While psychedelic drugs like psilocybin have been touted for their potential therapeutic benefits, it is crucial to examine the darker aspects of these substances. Recent research led by Dr. Joshua Siegel at Washington University in St. Louis highlights the profound risks associated with psilocybin, particularly its ability to disrupt critical brain networks and cause potential long-term psychological harm.
Long-Term Implications: While some brain functions return to normal shortly after psilocybin use, the study noted that certain changes in functional connectivity, particularly between the DMN and the hippocampus, can persist for weeks. These lasting alterations could have unknown long-term effects on mental health, hinting at the possibility of enduring cognitive or emotional disturbances.
Despite the growing interest in the therapeutic potential of psilocybin, the risks associated with its use cannot be overlooked
A recent surge of illnesses linked to mushroom edibles has raised significant concerns about the safety and regulation of these products. This issue centres around Amanita muscaria-infused gummies, known for their psychoactive effects, and other synthetic compounds found in these edibles. As more than 140 documented cases of sickness, including two suspected deaths, have been reported, scientists, regulators, and consumers are grappling with the implications of these findings.
The Role of Amanita Muscaria: Amanita muscaria, the red-capped mushroom often depicted in folklore and popular culture, is at the heart of the current health scare. While not federally controlled, it is known for its psychoactive properties, primarily due to compounds like muscimol and ibotenic acid. Muscimol, a compound with sedative effects, and ibotenic acid, a neurotoxin, are both capable of inducing hallucinations and delirium. However, the Amanita species is different from psilocybin-containing mushrooms, which are more commonly associated with psychedelic experiences.
The wave of illnesses has been linked to products marketed under the brand Diamond Shroomz, which were found to contain muscimol in only a fraction of the tested samples. Despite the recall of these products, poison centres continue to receive reports of adverse effects, highlighting the ongoing concern.
Symptoms and Health Risks: The symptoms associated with these mushroom edibles are severe and varied, including nausea, vomiting, seizures, loss of consciousness, and agitation. The inability to pinpoint the exact cause of these symptoms complicates efforts to address the issue. Toxicologists like Dr. Michael Moss have noted the unusual severity of these reactions, which are not typical of mushroom intoxication.
Challenges in Testing: Analysing the contents of these edibles presents a significant challenge. The complexity of identifying compounds like muscimol and ibotenic acid, especially in edible forms like chocolate or gummy candies, makes testing difficult. Moreover, preliminary investigations have uncovered the presence of synthetic psilocybin analogs and other substances like pregabalin and kava, further complicating the safety profile of these products.
Tryptomics, a company specialising in testing psychoactive substances, has identified various unlisted ingredients in over 100 products, underscoring the inconsistency and potential for contamination in the market.
Regulatory Concerns: The proliferation of these unregulated psychoactive products mirrors past issues with synthetic cannabis, raising fears of a regulatory backlash. The lack of oversight allows for the sale of these potentially dangerous edibles, with manufacturers exploiting legal loopholes. Experts like Roger Brown, CEO of ACS Laboratory, acknowledge the gaps in regulation and the challenges of enforcing existing laws.
Industry insiders and health experts express concern over the potential impact on consumers and the need for better regulatory frameworks to ensure safety and transparency in the market.
Potential Solutions and Future Directions: Addressing the risks associated with mushroom edibles requires a multi-faceted approach, including improved testing methods, clearer regulatory guidelines, and consumer education. The ongoing federal investigation aims to determine the root cause of the illnesses and develop strategies to prevent future occurrences.
Consumers are advised to exercise caution, verify product safety through lab analysis, and remain informed about the potential health risks. As interest in microdosing and psychedelic substances grows, ensuring the safety and regulation of these products will be crucial to prevent further public health issues.
E-cigarette use among adolescents has become a widespread public health concern. Despite the known harms of nicotine exposure, there has been a lack of empirically tested interventions aimed at helping teens quit vaping. A recent randomised clinical trial investigated the effectiveness of a tailored, interactive text message program designed to promote vaping cessation among adolescents.
Study Design and Participants
The study was a parallel, two-group, double-blind, individually randomised clinical trial conducted from October 1, 2021, to October 18, 2023. It included 1,503 adolescent e-cigarette users aged 13 to 17 years who were interested in quitting vaping within 30 days. Participants were recruited via social media ads and were required to own a mobile phone with an active text message plan. The intervention was delivered via text message, and assessments were completed online or by telephone.
Interventions
Participants were divided into two groups:
Assessment-Only Control Group (n=744): This group received only study retention text messages.
Intervention Group (n=759): In addition to receiving study retention text messages, this group received a tailored, automated, interactive text message program designed to deliver cognitive and behavioural coping skills training and social support.
Primary Outcome Measure
The primary outcome of the study was self-reported 30-day point-prevalence abstinence from vaping at seven months. This was analysed using intention-to-treat analysis, with any missing data coded as continued vaping.
Results
The trial achieved a 70.8% retention rate at seven months. The intention-to-treat analysis revealed the following abstinence rates:
Intervention Group: 37.8% of participants reported abstinence from vaping.
Assessment-Only Control Group: 28.0% of participants reported abstinence from vaping.
