DRUG INFORMATION RESOURCES - INTERNATIONAL
SAMHSA’s 15th Annual Prevention Day Afternoon Plenary Recording (February 4, 2019)
- The importance and efficacy of Prevention & Demand Reduction mechanisms
- Focusing on the real dangers of Marijuana, Kratom and E-Cigarettes (Vaping)
Are Electronic Cigarettes Facilitating Illicit Drug Use?
What are the reasons that substances other than nicotine may be found in e-cigarettes?
This is a question that many experts would like to know since the answer would probably address substance addiction worldwide. Drugs other than nicotine are being found in electronic cigarettes as they provide a great tool for inhaling drugs. Inhalation gives a really fast onset of effects. Lung tissue is in contact with blood vessels, and so the inhaled drugs can transfer into the blood easily, depending on the drug. Download PDF Copy Feb 5 2019
(MDMA)-related fatalities in Australia:
Demographics, circumstances, toxicology and major organ pathology
MDMA and 5-HT neurotoxicity:
the empirical evidence for its adverse effects in humans – no need for translation
“Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence. Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising.” By Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University. (2018)
Pills will kill, but testing them is not yet the answer
But it won’t work and is fraught with dangers. What if we don’t know what we are testing for? New psychoactive compounds are being developed all the time. In any case, is the drug we’re testing for consistent throughout the pill? We could easily miss it by scraping a little from the surface. And perhaps the deadly threat lurks in unidentified contaminants.
There is much to be considered — maybe first is the fact no forensic toxicologist I know recommends pill testing or believes it is practical.
Fitzgerald states the risks of pill testing appear to be minimal. That is curious. In a recent toxicology publication, a leading forensic scientist reported there was great concern in the US that these novel illicit substances typically are outside the scope of routine drug testing by hospitals and laboratories or below the sensitivity levels for detection. If major forensic facilities have difficulty in identifying these substances, it stands to reason that on-site pill testing could not adequately identify most of the potentially lethal components in a pill scraping.
In another recent publication, Australian forensic laboratories noted there were about 740 new psychoactive substances reported to the UN Office on Drugs and Crime from 2009 to 2016.
Again, leading Australian forensic institutions using high-resolution mass spectrometry struggle to keep up with ever-increasing variations in synthetic substances. Pill testing may identify some of these within the time and scope of the on-site facility, but the risk of an adverse or fatal episode remains with several hundred substances not detected.
Fitzgerald reckons there is a strong case from more than two decades of experience in Europe, but that’s ignoring the exponential increase in deadly adulterants.
The issue of pill testing should be decided on forensic science. The ability to identify a wide range of components in a compound depends on the ability to test a representative portion of the substances, and that representation is incumbent on the pill being homogeneously mixed when produced. If the pill has not been manufactured to ethical pharmaceutical standards then there is a risk of the pill tester missing the more toxic ingredients of the substances.
If pill testing were trialled, you would need sophisticated instrumentation such as high-resolution mass spectrometry to rapidly analyse the contents of the unknown substance. Such instrumentation is not amenable to on-site music festival venues. Critically, operators of the instrumentation would need to ensure their database of compounds is up to date. As newer synthetic drugs are regularly entering the market, forensic laboratories are struggling to obtain appropriate and expensive analytical reference material to identify unequivocally all ingredients in a pill.
To date, analytically trained experts have yet to explain adequately the complexity of attempting to test pills reliably and quickly at an on-site venue to be reasonably confident they can eliminate minute amounts of potentially lethal ingredients such as the deadly carfentanil.
Before moving ahead with a policy to trial pill testing, we need some sobering facts. The efficacy of pill testing is best left to forensic scientists, while the value of pill testing as a means of harm reduction is the domain of researchers into behavioural patterns of users and their potential for risk-taking. A 2004 study by the National Drug and Alcohol Research Centre into risk factors and risk perceptions found that those who perceived the possibility of getting caught or being involved in accidents were less likely to drive while impaired. Conversely, the perception of not getting caught or having an adverse reaction contributed to their drug-taking behaviour..
John Lewis is honorary associate at the Centre for Forensic Science at the University of Technology Sydney
'She was an alcohol girl': Friends of FOMO music festival fatality say she 'never took drugs and just wanted to try it once'
Daily Mail January 15, 2019
A 19-year-old who died of a suspected drug overdose at a Sydney music festival never took drugs and 'just wanted to try it', according to her friends. For more Pill Testing Would NOT have Stopped This!
New drug MDPV or ‘monkey dust’, found in Australia. What is it and what are the harms?
What does MDPV do?
An oral dose of MDPV is estimated to be around 5-20 milligrams (compared to 100-150 milligrams for MDMA). The main psychoactive effects last two to three hours, and side-effects persist for several additional hours.
Side-effects, particularly at high doses, can include anxiety and paranoia, delusions, muscle spasms, and an elevated heart rate. In extreme cases, MDPV has been linked to rhabdomyolysis (rapid muscle breakdown), brain injury, and death.
