on VHS and on Netflix — but I’m not sure I would have recognized Perry if I’d seen him on the street. If he was an ebullient terrier in those 1990s-era Must See TV days — as memorable for his full-body comedy as he was for the inflection that made “Can you BE any more [insert adjective]” the new “Gag me with a spoon” — he now seemed more like an apprehensive bulldog, with the forehead furrows to match. As his former co-star Lisa Kudrow confesses in the foreword to his memoir, “Friends, Lovers and the Big Terrible Thing,” the first question people ask about “Friends” is often “How’s Matthew Perry doing?” Perry answers that question in the book, which Flatiron will publish on Nov. 1, by starkly chronicling his decades-long cage match with drinking and drug use. His addiction led to a medical odyssey in 2018 that included pneumonia, an exploded colon, a brief stint on life support, two weeks in a coma, nine months with a colostomy bag, more than a dozen stomach surgeries, and the realization that, by the time he was 49, he had spent more than half of his life in treatment centers or sober living facilities. © 2022 The New York Times Company

Rise in Deaths Spurs Effort to Raise Alcohol Taxes

By Ted Alcorn Oregon is a drinker’s paradise. The state boasts more craft distilleries than Kentucky and is second only to California in the number of wineries. Some call Portland “beervana” for its bevy of breweries. But Oregon also has among the highest prevalence of problem drinking in the country. Last year, 2,153 residents died of causes attributed to alcohol, according to the Oregon Health Authority — more than twice the number of people killed by methamphetamines, heroin and fentanyl combined. Sonja Grove, a retiree in Portland whose adult son drank himself to death in April 2020, feels the toll is overlooked compared with those of other drugs. “Alcoholism has sort of taken a back seat.” In 2021, confronted by these conflicting trends, as the pandemic raged on, Oregon lawmakers made it easier to drink. They permanently legalized the sale of to-go cocktails, which the Distilled Spirits Council of the United States called a “lifeline,” and increased the number of cases that wineries could ship directly to consumers. Reginald Richardson, director of the state’s Alcohol and Drug Policy Commission, described the policies as incongruent. “We obviously want to create an environment that’s pro-business, that helps the state to develop, but we’ve got this other thing,” he said. That disconnect is typical: Before Covid lockdowns, no state permitted bars or restaurants to deliver liquor to customers at home, according to a trade association. Now, 28 have relaxed the rules. In contrast, policies that experts consider most effective at curbing excessive drinking have been ignored. For example, even as alcohol-related deaths soared to record highs in the last few years, alcohol taxes have fallen to the lowest rates in a generation. Americans drank more during the pandemic, but national data on the change have only recently become available. Alcohol tax revenues collected by the U.S. Treasury Department rose by eight percent in the fiscal year that ended on Sept. 30, 2021, compared with the previous year, and remain well above pre-pandemic levels. © 2022 The New York Times Company

Juul Settles Multistate Youth Vaping Inquiry for $438.5 Million

By Christina Jewett Juul Labs, fighting for its survival in the United States, on Tuesday tentatively agreed to pay $438.5 million to settle an investigation by nearly three dozen states over marketing and sales practices that they contend set off the nation’s teenage vaping crisis. The company said that it did not acknowledge any wrongdoing in the settlement, but that it was trying to “resolve issues from the past” while awaiting a decision by the Food and Drug Administration over whether it would be permitted to continue to sell its products. Juul has been trying to reposition itself as a seller of vaping products that could help adults quit smoking traditional cigarettes, in an effort to rehabilitate its tarnished reputation and improve its diminished market value. The tentative settlement prohibits the company from marketing to youth, funding education in schools and misrepresenting the level of nicotine in its products. But Juul had already discontinued several marketing practices and withdrawn many of its flavored pods that appealed to teenagers, under public pressure from lawmakers, parents and health experts a few years ago when the vaping crisis was at a peak. “We think that this will go a long way in stemming the flow of youth vaping,” William Tong, Connecticut’s attorney general, said at a news conference on Tuesday. “We are under no illusions and cannot claim that it will stop youth vaping. It continues to be an epidemic. It continues to be a huge problem. But we have essentially taken a big chunk out of what was once a market leader.” The multistate investigation found that the company appealed to young people by hiring young models, using social media to court teenagers and giving out free samples, he said. And, he added, the inquiry revealed that the company had a “porous” age verification system for its products and that 45 percent of its Twitter followers were ages 13 to 17. Jason Miyares, the attorney general for Virginia, pointed out in a statement that the company’s former strategy of selling flavors like mango and crème brûlée appealed to youth as did the sleek design of its device that was easy to conceal. One term of the settlement banned the company from depicting anyone under 35 in its marketing images, Mr. Miyares’ statement said. © 2022 The New York Times Company

