Warning of “history repeating,” researchers list ten problems with psychedelic research that make conclusions about efficacy and safety uncertain. March 20, 2023
Drugs like ketamine, psilocybin (mushrooms), LSD, and MDMA are at the forefront of a new wave of overhyped treatments for mental health problems that may fail to deliver on their promises, according to a new article by researchers Michael van Elk and Eiko Fried at Leiden University, the Netherlands. They write that psychedelic research is plagued by methodological problems that make the efficacy and safety of these drugs uncertain.
Despite the minimal research and its limitations, the drugs have been hyped as “miracle” drugs, with some, like esketamine, even receiving FDA approval—despite failing to beat placebo in five of its six initial efficacy trials (the sixth trial reached statistical, but not clinical, significance). In fact, last year, researchers wrote that the promotion of ketamine/esketamine treatments poses “a significant risk to the public.” In their new article, published before peer review on the preprint server PsyArXiv, van Elk and Fried focus on the top 10 methodological problems rampant in psychedelic research, how these issues undermine the evidence base, and how researchers can avoid them in the future.
“These problems threaten internal validity (treatment effects are due to factors unrelated to the treatment), external validity (lack of generalizability), construct validity (an unclear working mechanism), or statistical conclusion validity (conclusions do not follow from the data and methods),” the researchers write.
Worse, they add, most psychedelic studies feature more than one of these problems, which makes the studies far more unreliable: “These problems tend to co-occur in psychedelic studies, strongly limiting conclusions that can be drawn about the safety and efficacy of psychedelic therapy.”
While it's a drug that's widely considered as ‘safe’, nitrous oxide can cause serious harm.
Medical professionals are calling for tighter restrictions on the sale of nitrous oxide gas cartridges, colloquially known as ‘nangs’, due to potentially serious harm for users including lasting neurological damage. Nitrous oxide or ‘laughing gas’ is normally used by dentists and medical professionals to provide sedation and pain relief to patients undergoing minor procedures. It’s also a food additive, used to aerate whipped cream, and sold in gas cartridges online and in convenience stores.
An increasing number of Australians are also using nitrous oxide recreationally, inhaling the gas to produce a fleeting feeling of euphoria and excitement. Many people who use the drug consider it to be relatively harmless, but according to experts from the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, this is far from the case.
‘Nangs’ are increasingly popular – Among people who regularly use ecstasy and/or other illicit stimulants, surveyed by NDARC as part of the Ecstasy and Related Drugs Reporting System (EDRS), nitrous oxide use has jumped in recent years. From 2003 to 2015, approximately one-quarter of the group reported nitrous oxide use in the past six months. This proportion doubled to 50 per cent in 2018 and has remained at a similar level since. The frequency and quantity of nitrous oxide use among these participants has remained relatively low and stable over time. Less is known about nitrous oxide use in the general population, but this also appears to be increasing over time. The Australian Institute of Health and Welfare (AIHW) reported in their National Drug Strategy Household Survey that past year use of inhalants, which included nitrous oxide, increased from 0.4 per cent of participants in 2001, to 1.7 per cent in 2019.
Acute dangers and long-term neurological effects – With increased use of nitrous oxide among some groups, there have been increased reports of harm. For example, in a recent study of 60 emergency departments across New South Wales, presentations related to nitrous oxide use have increased from less than 10 in 2012 to more than 60 in 2018. According to Professor Shane Darke from NDARC, recreational nitrous oxide use has the potential for harmful effects in the short and longer term. “If you’re in a medical situation and you’re being given nitrous oxide… it’s mixed with oxygen. These people aren’t doing that. What they’re doing is covering their faces and inhaling pure gas,” Professor Darke said. “Now the problem with that is there’s no oxygen. You run the risk of asphyxia.” While using nitrous oxide, people are also at risk of entering a delirious state, according to Professor Darke. “They can be a risk to themselves and others. There have been spontaneous suicides and accidents.” Emergency physicians have also started noticing people presenting with jerking and odd movements after using nitrous oxide. That’s not just an unsteady gait due to intoxication – rather, a sign of significant nerve damage. “[Nitrous oxide] interferes with the absorption of Vitamin B12. This leads to neurological damage and eventually in severe cases, spinal degeneration,” Professor Darke said. “In an acute case you might be able to reverse that with infusions of B12. But in chronic cases it’s irreversible.” It’s important to note people with neurological symptoms have been heavy users of nitrous oxide, inhaling the gas every day for months and consuming hundreds of canisters at a time. More research is needed to understand the effects of light to moderate use, which may still carry risk of nerve damage. For complete article go to Nitrous oxide – not a laughing matter | UNSW Newsroom
Study finds damage in the lungs of chronic e-cigarette users
Chronic use of e-cigarettes, commonly known as vaping, can result in progressive small airway obstruction and asthma-like symptoms such as shortness of breath and chest pains, according to researchers at Massachusetts General Hospital (MGH). In the first study to microscopically evaluate the pulmonary tissue of e-cigarette users for chronic disease, the team found in a small sample of patients fibrosis and damage in the small airways, similar to the chemical inhalation damage to the lungs typically seen in soldiers returning from overseas conflicts who had inhaled mustard or similar types of noxious gases.
