Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By Jan Hoffman The death certificate for Ryan Bagwell, a 19-year-old from Mission, Texas, states that he died from a fentanyl overdose. His mother, Sandra Bagwell, says that is wrong. On an April night in 2022, he swallowed one pill from a bottle of Percocet, a prescription painkiller that he and a friend bought earlier that day at a Mexican pharmacy just over the border. The next morning, his mother found him dead in his bedroom. A federal law enforcement lab found that none of the pills from the bottle tested positive for Percocet. But they all tested positive for lethal quantities of fentanyl. “Ryan was poisoned,” Mrs. Bagwell, an elementary-school reading specialist, said. As millions of fentanyl-tainted pills inundate the United States masquerading as common medications, grief-scarred families have been pressing for a change in the language used to describe drug deaths. They want public health leaders, prosecutors and politicians to use “poisoning” instead of “overdose.” In their view, “overdose” suggests that their loved ones were addicted and responsible for their own deaths, whereas “poisoning” shows they were victims. “If I tell someone that my child overdosed, they assume he was a junkie strung out on drugs,” said Stefanie Turner, a co-founder of Texas Against Fentanyl, a nonprofit organization that successfully lobbied Gov. Greg Abbott to authorize statewide awareness campaigns about so-called fentanyl poisoning. “If I tell you my child was poisoned by fentanyl, you’re like, ‘What happened?’” she continued. “It keeps the door open. But ‘overdose’ is a closed door.” © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29191 - Posted: 03.16.2024

By Ben Seal When Oregon’s first psilocybin service center opened in June 2023, allowing those over 21 to take mind-altering mushrooms in a state-licensed facility, the psychedelic revival that had been unfolding over the past two decades entered an important new phase. Psilocybin is still illegal on the federal level. But now, as researchers explore the therapeutic potential of psilocybin and other psychedelics, including LSD and MDMA (also known as Molly or ecstasy), legal reform efforts are spreading across the country — raising tensions between state and federal laws. As a class, psychedelic drugs were outlawed in the United States by the Controlled Substances Act of 1970. The act designated psychedelics as Schedule I drugs — the most restrictive classification, indicating a high potential for abuse and no accepted medical use. That status limits research to federally approved scientific studies and restricts federal funding to research with “significant medical evidence of a therapeutic advantage.” Despite these limitations, researchers have demonstrated the potential of psychedelics in the treatment of post-traumatic stress disorder, major depressive disorder, anxiety and addiction. A 2020 systematic review of recent research found that psychedelics can lessen symptoms linked to a variety of mental health conditions. While that review found no serious, long-term adverse physical or psychological effects from ingesting psychedelics, more research is needed on the latter. Today, decades after research on the effects of hallucinogens on the brain was sidelined by the act, academic and cultural interest in psychedelics is on the rise. More than 60 percent of Americans now support regulated therapeutic use of psychedelics, while nearly half support decriminalization, and nearly 45 percent support spiritual and religious use. An estimated 5.5 million US adults use psychedelics each year.