This Teen Was Prescribed 10 Psychiatric Drugs. She’s Not Alone.

By Matt Richtel This article examines the increase in anxiety, depression, self harm and suicide among U.S. adolescents. Parents and teenagers dealing with these issues can find resources here. One morning in the fall of 2017, Renae Smith, a high school freshman on Long Island, N.Y., could not get out of bed, overwhelmed at the prospect of going to school. In the following days, her anxiety mounted into despair. “I should have been happy,” she later wrote. “But I cried, screamed and begged the universe or whatever godly power to take away the pain of a thousand men that was trapped inside my head.” Intervention for her depression and anxiety came not from the divine but from the pharmaceutical industry. The following spring, a psychiatrist prescribed Prozac. The medication offered a reprieve from her suffering, but the effect dissipated, so she was prescribed an additional antidepressant, Effexor. A medication cascade had begun. During 2021, the year she graduated, she was prescribed seven drugs. These included one for seizures and migraines — she experienced neither, but the drug can be also used to stabilize mood — and another to dull the side effects of the other medications, although it is used mainly for schizophrenia. She felt better some days but deeply sad on others. Her senior yearbook photo shows her smiling broadly, “but I felt terrible that day,” said Ms. Smith, who is now 19 and attends a local community college. “I’ve gotten good at wearing a mask.” She had come to exemplify a medical practice common among her generation: the simultaneous use of multiple heavy-duty psychiatric drugs. Psychiatrists and other clinicians emphasize that psychiatric drugs, properly prescribed, can be vital in stabilizing adolescents and saving the lives of suicidal teens. But, these experts caution, such medications are too readily doled out, often as an easy alternative to therapy that families cannot afford or find, or aren’t interested in. © 2022 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 28450 - Posted: 08.27.2022

Psilocybin Therapy Sharply Reduces Excessive Drinking, Small Study Shows

By Andrew Jacobs A small study on the therapeutic effects of using psychedelics to treat alcohol use disorder found that just two doses of psilocybin magic mushrooms paired with psychotherapy led to an 83 percent decline in heavy drinking among the participants. Those given a placebo reduced their alcohol intake by 51 percent. By the end of the eight-month trial, nearly half of those who received psilocybin had stopped drinking entirely compared with about a quarter of those given the placebo, according to the researchers. The study, published Wednesday in JAMA Psychiatry, is the latest in a cascade of new research exploring the benefits of mind-altering compounds to treat a range of mental health problems, from depression, anxiety and post-traumatic stress disorder to the existential dread experienced by the terminally ill. Although most psychedelics remain illegal under federal law, the Food and Drug Administration is weighing potential therapeutic uses for compounds like psilocybin, LSD and MDMA, the drug better known as Ecstasy. Dr. Michael Bogenschutz, director at NYU Langone Center for Psychedelic Medicine and the study’s lead investigator, said the findings offered hope for the nearly 15 million Americans who struggle with excessive drinking — roughly 5 percent of all adults. Excessive alcohol use kills an estimated 140,000 people each year. “These are exciting results,” Dr. Bogenschutz said. “Alcohol use disorder is a serious public health problem, and the effects of currently available treatments and medications tend to be small.” The double-blind randomized trial followed 93 participants for 32 weeks and divided them into two groups: One received psilocybin and the other a placebo in the form of antihistamine pills. The participants, all of whom struggled with excessive drinking, also took part in 12 therapy sessions that began several weeks before they received their first doses and continued for a month after the final dose. The psilocybin dosage was determined according to participants’ weight, and their heart rate and blood pressure were monitored during the eight-hour sessions. © 2022 The New York Times Company

