Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology

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By Emily Willingham As anyone who’s dealt with substance addiction can tell you, breaking the physical intimacy with the drug isn’t always the most challenging part of treatment. People trying to avoid resurrecting their addiction also must grapple with reminders of it: the sights, sounds and people who were part of their addictive behaviors. These cues can trigger a craving for the drug, creating anxiety that steers them straight back into addiction for relief. The opioid epidemic in the United States has taken more than 300,000 lives, and support for people working to keep these drugs out of their orbit has become crucial. Methadone and buprenorphine, the current medical treatment options, help break the physical craving for opioids by targeting the same pathways that opioids use. Although these drugs can ease physical need, they don’t quiet the anxiety that environmental cues can trigger, leaving open a door to addiction reentry. The cannabis compound cannabidiol (CBD), a nonpsychoactive component of cannabis, might be the key to keeping that door locked. Researchers report that among people with opioid addiction, CBD dampens cue-triggered cravings and anxiety, along with reducing stress hormone levels and heart rate. The results were published May 21 in the American Journal of Psychiatry. “These findings provide support for an effect of cannabidiol on this process,” says Kathryn McHugh, assistant professor in the department of psychiatry at Harvard Medical School’s Division of Alcohol and Drug Abuse, who was not involved in the study. However, she cautions, the results are preliminary, and behavioral therapies are also quite effective at dimming the signal from cues. © 2019 Scientific American

Keyword: Drug Abuse; Depression
Link ID: 26260 - Posted: 05.22.2019

Alison Abbott Pharmacologists gave mescaline a fair trial. In the early and mid-twentieth century, it seemed more than plausible that the fashionable hallucinogen could be tamed into a therapeutic agent. After all, it had profound effects on the human body, and had been used for centuries in parts of the Americas as a gateway to ceremonial spiritual experience. But this psychoactive alkaloid never found its clinical indication, as science writer Mike Jay explains in Mescaline, his anthropological and medical history. In the 1950s, the attention of biomedical researchers abruptly switched to a newly synthesized molecule with similar hallucinogenic properties but fewer physical side effects: lysergic acid diethylamide, or LSD. First synthesized by Swiss scientist Albert Hofmann in 1938, LSD went on to become a recreational drug of choice in the 1960s hippy era. And, like mescaline, it teased psychiatrists without delivering a cure. Jay traces the chronology of mescaline use. The alkaloid is found in the fast-growing San Pedro cactus (Echinopsis pachanoi) that towers above the mountainous desert scrub of the Andes, and the slow-growing, ground-hugging peyote cactus (Lophophora williamsii) native to Mexico and the southwestern United States. Archaeological evidence suggests that the use of these cacti in rites of long-vanished cultures goes back at least 5,000 years. © 2019 Springer Nature Publishing AG

Keyword: Drug Abuse; Depression
Link ID: 26255 - Posted: 05.21.2019

By Jane E. Brody One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain. In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes. The drug was initially approved 25 years ago to treat seizure disorders, but it is now commonly prescribed off-label to treat all kinds of pain, acute and chronic, in addition to hot flashes, chronic cough and a host of other medical problems. The F.D.A. approves a drug for specific uses and doses if the company demonstrates it is safe and effective for its intended uses, and its benefits outweigh any potential risks. Off-label means that a medical provider can legally prescribe any drug that has been approved by the Food and Drug Administration for any condition, not just the ones for which it was approved. This can leave patients at the mercy of what their doctors think is helpful. Thus, it can become a patient’s job to try to determine whether a medication prescribed off-label is both safe and effective for their particular condition. This is no easy task even for well-educated doctors, let alone for desperate patients in pain. Two doctors recently reviewed published evidence for the benefits and risks of off-label use of gabapentin (originally sold under the trade name Neurontin) and its brand-name cousin Lyrica (pregabalin) for treating all kinds of pain. (There is now also a third drug, gabapentin encarbil, sold as Horizant, approved only for restless leg syndrome and postherpetic neuralgia, which can follow a shingles outbreak.) © 2019 The New York Times Company