Keyword: Depression; Drug Abuse
Link ID: 29189 - Posted: 03.16.2024

By Lisa Sanders, M.D. Surrounded by the detritus of a Thanksgiving dinner, the woman was loading the dishwasher when a loud thump thundered through the house. She hurried out of the kitchen to find her husband of 37 years sitting on the second-floor landing. Her son and son-in-law, an emergency-room doctor, crouched at his side. Her husband protested that he was fine, then began to scooch himself on his bottom into the bedroom. The two young men helped him to his feet. The man’s body shook with a wild tremor that nearly knocked him down again. “I was getting into bed and fell,” he explained — though the bed was too far away to make this at all likely. “Get some sleep,” the woman said gently once her husband was settled in the bed. “We’ll go to the hospital in the morning.” Her daughter and son-in-law had arrived that morning and already mentioned the change they noticed in the 70-year-old senior. The normally gregarious man was oddly quiet. And the tremor he had for as long as they could remember was much more prominent. His hands shook so much he had trouble using his fork and ended up eating much of his Thanksgiving dinner with his fingers. And now this fall, this confusion — they were worried. His wife was also worried. Just after Halloween, she traveled for business, and when she came back, her husband was much quieter than usual. Even more concerning: When he spoke, he didn’t always make sense. “Have you had a stroke?” she asked her first day home. He was fine, he insisted. But a few days later she came home from work to find his face covered with cuts. He was shaving, he said, but his hand shook so much that he kept cutting himself. “There is something wrong with me,” he acknowledged. It was Thanksgiving week, but she was able to get him an appointment at his doctor’s office the next day. They were seen by the physician assistant (P.A.). She was kind, careful and thorough. After hearing of his confusion, she asked the man what day it was. “Friday?” he offered uncertainly. It was Wednesday. Could he touch his finger to his nose and then to her finger, held an arm’s length away? He could not. His index finger carved jagged teeth in the air as he sought his own nose then stretched to touch her finger. And when she asked him to stand, his entire body wobbled dangerously. “It’s all happened so quickly,” the man’s wife said. The P.A. reviewed his lab tests. They were all normal. She then ordered an M.R.I. of the brain. That, she explained, should give them a better idea of what direction to take. But, she added, if he falls or seems © 2024 The New York Times Company

Keyword: Neurotoxins; Movement Disorders
Link ID: 29182 - Posted: 03.07.2024

By Andrew Jacobs Ibogaine, a formidable hallucinogen made from the root of a shrub native to Central Africa, is not for the timid. It unleashes a harrowing psychedelic trip that can last more than 24 hours, and the drug can cause sudden cardiac arrest and death. But scientists who have studied ibogaine have reported startling findings. According to a number of small studies, between a third and two-thirds of the people who were addicted to opioids or crack cocaine and were treated with the compound in a therapeutic setting were effectively cured of their habits, many after just a single session. Ibogaine appears to provide two seemingly distinct benefits. It quells the agony of opioid withdrawal and cravings and then gives patients a born-again-style zeal for sobriety. Now, after decades in the shadows, and with opioid overdose deaths exceeding 100,000 a year, ibogaine is drawing a surge of fresh interest from researchers who believe it has the potential to treat opioid use disorder. “It’s not an exaggeration to say that ibogaine saved my life, allowed me to make amends with the people I hurt and helped me learn to love myself again,” said Jessica Blackburn, 37, who is recovering from heroin addiction and has been sober for eight years. “My biggest frustration is that more people don’t have access to it.” That’s because ibogaine is illegal in the United States. Patients have to go abroad for ibogaine therapy, often at unregulated clinics that provide little medical oversight. Kentucky and Ohio are considering proposals to spend millions of dollars of opioid settlement money on clinical trials for ibogaine therapy. And federal drug researchers have signaled a willingness to allow the drug to be studied again — more than 40 years after regulators pulled the plug on research over concerns about the drug’s cardiac risks. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29179 - Posted: 03.05.2024

By Benjamin Ryan People who frequently smoke marijuana have a higher risk of heart attack and stroke, according to a study published on Wednesday. The article, published in The Journal of the American Heart Association, is an analysis of responses to the U.S. government’s annual survey on behavioral risk from 2016 to 2020. The respondents answered health questions, including reporting their own health problems related to heart disease. About 4 percent of the respondents reported daily marijuana use, which the researchers suggested raised the chance of a heart attack by 25 percent and of a stroke by 42 percent. Among those who never smoked tobacco, daily use was tied to a 49 percent higher risk of heart attack and a more than doubled risk of stroke, the study indicated. About three-quarters of the respondents said that smoking was their main method of using weed. The other quarter consumed it by vaping, through edibles or drinking it. “Cannabis smoke releases the same toxins and particulate matter that tobacco does,” said the study’s first author, Abra M. Jeffers, a data analyst at Massachusetts General Hospital in Boston. She conducted the analysis during her post-doctoral fellowship at the University of California, San Francisco. The study is merely observational in its review of survey responses; it does not provide conclusive evidence that regular marijuana use causes heart disease. Even so, researchers and experts said they were concerned about its implications, especially as cannabis use has increased in recent years. Thirty-eight states have legalized medical use of marijuana, and 24 have begun allowing recreational use. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29168 - Posted: 02.29.2024