Like other cathinones, MDPV is a stimulant and shares some effects with other stimulants such as amphetamine, cocaine and MDMA. MDPV produces its effects by inhibiting the reuptake of two important signalling molecules (neurotransmitters) in the brain; norepinephrine and dopamine.
Norepinephine is generally responsible for preparing the brain and body for action in the so-called “fight or flight response”, while dopamine is involved in more complex functions such as arousal, motivation, reward and motor control.
By blocking the ability of certain brain cells (neurons) to reabsorb these neurotransmitters, MDPV effectively increases the intensity and duration of norepinephrine and dopamine signalling. Cocaine works in a similar way, but in a lab test, MDPV was a much more potent inhibitor than cocaine.
Other norepinephrine-dopamine reuptake inhibitors (NDRIs) include pharmaceuticals such as methylphenidate (known as ritalin and used to treat ADHD) and buproprion (an antidepressant). But the psychoactive and stimulant effects of MDPV are much stronger than pharmaceutical NDRIs.
Pyrovalerone – a hybrid of mephedrone and MDPV – is an approved appetite suppressant used medically for weight loss. However, it’s rarely used due to its potential for abuse.
Studies in laboratory animals highlight the stimulating effects of MDPV, and also its potential for dependence. Mice trained to identify MDPV find it similar to both MDMA and methamphetamine. MDPV stimulates movement in rats approximately ten times more potently than cocaine, and rats will readily self-administer MDPV, suggesting it’s addictive.
But many of these deaths involved extreme doses, repeated dosing (“bingeing”), intravenous use or additional drugs. In fatal cases involving a single synthetic cathinone, death has been attributed to complications arising from extremely high body temperatures or damage to the vessels of the heart. Fortunately, specialised drug testing can detect MDPV and its derivatives.
CHASING AFTER THE WIND! (Must have book!)
In a brutally honest account Kerryn Redpath describes the terrifying scenes she witnessed as what began as "a bit of fun" spiralled into a shocking journey through the dark world of drug addiction. Chilling stories of drug overdoses, precious lives lost, drug and alcohol fuelled fights, months spent gravely ill in hospital, at one point being given less than two hours to live, will have the reader gripped to every page….This is a compelling story that takes the reader through one person’s journey from the depths of despair to the realms of hope and is hard to put down until the final page is read.
This is a story that should be read by all - young and old, parents, teenagers and current or past addicts of all persuasions.” - Associate Professor Peter Ryan
Why Ecstasy is more harmful than alcohol (whatever Professor Nutt says)
By Professor Andy Parrott one of the world’s leading experts on MDMA, Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University.
Comparing alcohol with MDMA.Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence (Professor Nutt, 21st May). Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising. Yours etc . . .
In the next few paragraphs, I have provided more information on this topic. What is the basis for Professor Nutt claiming that MDMA is a safer drug than alcohol? This statement was based primarily on a survey he published in the Lancet (Nutt et al, 2007, vol 369; 1047). However this article contains some astounding errors. Indeed when I was first shown it, I contacted the Lancet stating that they needed to publish a detailed reply from me, since it was important to point out these errors. After some email exchanges with one of the Lancet editors, the journal decided not to publish my letter. However I presented some of my criticisms as a conference paper (Parrott, 2009. ‘How harmful is Ecstasy/MDMA: an empirical comparison using the Lancet scale for drug-related harm’. Journal of Psychopharmacology, vol 23, page 41).
I have listed below my main criticisms:
- Nutt stated that ‘for drugs which have only recently become popular such as Ecstasy or MDMA, the longer term health consequences can only be estimated from animal toxicology at present’. This statement was grossly incorrect. Numerous articles (indeed several hundred) had been published before 2006 by various research groups worldwide, including many papers from my own group. These papers revealed a wide range of adverse health and related problems.
- One of the Nutt harm scales was ‘intensity of pleasure’, since it is well documented that the most powerful mood enhancers also cause the most problems. Nutt’s article gave heroin and cocaine the maximum scores of 3.0, while nicotine was rated at 2.3, whereas MDMA was given the surprisingly low rating of 1.6. This made MDMA one of the least pleasurable of all their drugs (16th lowest out of their 20 drugs). This low pleasure score for MDMA is simply incomprehensible. How can anyone with even a rudimentary knowledge of human psychopharmacology state that Ecstasy/MDMA is less pleasurable than a cigarette? Yet this low rating was apparently given by Nutt’s group of experts! Recreational Ecstasy/MDMA users would certainly be very surprised at this low rating. It should be noted that this very low ‘pleasure’ score contributed directly to MDMA’s low ‘harm’ score.
- Drug ‘injection potential’ was another scale, with heroin and cocaine again being given maximum scores of 3.0. In contrast MDMA was given a score of 0.0. This zero score was again bizarre, since MDMA is injected by some heavy users, and they suffer from the problems typically associated with drug injecting. This practice has been noted in various academic papers. Hence the injection score for MDMA should have been similar to that given for cocaine – namely 3.0. The zero score in Nutt et al may be difficult to comprehend, but again it was crucial for generating MDMA’s low overall harm score.