Keyword: Pain & Touch; Drug Abuse
Link ID: 26253 - Posted: 05.21.2019

By Kim Tingley Humans have been drinking fermented concoctions since the beginning of recorded time. But despite that long relationship with alcohol, we still don’t know what exactly the molecule does to our brains to create a feeling of intoxication. Likewise, though the health harms of heavy drinking are fairly obvious, scientists have struggled to identify what negative impacts lesser volumes may lead to. Last September, the prestigious peer-reviewed British medical journal The Lancet published a study that is thought to be the most comprehensive global analysis of the risks of alcohol consumption. Its conclusion, which the media widely reported, sounded unequivocal: “The safest level of drinking is none.” Sorting through the latest research on how to optimize your well-being is a constant and confounding feature of modern life. A scientific study becomes a press release becomes a news alert, shedding context at each stage. Often, it’s a steady stream of resulting headlines that seem to contradict one another, which makes it easy to justify ignoring them. “There’s so much information on chocolate, coffee, alcohol,” says Nicholas Steneck, a former consultant to the Office of Research Integrity for the U.S. Department of Health and Human Services. “You basically believe what you want to believe unless people are dropping dead all over the place.” Scientific studies are written primarily for other scientists. But to make informed decisions, members of the general public have to engage with them, too. Does our current method of doing so — study by study, conclusion by conclusion — make us more informed as readers or simply more mistrustful? As Steneck asks: “If we turn our back on all research results, how do we make decisions? How do you know what research to trust?” It’s a question this new monthly column aims to explore: What can, and can’t, studies tell us when it comes to our health? © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26240 - Posted: 05.17.2019

By MOISES VELASQUEZ-MANOFF When Catherine Jacobson first heard about the promise of cannabis, she was at wits’ end. Her 3-year-old son, Ben, had suffered from epileptic seizures since he was 3 months old, a result of a brain malformation called polymicrogyria. Over the years, Jacobson and her husband, Aaron, have tried giving him at least 16 different drugs, but none provided lasting relief. They lived with the grim prognosis that their son — whose cognitive abilities never advanced beyond those of a 1-year-old — would likely continue to endure seizures until the cumulative brain injuries led to his death. In early 2012, when Jacobson learned about cannabis at a conference organized by the Epilepsy Therapy Project, she felt a flicker of hope. The meeting, in downtown San Francisco, was unlike others she had attended, which were usually geared toward lab scientists and not directly focused on helping patients. This gathering aimed to get new treatments into patients’ hands as quickly as possible. Attendees weren’t just scientists and people from the pharmaceutical industry. They also included, on one day of the event, families of patients with epilepsy. The tip came from a father named Jason David, with whom Jacobson began talking by chance outside a presentation hall. He wasn’t a presenter or even very interested in the goings-on at the conference. He had mostly lost faith in conventional medicine during his own family’s ordeal. But he claimed to have successfully treated his son’s seizures with a cannabis extract, and now he was trying to spread the word to anyone who would listen. The idea to try cannabis extract came to David after he found out that the federal government held a patent on cannabidiol, a molecule derived from the cannabis plant that is commonly referred to as CBD. Unlike the better-known marijuana molecule delta-9-tetrahydrocannabinol, or THC, CBD isn’t psychoactive; it doesn’t get users high. But in the late 1990s, scientists at the National Institutes of Health discovered that it could produce remarkable medicinal effects. In test tubes, the molecule shielded neurons from oxidative stress, a damaging process common in many neurological disorders, including epilepsy.

Keyword: Drug Abuse; Epilepsy
Link ID: 26236 - Posted: 05.15.2019

Esther Honig Denver voters narrowly approved a grassroots ballot initiative to decriminalize psilocybin mushrooms, commonly referred to as psychedelic mushrooms. What appeared to be a failed effort on the evening of Tuesday's referendum made an unexpected comeback the following afternoon, when Denver election officials released the final count. It showed a slim majority of 50.56% voted in favor of ordinance 301. The action doesn't legalize psilocybin mushrooms, but effectively bars the city from criminally prosecuting or arresting adults 21 or older who possess them. In the ballot language, adults can even grow the fungus for personal use and be considered a low priority for Denver police. The changes could take effect as soon as next year. What happened in Denver may be the start of a much larger movement, which seeks safe access to psilocybin for its purported medicinal value. Supporters point to research, suggesting psilocybin is not addictive and causes few ER visits compared to other illegal drugs. Ongoing medical research shows it could be a groundbreaking medicine for treatment-resistant depression and to help curb nicotine addiction. In Iowa, a Republican lawmaker recently proposed two bills to remove the drug from the state's list of controlled substances. And in Oregon and California, campaigns are working to get similar issues on the ballot for the 2020 elections. © 2019 npr