By David Ovalle Keifer Geers was born with a hole in his diaphragm that led to painful surgeries in adulthood. Despite physical challenges that included deafness, Geers graduated from Texas A&M University with a degree in biomedical engineering. He hoped to one day create medical devices for disabled children and wounded veterans. On a spring day as Geers walked with his mother through an airport in Midland, Tex., he stumbled, then collapsed into a seizure, his face contorted in shock. Geers, 33, was pronounced dead at a hospital. His mother later found inside his suitcase several packages of powder kratom, an herbal product he consumed to manage pain from surgeries. Patricia Geers said she was stunned when an autopsy concluded that her son died from the toxic effects of kratom — levels in his blood were more than nine times what some experts believe can prove lethal. The death of Keifer Geers was hardly an isolated episode. A Washington Post review of federal and state statistics shows that medical examiners and coroners are increasingly blaming deaths on kratom — it was listed as contributing to or causing at least 4,100 deaths in 44 states and D.C. between 2020 and 2022. The vast majority of those cases involved other drugs in addition to kratom, which is made from the leaves of tropical trees. Still, the kratom-involved deaths account for a small fraction of the more than 300,000 U.S. overdose deaths recorded in those three years. Dozens of wrongful death lawsuits involving kratom have been filed nationwide — including by Geers’s mother, who in February sued a Nevada retailer. The suits illustrate increased scrutiny of deaths involving products made from kratom, which is banned in six states but remains widely available online and in vape and convenience stores despite health warnings from federal authorities.

Keyword: Drug Abuse
Link ID: 29155 - Posted: 02.22.2024

By Erin Garcia de Jesús DENVER — A weight-loss drug used to treat obesity and diabetes has shown promise to treat another disorder: opioid addiction. Early results from a small clinical trial, presented February 17 at the annual meeting of the American Association for the Advancement of Science, suggest that a close relative of the weight-loss drugs Wegovy and Ozempic significantly lessened cravings for opioids in people with opioid use disorder. “For them to have any time when they might be free of that craving seems to be very hopeful,” Patricia “Sue” Grigson, a behavioral neuroscientist at Penn State College of Medicine in Hershey said at the conference. The vast majority of drug overdose deaths in the United States are due to opioids (SN: 2/14/24). The drug, called liraglutide, mimics a hormone called GLP-1 that the body releases after people eat. Wegovy and Ozempic — brand names for semaglutide, a molecule that induces weight loss more effectively than liraglutide — also imitate the hormone. It’s unclear exactly how the drugs work when it comes to weight loss, but researchers think such GLP-1 dupes prompt the body and brain to make people feel full (SN: 12/13/23). There are hints that such drugs could work for addiction, too. People taking Wegovy or Ozempic have reported lessened desire for not just food but also alcohol and nicotine. What’s more, Grigson and colleagues showed in a previous study in rats that liraglutide can cut down on heroin-seeking behavior, perhaps by changing the animals’ brain activity (SN: 8/30/23). © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse; Obesity
Link ID: 29150 - Posted: 02.20.2024

By Benjamin Breen When I began researching Tripping on Utopia in 2018, I was aware that many midcentury scientists and psychiatrists had shown a keen interest in the promise of psychedelics. But what I didn’t realize was how remarkably broad-based this interest was. As I dug deeper into the archival record, I was struck by the public enthusiasm for the use of substances like LSD and mescaline in therapy—as manifested not just in scientific studies, but in newspaper articles and even television specials. (My favorite is this remarkable 1957 broadcast which shows a woman taking LSD on camera, then uttering memorable lines like “I’ve never seen such infinite beauty in my life” and “I wish I could talk in Technicolor.”) Above all, I was surprised by the public response to the Hollywood actor Cary Grant’s reveal that he was regularly using LSD in psychedelic therapy sessions. In a series of interviews starting in 1959—the same year he starred in North by Northwest—Grant went public as an unlikely advocate for psychedelic therapy. It was the surprisingly positive reaction to Grant’s endorsement that most struck me. As recounted in my book, the journalist who broke the story was overwhelmed by phone calls and letters. “Psychiatrists called, complaining that their patients were now begging them for LSD,” he remembered. “Every actor in town under analysis wanted it.” Nor was this first wave of legal psychedelic therapy restricted to Hollywood. Two other very prominent advocates of psychedelic therapy in the late 1950s were former Congresswoman Clare Boothe Luce and her husband Henry Luce, the founder of Time and Life magazines. It is not an exaggeration to say that this married couple dominated the media landscape of the 20th century. Nor is it an exaggeration to say that psychedelics profoundly influenced Clare Boothe Luce’s life in the late 1950s. She credited LSD with transformative insights that helped her to overcome lasting trauma associated with her abusive childhood and the death of her only daughter in a car accident. © 2024 NautilusNext Inc.,