Use of Marijuana and Psychedelics Is Soaring Among Young Adults

By Andrew Jacobs Marijuana and hallucinogen use among young adults reached an all-time record last year after having leveled off during the first year of the coronavirus pandemic, according to federal survey data. The findings, part of the government’s annual survey of drug use among young Americans, also found that nicotine vaping and excessive alcohol consumption continued to climb in 2021 after a brief pause. Another worrying trend among young people, ages 19 to 30: mounting consumption of alcoholic beverages suffused with THC, the psychoactive ingredient in cannabis. But there were some bright spots in the survey. Cigarette smoking and opioid abuse among young adults dropped last year, a continuing trend that has heartened public health experts. Taken in its entirety, the report provides a mixed picture of substance use in the United States that experts say reflects a number of disparate trends affecting young Americans: the devastating mental health effects of the pandemic; the increased availability of legal marijuana; and the emerging therapeutic embrace of psychedelics to treat depression, post-traumatic stress disorder and other psychological problems. “Overall, the results are very concerning,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which publishes the annual Monitoring the Future survey. “What they tell us is that the problem of substance abuse among young people has gotten worse in this country, and that the pandemic, with all its mental stressors and turmoil, has likely contributed to the rise.” The online survey of people ages 19 to 60 was conducted from April to October 2021. Substance use research experts said the mounting use of marijuana in young adults was especially notable. The survey found that 43 percent in the 19-30 age group had used cannabis 20 or more times over the previous month, up from 34 percent. In 2011, that figure was 29 percent. Daily marijuana consumption also jumped significantly, to 11 percent from 6 percent in 2011. © 2022 The New York Times Company

One of the Best Tools to Manage the Opioid Crisis Already Exists

By Emma Yasinski In the years since a family member of mine started taking methadone, a drug that helps him avoid the excruciating withdrawal symptoms and intense cravings that come with an opioid use disorder, he’s attended the funerals of three of his closest friends with whom he used to use drugs. The number of acquaintances he’s lost is in the double digits. Methadone might have saved them — if only they could have picked it up from their local pharmacy. Like heroin or oxycodone, methadone stimulates the opioid receptors in the brain. The difference is that while heroin rapidly floods these receptors leading to an intense high, the effect of methadone is more gradual and long-lasting. At the appropriate dose, my family member (whom I’m not naming due to the continued stigma surrounding opioids) and other patients can get full days of relief from pain, withdrawal, and cravings, without the intoxication. But methadone is tightly regulated. Rather than pick it up from the local pharmacy, patients have to visit a specialized clinic — often daily — to get each individual dose. In March 2020, concerns about Covid-19 led the Substance Abuse and Mental Health Services Administration, or SAMHSA, to relax those restrictions. The agency announced that states could request an exception allowing clinics to offer a greater amount of take-home doses— up to 28 days — for patients the clinical team believed were stable and could safely handle the medication. Some clinics embraced the opportunity. In a multistate survey of 170 opioid treatment programs, about half followed the relaxed SAMHSA guidelines for newly enrolled or less stable patients. And two-thirds of the clinics surveyed offered their stable patients a full four weeks of take-home doses. The pandemic provided the natural experiment to demonstrate that loosening regulations on methadone in the U.S. was safe for both patients and communities. More than two years later, on July 13, researchers at the National Institute on Drug Abuse and the National Center for Injury Prevention and Control published some of the most powerful results of that experiment. While deadly overdoses involving opioids rose to staggering heights in the U.S. during the first year of the pandemic, the percentage of overdose deaths involving methadone decreased.