Keyword: Drug Abuse
Link ID: 26219 - Posted: 05.09.2019

Bruce Bower A leather bag stuffed with ritual items, found high in the Andes Mountains, has yielded rare clues to South American shamans’ hallucinatory visions around 1,000 years ago. One artifact in the radiocarbon-dated bag, a pouch stitched out of three fox snouts, contains chemical traces of five mind-altering substances obtained from at least three plants, say bioarchaeologist Melanie Miller of the University of Otago in Dunedin, New Zealand and her colleagues. Chemical residues include two primary ingredients of ayahuasca, a vision-inducing concoction still used by ritual specialists in native South American communities, the scientists report online the week of May 6 in the Proceedings of the National Academy of Sciences. Cocaine residue suggests that the fox pouch also held coca leaves. The researchers found the ancient ritual bundle in a Bolivian rock-shelter called Cueva del Chileno. Along with the fox pouch, the leather bag contained two carved wooden tablets used for snorting, or snuffing, powdered substances, a carved snuffing tube, a pair of llama-bone spatulas, a woven band thought to be a headband and two dried plant fragments tied to wool and fiber strings. Objects in the bag show influences of an ancient Andean society called Tiwanaku (SN Online: 8/24/15), the researchers say. As in many ancient Andean and Amazonian cultures, Tiwanaku shamans entered altered mental and physical states to communicate with revered ancestors and supernatural beings. |© Society for Science & the Public 2000 - 2019

Keyword: Drug Abuse
Link ID: 26211 - Posted: 05.07.2019

Hattie Garlick Rosie has just returned from the school run. She drops a bag of groceries on to her kitchen table, and reaches for a clear plastic cup, covered by a white hanky and sealed with a hairband. Inside is a grey powder; her finely ground homegrown magic mushrooms. “I’ll take a very small dose, every three or four days,” she says, weighing out a thumbnail of powder on digital jewellery scales, purchased for their precision. “People take well over a gram recreationally. I weigh out about 0.12g and then just swallow it, like any food. It gives me an alertness, an assurance. I move from a place of anxiety to a normal state of confidence, not overconfidence.” Over the last 12 months, I have been hearing the same story from a small but increasing number of women. At parties and even at the school gates, they have told me about a new secret weapon that is boosting their productivity at work, improving their parenting and enhancing their relationships. Not clean-eating or mindfulness but microdosing – taking doses of psychedelic drugs so tiny they are considered to be “subperceptual”. In other words, says Rosie: “You don’t feel high, just… better.” It’s a trend that first emerged in San Francisco less than a decade ago. Unlike the hippies who flocked to the city in the 60s, these new evangelists of psychedelic drugs were not seeking oblivion. Quite the opposite. While a “full” tripping dose of LSD is about 100 micrograms, online forums began to buzz with ambitious tech workers from Silicon Valley eulogising the effect of taking 10 to 20 micrograms every few days. Others used magic mushrooms. While both drugs are illegal in the US and the UK, increasing numbers claimed that tiny amounts were making them more focused, creative and productive. © 2019 Guardian News & Media Limited

Keyword: Depression; Drug Abuse
Link ID: 26210 - Posted: 05.04.2019

By Gabrielle Emanuel and Katie Thomas BOSTON — A federal jury on Thursday found the top executives of Insys Therapeutics, a company that sold a fentanyl-based painkiller, guilty of racketeering charges in a rare criminal prosecution that blamed corporate officials for contributing to the nation’s opioid epidemic. The jury, after deliberating for 15 days, issued guilty verdicts against the company’s founder, the onetime billionaire John Kapoor, and four former executives, finding they had conspired to fuel sales of its highly potent drug, Subsys, by not only bribing doctors to prescribe their product but also by misleading insurers about patients’ need for the drug. The verdict against Insys executives is a sign of the accelerating effort to hold pharmaceutical and drug distribution companies and their executives and owners accountable in ways commensurate with the devastation wrought by the prescription opioid crisis. More than 200,000 people have overdosed on such drugs in the past two decades. Federal authorities last month for the first time filed felony drug trafficking charges against a major pharmaceutical distributor, Rochester Drug Cooperative, and two former executives, accusing them of shipping tens of millions of oxycodone pills and fentanyl products to pharmacies that were distributing drugs illegally. And the state attorneys general of Massachusetts and New York have recently sued not just Purdue Pharma, the maker of OxyContin, but also members of the Sackler family who own the company — and who have largely escaped personal legal penalties for the company’s role in the epidemic, culpability they deny. © 2019 The New York Times Company