Keyword: Drug Abuse; Consciousness
Link ID: 29142 - Posted: 02.10.2024

Rhitu Chatterjee In recent years, there's been growing interest in psilocybin, the psychoactive ingredient in "magic mushrooms" or "shrooms" as a potentially beneficial therapy for mental health conditions. At the same time, drug busts of mushrooms went way up between 2017 and 2022, and the amount of the psychedelic substance seized by law enforcement more than tripled, according to a new study. "What I think the results indicate is that shroom availability has likely been increasing," says Joseph Palamar, an epidemiologist at NYU Langone Health and the main author of the new study published in the journal Drug and Alcohol Dependence. Sponsor Message The findings come at a time when there's a "psychedelic renaissance" happening in the country, says Dr. Joshua Siegel of Washington University in St. Louis, who wasn't involved in the new study. There's growing public and scientific interest in psychedelics' potential therapeutic effects on various mental and behavioral health issues, says Siegel, who also studies how psychedelics affect the human brain. At the same time, a small number of states have already decriminalized psychedelic drugs, and many more are looking into doing the same. The new study is "an important part of the bigger picture of where we are headed as a nation" with psychedelics, says Siegel. "It's important to understand what's happening in terms of the health care side of things. It's important to understand what's happening recreationally and legally." The new study found that the total amount of mushrooms seized by law enforcement across the country went from nearly 500 pounds in 2017 to more than 1,800 pounds in 2022. The largest amount (42.6% of total) seized was in the West, followed closely by the Midwest (41.8%). © 2024 npr

Keyword: Drug Abuse; Depression
Link ID: 29141 - Posted: 02.08.2024

By Ernesto Londoño Seizures of psychedelic mushrooms across the nation by law enforcement officials have increased significantly in recent years as attitudes regarding their use have grown more permissive, according to a government-funded study released Tuesday. Researchers found that law enforcement officials confiscated 844 kilos of mushrooms containing psilocybin in 2022, an increase of 273 percent from 2017. Psilocybin is the psychoactive component in the fungi commonly known as magic mushrooms. Officials at the National Institute on Drug Abuse, which commissioned the study, said that the increase in seizures of magic mushroom reflected rising use of the drugs, rather than an indication that counternarcotics officials were pursuing the substances more aggressively than before. The marketplace for magic mushrooms, which are illegal under federal law, has boomed in recent years as several clinical studies have shown that they may be effective as therapies to treat depression and other serious conditions. But many medical professionals say they worry that the hype surrounding psychedelics has moved faster than the science. Dr. Nora Volkow, the director of the N.I.D.A, said that preliminary clinical studies had shown that psychedelics might one day become an important tool for the treatment of psychiatric disorders, including addiction to other drugs. But she said she worried that many people were self-medicating with psychedelics. “Psychedelic drugs have been promoted as a potential cure for many health conditions without adequate research to support these claims,” Dr. Volkow said. “There are people who are very desperate for mental health care, and there are businesses that are very eager to make money by marketing substances as treatments or cures.” © 2024 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 29130 - Posted: 02.06.2024