- In my commentary paper (Parrott, 2009, see above), I provided harm estimates based on the empirical literature, and MDMA rose from 18th to 5th in the list of most damaging drugs. Hence the position of 18th given by Nutt et al in their Lancet paper is extremely misleading – and has no basis in science.
- So what exactly are the problems caused by MDMA?
- In 2011 I was asked by the USA Deputy Attorney General to be an expert witness in a court case, which debated the issue of the most appropriate sentences for Ecstasy/MDMA drug traffickers. I was asked to write a comprehensive report, based on all the available scientific research. This was later expanded into a comprehensive review (Parrott, 2013, Neuroscience and Biobehavioral Reviews 37: 1466-1484). The following brief summaries are based on that review, and many of my more recent papers.
- MDMA is damaging when taken acutely, since it heats up the brain, impairs thermal control, increases neurotransmitter release, and generates extreme mood changes. It also leads to cognitive confusion, and a marked increase in neurohormonal activity. Death rates from acute abreactions are comparatively rare (around 60 per year in the UK), but have been increasing due probably to the increasing levels of MDMA in Ecstasy tablets (see reports by Professor Fabrizio Schifano for the UK, with similar increases reported within mainland Europe).
- MDMA is also damaging when taken repeatedly. It leads to alterations and/or deficits in brain activity which may be permanent, with reductions in memory ability, reductions in problem-solving skills, deficits in complex visual abilities, impairments in some psychomotor skills, various health impairments, increased levels of depression, increased levels of aggression, and other deficits. Young women should certainly avoid MDMA if there is any possibility of pregnancy – since it can lead to impairments in subsequent child development (Professor Lynn Singer, et al, Neurotoxicology and Teratology, vol 54, pages 22-28).
- I could go on describing more of the problems caused by MDMA – but will limit myself to one final point. MDMA has been medically tested for cancer therapy, since it can damage/kill human cells. The medical term for this is apoptosis, and it was first demonstrated in laboratory animals, but has subsequently been confirmed in human cells (the relevant medical papers were cited in Parrott, 2013, Human Psychopharmacology, vol 28, pages 289-307).
- In summary, alcohol is certainly a damaging drug, and when misused it causes massive problems to individual drinkers, their families, and wider society. However the majority of alcohol drinkers are able to use it safely over their lifetimes. In contrast, MDMA is a far more powerful and damaging drug. Current evidence suggest that its regular usage is not only damaging to many young users, but that this damage may endure for several years following drug cessation (Taurah et al, 2013, Psychopharmacology vol 231, pages 737-751).
Similar to other fentanils, the most serious acute health risk from using carfentanil is likely to be rapid and severe respiratory depression, which in overdose could lead to apnoea, respiratory arrest, and death (Dahan et al., 2010; EMCDDA, 2017; Lindsay et al., 2016; Pattinson, 2008; Wax et al., 2003; White and Irvine, 1999). Factors that may exacerbate this risk include: the difficulty in diluting the substance, which can lead to a toxic dose being inadvertently used; the use of routes of administration that have high bioavailability (such as injecting, insufflation, and inhalation); a lack of experience with its effects and dosing; the use of other central nervous system depressants at the same time (such as other opioids, benzodiazepines, gabapentanoids, and alcohol); no or limited tolerance to opioids; and, using the substance alone (such as at home) which would make it more difficult for users to call for help in the case of poisoning. In addition, as discussed below, as carfentanil is being sold as or in heroin and other illicit opioids, many users will not be aware that they are using carfentanil.
The Global SMART
(Synthetics Monitoring: Analyses, Reporting and Trends)
Programme improves the capacity of targeted Member States to generate, manage, analyse, report and use information on illicit synthetic drugs. The SMART programme was launched in September 2008 in Bangkok.
Why Australia Should Not Decriminalise Drugs
By Drug Free Australia
Australia21 and NDARC, two Australian entities sympathetic towards the use of illegal drugs, are pushing our politicians and media to advocate for the decriminalisation of all illegal drugs, including heroin and ice. But decriminalisation mostly increases drug use and Australians want LESS use. Convicting users is a major deterrent to drugs while encouraging rehab. When users can show they are clean for 3-5 years, then, and not before, is the time to wipe their conviction
The Journal of Global Drug Policy & Practice
Dalgarnowledge - Ecstacy
Dalgarnowledge - Speed
Dalgarnowledge - Ketamine
Dalgarnowledge - GHB
Dalgarnowledge - Heroin
Dalgarnowledge - COCAINE
Dalgarnowledge FASD for Mothers
Dalgarnowledge FASD for Girls Only
Dalgarnowledge - Khat
Dalgarnowledge - LEGALHIGHS
How Marijuana Harms Youth
Dalgarnowledge – Bathsalts
Here is a great interview on “medical” marijuana by Dr. David A. Gross who chairs our International Scientific and Medical Forum. He is a psychiatrist in Delray Beach, Florida. The Florida Psychiatric Society owns the copyright but we have been granted free and open use for educational purposes.