Keyword: Drug Abuse; Pain & Touch
Link ID: 26209 - Posted: 05.04.2019

Sara Reardon The cannabis that’s used for research in the United States is genetically different to the stuff people are smoking, says a recent study1. The finding suggests that research investigating the plant’s biological effects might not completely replicate the experience of people using commercially available strains ― something researchers have long suspected. Scientists studying cannabis in the United States must source it from the National Center for Natural Products Research at the University of Mississippi in University. The facility holds the only licence from the US Drug Enforcement Administration (DEA) to grow and distribute cannabis for research purposes, and it has a contract with the National Institute on Drug Abuse (NIDA) to give researchers access to its products. Critics have long complained that NIDA’s pot is weaker than strains typically sold in dispensaries in states where the drug is now legal, or available on the street. The agency’s strongest variety contains more than 10% tetrahydrocannabinol (THC), the main psychoactive chemical responsible for marijuana’s ‘high’. Some street varieties contain more than 20% THC. The DEA, which licenses labs to buy and study illegal drugs, announced in 2016 that it would allow other institutions to apply for permission to grow marijuana for research. According to news reports, dozens of applications have since been submitted. But the DEA hasn’t yet approved any of them, leaving scientists to source research strains from NIDA. © 2019 Springer Nature Publishing AG

Keyword: Drug Abuse
Link ID: 26201 - Posted: 05.03.2019

By Sheila Kaplan WASHINGTON — The Food and Drug Administration said Tuesday that it would permit the sale of IQOS, a “heat not burn” tobacco device made by Philip Morris International, in the United States. While the agency stopped short of declaring that the device was safer than traditional cigarettes, the F.D.A. did say the heated tobacco-stick system could help people to quit smoking. Philip Morris has waited two years for the agency to clear IQOS (pronounced EYE-kose), a penlike electronic device that comes with a sleek battery pack resembling a cigarette case. The product includes an electronically controlled heating blade that warms a tobacco stick and releases a vapor with the taste of tobacco but fewer harmful chemicals than cigarette smoke. It differs from e-cigarettes already on the market because it contains tobacco rather than liquid nicotine. But IQOS still delivers an amount of nicotine that’s similar to traditional cigarettes. “The F.D.A.’s decision to authorize IQOS in the U.S. is an important step forward for the approximately 40 million American men and women who smoke,” said André Calantzopoulos, the chief executive of Philip Morris International. “Some will quit. Most won’t, and for them IQOS offers a smoke-free alternative to continued smoking.” Howard A. Willard III, chief executive of Altria, which will distribute the product in this country, said the company planned to begin sales of IQOS in Atlanta. A few years ago, the F.D.A.’s decision would have been a clear win for both Philip Morris and Altria. But IQOS products will now have to compete with the extremely popular devices sold by the vaping giant Juul Labs, in which Altria has a 35 percent stake. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26189 - Posted: 05.01.2019

April Dembosky Amelia and her roommate had been awake for two days straight. They decided to spray-paint the bathroom hot pink. After that, they laid into building and rebuilding the pens for the nine pit bull puppies they were raising in their two-bedroom apartment. Then the itching started. It felt like pin pricks under the skin of her hands. Amelia was convinced she had scabies, skin lice. She spent hours in front of the mirror checking her skin, picking at her face. She even got a health team to come test the apartment. All they found were a few dust mites. "At first, with meth, I remember thinking, 'What's the big deal?' " says Amelia, who asked that we not reveal her last name to protect her family's privacy. "But when you look at how crazy things got, everything was so out of control. Clearly, it is a big deal." While public health officials have focused on the opioid epidemic in recent years, another epidemic has been brewing quietly, but vigorously, behind the scenes. Methamphetamine use is surging in parts of the U.S., particularly the West, leaving first responders and addiction treatment providers struggling to handle a rising need. Across the country, overdose deaths involving methamphetamine doubled from 2010 to 2014. Admissions to treatment facilities for meth are up 17%. Hospitalizations related to meth jumped by about 245% from 2008 to 2015. And throughout the West and Midwest, 70% of local law enforcement agencies say meth is their biggest drug threat. © 2019 npr