Dawn Megli In late 2022, Sarah Gutilla's treatment-resistant depression had grown so severe that she was actively contemplating suicide. Raised in foster care, the 34-year-old's childhood was marked by physical violence, sexual abuse and drug use, leaving her with life-threatening mental scars. Out of desperation, her husband scraped together $600 for the first of six rounds of intravenous ketamine therapy at Ketamine Clinics Los Angeles, which administers the generic anesthetic for off-label uses such as treating depression. When Gutilla got into an Uber for the 75-mile ride to Los Angeles, it was the first time she had left her home in Llano, Calif., in two years. The results, she says, were instant. "The amount of relief I felt after the first treatment was what I think 'normal' is supposed to feel like," she says. "I've never felt so OK and so at peace." For-profit ketamine clinics have proliferated over the past few years, offering infusions for a wide array of mental health issues, including obsessive-compulsive disorder, depression and anxiety. Although the off-label use of ketamine hydrochloride, a Schedule III drug approved by the Food and Drug Administration as an anesthetic in 1970, was considered radical just a decade ago, now between 500 and 750 ketamine clinics have cropped up across the United States. Market analysis firm Grand View Research pegged industry revenues at $3.1 billion in 2022, and it projects them to more than double to $6.9 billion by 2030. Most insurance doesn't cover ketamine for mental health, so patients must pay out-of-pocket. While it's legal for doctors to prescribe ketamine, the FDA hasn't approved it for mental health treatment, which means that individual practitioners develop their own treatment protocols. The result is wide variability among providers, with some favoring gradual, low-dosage treatments while others advocate larger amounts that can induce hallucinations, as the drug is a psychedelic at the right doses. "Ketamine is the Wild West," says Dustin Robinson, the managing principal of Iter Investments, a venture capital firm specializing in hallucinogenic drug treatments. © 2024 npr

Keyword: Depression; Drug Abuse
Link ID: 29129 - Posted: 02.03.2024

By Jyoti Madhusoodanan On July 12, 2015, Elena Daly was packing for a family vacation when she walked into her 16-year-old son’s room and found him unconscious. Her son, Max, had overdosed on opioids, aspirated vomit, and fallen into a coma. By that point, Max had struggled with addiction for about three years. He had tried medication, therapy, and residential treatment programs in France, where the family lives, as well as in the United States and the United Kingdom. In fact, his July relapse occurred just days after returning home from a six-month stint in an in-patient rehab program. The coma lasted three days and worsened a pre-existing movement disorder to a degree where Max was unable to attend high school. “I couldn’t hold a pen without throwing it across the room or hold a cup of coffee without spilling it on myself,” he recently recalled. Max’s struggles with opioid use are not unusual: An estimated 40 to 60 percent of people who have an addiction experience relapse after treatment. Some researchers have suggested that a substantial portion of those who relapse suffer from what might be considered a “treatment-resistant” form of the disorder, though that condition is not formally recognized as a medical diagnosis. In recent years, scientists have explored treating these intractable cases of opioid dependence with deep brain stimulation, an intervention that entails surgically implanting an electrode into a precisely determined region of the brain, where it delivers regular pulses to control problematic electric signals. The surgery has proven effective for neurological conditions such as Parkinson’s disease and essential tremor, a disorder that can cause a person’s limbs, head, trunk, and voice to quake. But for researchers attempting to study its efficacy for addiction, the procedure’s invasiveness and cost — typically in the hundreds of thousands of dollars — have raised steep hurdles. Work in the field has largely been limited to one-off treatments and small studies with one or a few participants, making it tough to ascertain how many people globally have received the treatment or how successful it has been for them.