This difference was statistically significant (P < .001). Importantly, no baseline characteristics, including nicotine dependence, moderated the treatment-outcome relationship. Additionally, there was no evidence that adolescents who quit vaping transitioned to combustible tobacco products.
Implications
The study demonstrated that a tailored, interactive text message program significantly increased self-reported vaping cessation rates among adolescents. This finding is crucial given the high prevalence of e-cigarette use among teens and the associated health risks. The success of this intervention highlights the potential of using digital health tools to support adolescent vaping cessation.
This randomised clinical trial provides strong evidence that a tailored text message program can effectively help adolescents quit vaping. Given the high rates of e-cigarette use among teens and the lack of empirically tested cessation interventions, this study underscores the importance of developing and implementing innovative digital health solutions to address this public health challenge.
A groundbreaking study conducted by The Ohio State University Comprehensive Cancer Center (OSUCCC) and published in the Journal of Oncology Research and Therapy has revealed that individuals who both vape and smoke are four times more likely to develop lung cancer than those who only smoke. This research offers the first concrete evidence that the combination of smoking and vaping significantly increases cancer risk compared to smoking alone. The findings have profound implications for public health and tobacco product regulation.
Study Design and Methods
Research Overview
The study analysed data from 4,975 individuals diagnosed with lung cancer and a control group of 27,294 individuals without cancer. All participants were from the same geographic area (Columbus, Ohio) and had similar distributions of age, gender, and race. The research aimed to compare the incidence of lung cancer among exclusive smokers, exclusive vapours, and those who both vape and smoke.
Key Findings
The results were striking: dual use of cigarettes and e-cigarettes was eight times more common among lung cancer patients compared to the control group. Furthermore, the risk of developing lung cancer was found to be four times higher for dual users than for those who only smoked. These findings were consistent across different genders and racial groups.
“Our findings provide the first evidence that smoking in combination with vaping significantly increases the risk of lung cancer compared to smoking alone. Most people know that tobacco smoke contains cancer-causing chemicals but, overall, there is less knowledge about the chemicals that are inhaled through vape vapours,” said Dr. Randall Harris, the study’s corresponding author and professor of epidemiology.
Implications for Public Health
Increased Cancer Risk
Lung cancer remains the leading cause of cancer-related deaths worldwide, responsible for 1.8 million deaths in 2020 alone. The American Thoracic Society attributes approximately 87% of these cancers to persistent tobacco smoking. The new study underscores that dual use of smoking and vaping compounds this already high risk.
“From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products. This study presents clear evidence showing that vaping in addition to smoking can increase your risk for lung cancer. This is especially concerning given the rate of youth and young adults using these products,” said Dr. Marisa Bittoni, the study’s lead author and researcher in the medical oncology division.
Need for Regulation
The study highlights the urgent need for regulatory measures to address the dual use of tobacco and vaping products. Researchers argue that existing regulations may not adequately account for the combined health risks posed by both smoking and vaping.
“Regulators need to consider these additional health exposures in their regulation of the tobacco product industry to further protect public health, particularly when it comes to inhaled flavourings and nicotine dose concentrations,” Dr. Harris emphasised.
Broader Context of Tobacco Product Regulation
Calls for Comprehensive Research
The study was supported by grants from the National Cancer Institute and the Richard B. Early Cancer Research Fund. It calls for more extensive research into the health effects of alternative tobacco products. The OSUCCC – James Center for Tobacco Research, funded by the National Institutes of Health, is at the forefront of research aimed at informing the U.S. Food and Drug Administration’s regulation of tobacco products.
“More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry,” Dr. Bittoni concluded.
Public Health Recommendations
To mitigate the elevated cancer risk associated with dual use, public health officials recommend several strategies:
Enhanced Regulation: Tightening regulations on both traditional and e-cigarette products to account for their combined use.
Public Awareness Campaigns: Increasing public awareness about the heightened risks of dual use, particularly among youth and young adults.
Targeted Interventions: Developing targeted interventions to reduce the prevalence of dual use, focusing on both prevention and cessation programs.
The study provides compelling evidence that the combination of smoking and vaping significantly increases the risk of lung cancer. These findings necessitate urgent action from public health officials and regulators to address the compounded risks posed by dual use. Continued research and robust regulatory measures are essential to protect public health and reduce the burden of lung cancer.
The Australian Government wants to protect young people from the harms of vaping and nicotine dependence. From 1 July 2024, nicotine vapes in Australia are regulated as therapeutic goods. This means they are only available at pharmacies to help people quit smoking or manage nicotine dependence. It is illegal for any other business, such as tobacconists, vape shops and convenience stores, to sell any type of vape or vape product.
Until 30 September 2024, everyone needs a prescription from a doctor or nurse practitioner to purchase therapeutic vapes from a pharmacy.
From 1 October 2024, people 18 years or over will be able to purchase nicotine vapes directly from a pharmacy without a prescription.
People under 18 will still need a prescription to access vapes, where state and territory laws allow it, to ensure they get appropriate medical advice and supervision.
The concentration of nicotine in vapes sold in pharmacies without a prescription will be limited to 20mg/ml; people who need vapes with a higher concentration of nicotine will still require a prescription.
Additional changes will limit the flavours available to mint, menthol and tobacco, and require plain pharmaceutical packaging for all vape products.
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