Keyword: Drug Abuse
Link ID: 26188 - Posted: 05.01.2019

By Sheila Kaplan COLUMBIA, S.C. — For months, Juul Labs has had a clear, unwavering message for officials in Washington: The e-cigarette giant is committed to doing all it can to keep its hugely popular vaping products away from teenagers. But here in Columbia, the South Carolina capital, and in statehouses and city halls across the country, a vast, new army of Juul lobbyists is aggressively pushing measures that undermine that pledge. The company’s 80-plus lobbyists in 50 states are fighting proposals to ban flavored e-cigarette pods, which are big draws for teenagers; pushing legislation that includes provisions denying local governments the right to adopt strict vaping controls; and working to make sure that bills to discourage youth vaping do not have stringent enforcement measures. Though Juul supports numerous state bills that would raise the legal age for buying vaping and tobacco products to 21, some of those bills contain minimal sanctions for retailers. Others fine only the clerks and not the owners for violations. “Juul is attempting to rehabilitate its public image by posing as a public health advocate while working behind the scenes to weaken or defeat tobacco control proposals and prevent communities from even considering policies to curb tobacco use,” said Nancy Brown, chief executive of the American Heart Association, whose network of lobbyists has parried with e-cigarette and tobacco industries in many states this year. In a statement, Juul said, “We are as committed as ever to combating youth usage but don’t take our word for it — look at our actions.” The company cited its action plan, unveiled in November, which included shutting down its social media accounts, discontinuing sales of many flavored pods in retail stores and strengthening its online age verification systems. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26178 - Posted: 04.29.2019

Sam Wolfson People who are stoned often think they’re being funnier than they actually are, now we know they overestimate their driving ability too. Almost half of cannabis users believe it’s safe to drive when you’re high, according to a new study by PSB Research and Buzzfeed News. Perhaps unsurprisingly, those who abstain from weed, take a different view – only 14% believe someone who’s stoned can drive safely. The dangers of driving while intoxicated have been so well established that it’s easy to assume it’s the abstainers who are right and pot-smokers are simply failing to recognize the danger they pose to themselves. But a number of studies into the issue have produced a murkier picture. It’s true that THC, the psychoactive ingredient in cannabis, can impair a person’s levels of attention and their perception of time and speed, important skills you might think for driving a car. One meta-analysis of 60 studies found that marijuana use causes impairment on every measure of safe driving, including motor-coordination, visual function and completion of complex tasks. But a 2010 analysis published in the American Journal of Addiction found that while “cannabis and alcohol acutely impair several driving-related skills … marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioral strategies”. The authors concluded that while marijuana should, in theory, make you a worse driver, in tests it doesn’t seem to. “Cognitive studies suggest that cannabis use may lead to unsafe driving, experimental studies have suggested that it can have the opposite effect,” they wrote. © 2019 Guardian News & Media Limited

Keyword: Drug Abuse; Attention
Link ID: 26176 - Posted: 04.27.2019

Jayne O'Donnell and Ken Alltucker, Doctors are misusing 2016 opioid pain medication guidelines, federal officials said Wednesday, a clear response to increasing complaints from chronic pain patients who say they are the victims of an overreaction to the opioid crisis. The Centers for Disease Control and Prevention, in new guidance for opioid prescribing, said many physicians were guilty of a "misapplication" of 2016 guidelines that clamped down on the use of opioids. The new guidelines, published in the New England Journal of Medicine, was the latest federal acknowledgement that many physicians' responses to the opioid crisis went too far. Former Food and Drug Administration commissioner Scott Gottlieb, a physician, spoke out last July about the impact the opioid crisis response had on pain patients when he called for development of more options. Until then, people in the middle of cancer treatments, having "acute sickle cell crises" or with pain after surgery shouldn't be affected by the earlier recommendations, CDC said. These patients were outside the scope of the guidelines, which were intended for primary care doctors treating chronic pain patients, CDC said. Doctors that set hard limits or cut off opioids are also misapplying the government's guidance, CDC said. Doctors should prescribe the lowest effective dosage and avoid increasing it to 90 "morphine milligram equivalents" a day or "carefully justify" any decision to raise the dose to that level.