Keyword: Drug Abuse
Link ID: 29121 - Posted: 01.31.2024

By Ewen Callaway Researchers have used the protein-structure-prediction tool AlphaFold to identify1 hundreds of thousands of potential new psychedelic molecules — which could help to develop new kinds of antidepressant. The research shows, for the first time, that AlphaFold predictions — available at the touch of a button — can be just as useful for drug discovery as experimentally derived protein structures, which can take months, or even years, to determine. The development is a boost for AlphaFold, the artificial-intelligence (AI) tool developed by DeepMind in London that has been a game changer in biology. The public AlphaFold database holds structure predictions for nearly every known protein. Protein structures of molecules implicated in disease are used in the pharmaceutical industry to identify and improve promising medicines. But some scientists had been starting to doubt whether AlphaFold’s predictions could stand in for gold standard experimental models in the hunt for new drugs. “AlphaFold is an absolute revolution. If we have a good structure, we should be able to use it for drug design,” says Jens Carlsson, a computational chemist at the University of Uppsala in Sweden. Efforts to apply AlphaFold to finding new drugs have been met with considerable scepticism, says Brian Shoichet, a pharmaceutical chemist at the University of California, San Francisco. “There is a lot of hype. Whenever anybody says ‘such and such is going to revolutionize drug discovery’, it warrants some scepticism.” Shoichet counts more than ten studies that have found AlphaFold’s predictions to be less useful than protein structures obtained with experimental methods, such as X-ray crystallography, when used to identify potential drugs in a modelling method called protein–ligand docking. © 2024 Springer Nature Limited

Keyword: Drug Abuse
Link ID: 29110 - Posted: 01.23.2024

Karla Kaun Many people are wired to seek and respond to rewards. Your brain interprets food as rewarding when you are hungry and water as rewarding when you are thirsty. But addictive substances like alcohol and drugs of abuse can overwhelm the natural reward pathways in your brain, resulting in intolerable cravings and reduced impulse control. A popular misconception is that addiction is a result of low willpower. But an explosion of knowledge and technology in the field of molecular genetics has changed our basic understanding of addiction drastically over the past decade. The general consensus among scientists and health care professionals is that there is a strong neurobiological and genetic basis for addiction. As a behavioral neurogeneticist leading a team investigating the molecular mechanisms of addiction, I combine neuroscience with genetics to understand how alcohol and drugs influence the brain. In the past decade, I have seen changes in our understanding of the molecular mechanisms of addiction, largely due to a better understanding of how genes are dynamically regulated in the brain. New ways of thinking about how addictions form have the potential to change how we approach treatment. Each of your brain cells has your genetic code stored in long strands of DNA. For all that DNA to fit into a cell, it needs to be packed tightly. This is achieved by winding the DNA around “spools” of protein called histones. Areas where DNA is unwound contain active genes coding for proteins that serve important functions within the cell. When gene activity changes, the proteins your cells produce also change. Such changes can range from a single neuronal connection in your brain to how you behave. This genetic choreography suggests that while your genes affect how your brain develops, which genes are turned on or off when you are learning new things is dynamic and adapts to suit your daily needs. © 2010–2024, The Conversation US, Inc.

Keyword: Drug Abuse; Epigenetics
Link ID: 29108 - Posted: 01.23.2024

By Lauren Peace Tampa Bay Times Nina Shand couldn’t stay awake. She had taken afternoon naps since she was a teenager to accommodate her “work hard, play hard” attitude, but when she was in her mid-20s the sleepiness became more severe. Menial computer tasks put her to sleep, and a 20-minute drive across her city, St. Petersburg, Florida, brought on a drowsiness so intense that her eyelids would flutter, forcing her to pull over. She knew something was really wrong when she no longer felt safe behind the wheel. In 2021, she received a diagnosis: narcolepsy, a rare disorder that causes excessive daytime sleepiness. Her doctor prescribed her Adderall, the brand-name version of the amphetamine-powered medication commonly known for treating attention-deficit/hyperactivity disorder. It worked. For the first time in years, Shand, now 28, felt energized. She was no longer struggling at work, sneaking naps, or downing coffees to trick her body into staying awake. She felt hope. But by 2022, a national Adderall shortage meant pharmacies were no longer able to fill her prescription. Shand and countless others across the country were being turned away, left to piece together a new — and often less effective — treatment plan with doctors scrambling to meet their needs. More than a year later, the shortage continues. In October, Democrats in the U.S. House of Representatives implored the FDA and Drug Enforcement Administration to work with drug manufacturers to ensure better supply. “We cannot allow this to be the continuing reality for Americans,” read their letter, led by Rep. Abigail Spanberger (D-Va.). But for now, it is.