An animal tranquilizer is making street drugs even more dangerous

Martha Bebinger Approaching a van that distributes safe supplies for drug use in Greenfield, Mass., a man named Kyle noticed an alert about xylazine. "Xylazine?" he asked, sounding out the unfamiliar word. "Tell me more." A street-outreach team from Tapestry Health delivered what's becoming a routine warning. Xylazine is an animal tranquilizer. It's not approved for humans, but it's showing up in about half of the drug samples that Tapestry tests in the rolling hills of western Massachusetts. It's appearing mostly in the illegal fentanyl supply but also in cocaine. Kyle rocked backward on his heels at the mention of cocaine. He and his friends regularly use cocaine, but lately, they had suspected that something else was in the bag. "The past week, we've all been just racking our brains, like 'What is going on?'" he said. "Because if we cook it up and we smoke it, we're falling asleep after." Kyle's deep sleep might have been triggered by fentanyl too, but Kyle said one of his buddies used a test strip to check for the opioid and none was detected. Xylazine surged first in some areas of Puerto Rico and then in Philadelphia, where it was found in 91% of opioid samples last year, the most recent reporting period. Data from January to mid-June shows that xylazine was in 28% of drug samples tested by the Massachusetts Drug Supply Data Stream (MADDS), a state-funded network of community drug-checking and advisory groups that uses mass spectrometers to let people know what's in bags or pills purchased on the street. Some areas of the state, including western Massachusetts, are seeing xylazine in 50% to 75% of samples. In Greenfield, that's a big change from last year, when xylazine wasn't a concern. © 2022 npr

Breaking Nicotine’s Powerful Draw

By Andrew Jacobs At some point in the next few years, the 30 million smokers in the United States could wake up one day to find that cigarettes sold at gas stations, convenience stores and smoke shops contain such minuscule amounts of nicotine that they cannot get their usual fix when lighting up. Would the smokers be plunged into the agonizing throes of nicotine withdrawal and seek out their favorite, full-nicotine brand on illicit markets, or would they turn to vaping, nicotine gum and other less harmful ways to get that angst-soothing rush? Such scenarios inched closer to the realm of possibility in June, when the Food and Drug Administration said that it would move toward slashing nicotine levels in cigarettes in an effort to reduce the health effects of an addiction that claims 480,000 lives a year. The agency set next May as its timetable for introducing a fully developed proposal. But many experts hope regulators will champion an immediate 95 percent reduction in nicotine levels — the amount federally funded studies have determined is most effective for helping smokers kick the habit. It could be years before any new policy takes effect, if it survives opposition from the tobacco industry. Even so, health experts say any effort to decrease nicotine in cigarettes to nonaddictive levels would be a radical experiment, one that has never been implemented by any other country. The science of nicotine addiction has come a long way since 1964, when a U.S. Surgeon General report first linked smoking to cancer and heart disease, although it would take another two decades for the mechanics of nicotine dependence to be understood and widely accepted. Tobacco contains more than 7,000 chemicals, many of them harmful when burned and inhaled, but it is nicotine that keeps smokers coming back for more. Nicotine stimulates a surge of adrenaline in the brain while indirectly producing a flood of dopamine, the chemical that promotes feelings of contentment and relaxation. The effects, however, are short-lived, which is why heavy smokers need a fresh injection a dozen or more times a day. © 2022 The New York Times Company

Regular coffee drinkers had lower chance of dying in 7-year period

By Linda Searing People who drink a moderate amount of coffee — up to 3½ cups a day — might have a better chance at a longer life span, even if their coffee is lightly sweetened with sugar, according to research published in Annals of Internal Medicine. For about seven years, the researchers tracked the coffee consumption and health of 171,616 participants, who were an average of nearly 56 years old and were free of cancer and cardiovascular disease when the study started. They found that those who regularly drank 1½ to 3½ cups of coffee a day, whether plain or sweetened with about a teaspoon of sugar, were up to 30 percent less likely to die in that time frame from any cause, including cancer and cardiovascular disease, than were those who did not drink coffee. The type of coffee — whether instant, ground or decaffeinated — made no difference, but the results were described as inconclusive for the use of artificial sweeteners. The latest research does not prove that coffee alone was responsible for participants’ lowered mortality risk. Still, over the years, research has revealed a variety of health benefits for coffee, linking its consumption to a reduced risk for Type 2 diabetes, Parkinson’s disease, depression and more. Nutritionists often attribute the benefits of coffee to the abundance of antioxidants in coffee beans, which may help reduce internal inflammation and cell damage and protect against disease. Drinking caffeinated coffee also provides an energy boost and increased alertness. Caffeine, however, can disrupt sleep and be risky during pregnancy.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 28406 - Posted: 07.23.2022

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