Keyword: Pain & Touch; Drug Abuse
Link ID: 26173 - Posted: 04.25.2019

Sarah Boseley Antidepressants can save lives. At best, they work. At worst, they are a sticking plaster, hopefully enabling people to hold it all together until they get other help in the form of talking therapies. Either way, they are not supposed to be long-term medication. But whether depression is now better diagnosed or we live in sad times, more and more people are taking the pills and the weeks extend into months and years. In some cases, the users find they can’t stop. “I am currently trying to wean myself off,” one told researchers, “which honestly is the most awful thing I have ever done. I have horrible dizzy spells and nausea whenever I lower my dose.” “The withdrawal effects if I forget to take my pill,” another reported, “are severe shakes, suicidal thoughts, a feeling of too much caffeine in my brain, electric shocks, hallucinations, insane mood swings … Kinda stuck on them now cos I’m too scared to come off.” “While there is no doubt I am better on this medication,” said a third, “the adverse effects have been devastating when I have tried to withdraw – with ‘head zaps’, agitation, insomnia and mood changes. This means that I do not have the option of managing the depression any other way.” These anonymised accounts come from scientific studies cited in a report last year to the all-party parliamentary group for prescribed drug dependence and published in the journal Addictive Behaviors. They give a flavour of the reality of dependence on modern antidepressants, the SSRIs (selective serotonin reuptake inhibitors). The most famous is Prozac, AKA fluoxetine, once portrayed as a wonder drug that would make the world rosy and shiny again for all of us, without the dangerous dark side of Valium and the rest of the benzodiazepines. Not only was it harder to overdose on SSRIs than on “benzos”, the experts said; it was also easier to come off them. © 2019 Guardian News & Media Limited

Keyword: Depression
Link ID: 26169 - Posted: 04.24.2019

Laura Sanders Kratom, an herbal supplement available at vape shops and online stores, has been linked to 91 deaths over 18 months from July 2016 to December 2017, according to a report by the U.S. Centers for Disease Control and Prevention. Those deaths made up less than 1 percent of the 27,338 overdose fatalities analyzed for the report, released online on April 12. Although small, the numbers point to increasing numbers of people using the plant to combat pain, depression and even opioid addiction. Interest in, and exposure to, kratom is apparently rising. “We’d see about 10 cases a year, and now we’re seeing hundreds,” says toxicologist Henry Spiller of the Central Ohio Poison Center in Columbus. Here, scientists weigh in on what’s known and unknown about the herbal supplement. What is kratom, and why are people using it? The supplement is mashed leaves from the tropical tree Mitragyna speciosa, a coffee cousin that grows in the warm, wet forests of Southeast Asia. Pulverized leaves create a green powder that can be dissolved in tea, packed into pill capsules or extracted into alcohol. Traditionally, workers chew the leaves in search of a mild stimulant effect during the day, and then drink tea to relieve pain, says pharmacologist and toxicologist Oliver Grundmann of the University of Florida in Gainesville. |© Society for Science & the Public 2000 - 2019