Keyword: Sleep; Drug Abuse
Link ID: 29102 - Posted: 01.16.2024

By Meryl Davids Landau When Brian Meyer received a Stage 4 prostate cancer diagnosis three years ago at age 62, he was determined to make the most of his remaining years. He immediately retired from a decades-long career in the grocery business and took every opportunity to hike, camp and — his all-time favorite — fish for salmon. Brian and his wife, Cheryl, regularly visited their two grown children and three grandsons and spent time with their many friends. But it was sometimes hard to keep his mind off his pain and the reality that life was nearing an end. “It tugs at the heart all the time,” Meyer, from Vancouver Island, British Columbia, said in August. A calm person by nature, he found his anxiety skyrocketing. By November, though, despite a new, highly aggressive liver cancer that shrank his prognosis to months or weeks, Meyer felt calm much of the time. The prime reason: a 25-milligram dose of the psychedelic drug psilocybin he had taken several months earlier, due to a Canadian program being watched elsewhere for the emotional benefits it may offer people nearing death. In mid-August, Meyer and nine other people with terminal cancers had gathered in two rooms, and there, lying on plush floor mats with blankets covering their bodies, their eyes covered by sleeping masks and music piped in over headphones, they swallowed the psilocybin capsules. The consciousness-altering drug, administered by the nonprofit Vancouver Island wellness center Roots to Thrive, set Meyer and the others on a six-hour journey of fantastical images and thoughts. The hope was that this “trip” would lead to lasting improvements in mood and lessen their angst around death. It was accompanied by weeks of Zoom group therapy sessions before and after, along with an in-person gathering the evening before for a medical clearance and the opportunity for participants and their spouses to meet in person.

Keyword: Drug Abuse; Stress
Link ID: 29100 - Posted: 01.16.2024

By Christina Jewett and Noah Weiland Marijuana is neither as risky nor as prone to abuse as other tightly controlled substances and has potential medical benefits, and therefore should be removed from the nation’s most restrictive category of drugs, federal scientists have concluded. The recommendations are contained in a 250-page scientific review provided to Matthew Zorn, a Texas lawyer who sued Health and Human Services officials for its release and published it online on Friday night. An H.H.S. official confirmed the authenticity of the document. The records shed light for the first time on the thinking of federal health officials who are pondering a momentous change. The agencies involved have not publicly commented on their debates over what amounts to a reconsideration of marijuana at the federal level. Since 1970, marijuana has been considered a so-called Schedule I drug, a category that also includes heroin. Schedule I drugs have no medical use and a high potential for abuse, and they carry severe criminal penalties under federal trafficking laws. The documents show that scientists at the Food and Drug Administration and the National Institute on Drug Abuse have recommended that the Drug Enforcement Administration make marijuana a Schedule III drug, alongside the likes of ketamine and testosterone, which are available by prescription. The review by federal scientists found that even though marijuana is the most frequently abused illicit drug, “it does not produce serious outcomes compared to drugs in Schedules I or II.” Marijuana abuse does lead to physical dependence, the analysis noted, and some people develop a psychological dependence. “But the likelihood of serious outcomes is low,” the review concluded. The review also said there is some “scientific support” for therapeutic uses of marijuana, including treatment of anorexia, pain, and nausea and vomiting related to chemotherapy. © 2024 The New York Times Company