Keyword: Drug Abuse
Link ID: 26157 - Posted: 04.20.2019

By Richard A. Oppel Jr. and Serge F. Kovaleski The steep rise in the number of people suffering opioid addiction has helped spawn the widespread use of another substance: kratom, a green powdered herbal supplement that is widely available and virtually unregulated. Derived from the leaves of a tree native to Southeast Asia and sold in the United States online and in bodegas and head shops, kratom has long been used as a mood booster, energy supplement and pain reliever. It is also increasingly being used by those who swear by it as a curb for opioid addiction. Some veterans also say it helps control symptoms of post-traumatic stress. Several million Americans are now believed to use kratom. One is Andrew Turner, whose PTSD, herniated discs and movement problems affecting his face and neck were so severe after multiple deployments with the Navy that he took as many as 20 prescription medications, including opioids, daily. “I was on the path to suicide, and losing hope,” Mr. Turner said. After he began drinking kratom tea, the pain and dread diminished, he said. “It was a night-and-day difference.” But the authorities warn that kratom can be dangerous. Reported side effects include seizures, hallucinations and symptoms of psychosis, and there have been calls from inside the Trump administration to curb its use. A new government review links kratom to nearly 100 overdose deaths. “There is no evidence to indicate that kratom is safe or effective for any medical use,” Scott Gottlieb, until recently the commissioner of the Food and Drug Administration, said last year. © 2019 The New York Times Company

Keyword: Drug Abuse
Link ID: 26154 - Posted: 04.19.2019

By Sam Rose You’ve probably heard about microdosing, the “productivity hack” popular among Silicon Valley engineers and business leaders. Microdosers take regular small doses of LSD or magic mushrooms. At these doses, they don’t experience mind-bending, hallucinatory trips, but they say they get a jolt in creativity and focus that can elevate work performance, help relationships, and generally improve a stressful and demanding daily life. If its proponents are to be believed, microdosing offers the cure for an era dominated by digital distractions and existential anxiety—a cup of coffee with a little Tony Robbins stirred in. So far, though, it’s been impossible to separate truth from hype. That’s because, until recently, microdoses haven’t been tested in placebo-controlled trials. Late last year, the first placebo-controlled microdose trial was published. The study concluded that microdoses of LSD appreciably altered subjects’ sense of time, allowing them to more accurately reproduce lapsed spans of time. While it doesn’t prove that microdoses act as a novel cognitive enhancer, the study starts to piece together a compelling story on how LSD alters the brain’s perceptive and cognitive systems in a way that could lead to more creativity and focus. The idea behind microdosing traces its roots back decades. In the 1950s, a handful of psychedelic therapists at a mental health facility in Saskatchewan wanted to help alcoholics get clean. They guided the patients through a high dose, ego-dissolving, LSD experience. When they came out the other side, over half of the patients reported complete recovery from alcoholism. The Canadian government was intrigued and ordered more rigorous trials, this time with placebo controls, and without the experienced “trip guides” offering suggestions on what patients should feel. These trials were a bust. In the fall-out, many viewed psychedelic therapy as more shamanism than science. The mindset of the user and suggestion from the therapist (termed “set and setting” to LSD proponents) are just as important as the drug itself. In other words, LSD’s effects had as much to do with goings on outside the brain as inside it. To LSD proponents, though, this was part of how it worked. “Set and setting” guard against a bad trip (with large doses), and give the user an idea of what they should experience. © 2019 Scientific American

Keyword: Depression; Drug Abuse
Link ID: 26148 - Posted: 04.17.2019

by Jesse Noakes In August 2016 I went to New York for the first time. On the second evening, as the sun slipped behind the building across the street, I was sitting on a long couch on the top floor of an old church. All around me instruments were scattered on the floor – singing bowls, tuning forks, rainsticks, Tibetan bells. At the foot of a wall carpeted completely in moss, dripping like the jungle in the baking heat, was a large bronze gong. On the table in front of me two small ceramic bowls contained a capsule of 125mg of pure MDMA and a chilli guacamole with three grams of powdered magic mushrooms stirred through it. I eyed them nervously. I was terrified that I was going to lose my mind but I was more scared that nothing would happen at all, that I was too broken for even this radical treatment. I’d left Australia to take psychedelics with a therapist. Almost a decade of regular talk therapies for depression had done little to explain why I still felt so numb, trapped and terrified. A few months earlier I’d tracked down a guy online who said that, while it wasn’t a magic bullet, he might have something that would help. I can’t name him because it’s still completely illegal. He was sitting across from me and after I’d swallowed the contents of both bowls he handed me a padded eye mask and suggested I lie back on the couch. I heard him move across the room in the steamy darkness as I tried to relax and focus on my breathing. Moments later I heard the first strange notes from the gong. © 2019 Guardian News & Media Limited

Keyword: Depression; Drug Abuse
Link ID: 26141 - Posted: 04.15.2019