Keyword: Drug Abuse
Link ID: 29097 - Posted: 01.13.2024

By Aimee Cunningham Ask thousands of teens whether frequent use of certain substances brings a high risk of harm, and they mostly nail it: a majority say yes for cigarettes, alcohol, cocaine and heroin. But there’s one substance that many skip over — cannabis. Only 35 percent of 12- to 17-year-olds perceive a “great risk of harm” from smoking marijuana once or twice a week, according to the National Survey on Drug Use and Health. It’s a sentiment that some of their parents may share. Parents often don’t understand that the products used today “are not what they knew when they were in high school,” says Kelly Young-Wolff, a licensed clinical psychologist and research scientist at Kaiser Permanente Northern California Division of Research in Oakland. If their children are using cannabis, parents may think, “‘it’s not that bad, at least they’re not using this other drug that’s worse.’” But the cannabis products available now are leaps and bounds more potent — which may increase the risks for addiction and psychosis — than in the past. Marijuana plants have been bred to contain more delta-9-tetrahydrocannabinol, or THC, the main psychoactive chemical. In 1995, the total percent of THC by weight of marijuana plant material was around 4 percent; now marijuana with a THC potency of 20 percent or more is available. Trouncing that are concentrated cannabis products, including wax, budder and shatter, which can have a THC potency as high as 95 percent. Cannabis is legal for adults to use recreationally in 24 states and Washington, D.C., and is allowed for medical use in 38 states and D.C. The widespread availability of cannabis “promotes the idea that it’s safe,” says pediatrician Beth Ebel of the University of Washington School of Medicine and Seattle Children’s Hospital. But that “is an incorrect assumption.” THC can impact brain chemistry “in a way that wasn’t intended,” Ebel says. “Some of the worst effects can have lifelong health consequences, especially for a young person.” © Society for Science & the Public 2000–2024.

Keyword: Drug Abuse; Development of the Brain
Link ID: 29083 - Posted: 01.06.2024

By Catherine Pearson Dry January sounds like a simple proposition: No alcohol. For 31 days. And some enthusiasts jump in without much planning — perhaps even hungover after a rowdy New Year’s Eve. There is no data suggesting that those folks won’t be able to abstain from drinking, said Dr. David Wolinsky, an assistant professor of psychiatry and behavioral sciences with Johns Hopkins Medicine, who specializes in addiction. But starting the month with a few strategies in your back pocket — and with a clear sense of your goals — may help you get the most out of the challenge. “Most of the benefits of Dry January are probably going to be related to the intention with which you go into Dry January,” Dr. Wolinsky said. The challenge isn’t a stand-in for treatment for people with alcohol use disorder, he stressed, but those who are looking to get a fresh start to the year may benefit from the mental and physical reset it can offer, and the opportunity to adopt new habits. For instance, a 2016 study found that six months after Dry January ended, participants were drinking less than they were before. We spoke to Dr. Wolinsky and other experts about some strategies for a successful month. One of the simplest steps is to spread the word among friends and family that you intend to take the month off, said Casey McGuire Davidson, a sobriety coach and host of “The Hello Someday Podcast,” which focuses on “sober-curious” topics. Research has shown that accountability can play a critical role in helping habits stick, and you might find a friend or partner to join you, Ms. Davidson suggested. Even if you don’t, you may be surprised by how encouraging people are of your goal (though she said you should share it only with people you trust). “Dry January gives people a period of time when they can stop drinking with community and support,” she said, “without a lot of questions.” Ms. Davidson also recommended reading books that may help you evaluate your relationship with alcohol, or listening to sobriety podcasts. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29071 - Posted: 12.31.2023

By Andrew Jacobs An autopsy report released by the Los Angeles County medical examiner on Friday said the death of “Friends” actor Matthew Perry, who was found face down and unresponsive in a hot tub at his home on Oct. 28, resulted from the “acute effects” of ketamine, an anesthetic with psychedelic properties. Ketamine has become increasingly popular as a therapy for treatment-resistant depression and other mental health issues. It is also used recreationally. Mr. Perry had publicly acknowledged his long struggle with alcohol and drug use, but the report said he had been sober for 19 months and little was known about his relationship to ketamine. What is ketamine, and is it legal? Ketamine is an injectable, short-acting dissociative anesthetic that can have hallucinogenic effects at certain doses. It distorts perceptions of sight and sound and makes users feel detached from pain and their surroundings. Developed as a battlefield anesthetic in the 1960s, ketamine has been legal since 1970 for use in both people and animals. It is frequently used as an anesthetic for children, especially in the developing world. But the psychiatric use of ketamine is still unapproved and unregulated, although it is increasingly used off label for treating depression, suicidal ideation and chronic pain In 2019, the Food and Drug Administration approved a derivative of ketamine called esketamine in a nasal spray for treatment-resistant depression. Ketamine has the potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence, but experts consider it a safe medication. Those who use it recreationally often snort the drug in powder form or administer it intranasally by spray. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29057 - Posted: 12.19.2023