In addition, three of the four patients had evidence of mild emphysema consistent with their former combustible cigarette smoking history, though researchers concluded this was distinct from the findings of constrictive bronchiolitis seen in the patient cohort.
Because the same type of lung damage was observed in all patients, as well as partial improvement in symptoms after e-cigarette usage was stopped, researchers concluded that vaping was the most likely cause after thorough evaluation and exclusion of other possible causes. "Our investigation shows that chronic pathological abnormalities can occur in vaping exposure," says senior author David Christiani, MD, a physician investigator at Mass General Research Institute. "Physicians need to be informed by scientific evidence when advising patients about the potential harm of long-term vaping, and this work adds to a growing body of toxicological evidence that nicotine vaping exposures can harm the lung." The study was published in New England Journal of Medicine Evidence.
One of the quickest ways to teen and future adult addiction, is Vaping Nicotine! Vape lab test: No wonder nicotine hooks teens
A flagrant black market is selling vapes and e-cigarettes containing nicotine to young people in plain sight of authorities and in contravention of the law, exposing a new generation to the highly addictive substance. Nearly all store-bought vapes contain the chemical nicotine, despite not stating so on the packaging, threatening to undo decades of public health campaigning on the dangers of smoking. Health experts said the true toll of vaping may not be known for years as convenience stores and tobacconists continue to sell vapes with near impunity. Tobacconists in inner Sydney sold The Oz vapes without asking for proof-of-age identification or a valid prescription for nicotine e-cigarettes, which is a requirement by law. None of the vapes said they contained nicotine on the packaging and only one tobacconist said that the vape they sold The Oz contained nicotine, an IGET Shion Pod. They did not ask for a prescription. Independent testing by the University of Wollongong (UOW) confirmed all but one of the four store-bought vapes – a strawberry lychee flavoured One Vape – contained the highly addictive chemical. Dr Celine Kelso said the UOW’s School of Chemistry has tested hundreds of vapes. She said all contained nicotine except for the one supplied by The Oz For more go to Almost all vapes contain nicotine: health effects still unclear Also see
Vaping cannabinoid acetate leads to formation of deadly gas – New Study
A new study by Portland State University… found that the toxic gas known as ketene is released when cannabinoid acetates are heated under vaping conditions. Ketene was found previously by researchers studying vitamin E acetate in 2019 in the emissions from a commercial e-cigarette. This led to ketene's identification as a possible source of the vaping-induced lung injury outbreak that led to nearly 3,000 hospitalizations and deaths in the U.S. as of February 2020. While ketene is known to be toxic to humans, Researchers said “it's too dangerous to study in order to fully understand its impact on the human body.”
The acetate group used in products, like Delta 8, make it easier to cross the blood-brain barrier, enhancing potency, Strongin said. The chemical reaction is similar to how morphine becomes heroin, he added. Strongin hopes to work with regulatory agencies to alert consumers and regulators about this finding.
The study provides results based on one puff, which showed not only that ketene formed at lower temperature settings than previously thought but at levels that are known to be dangerous to an individual's health.
New psychoactive substances (NPS) are a diverse group of substances designed to replicate the effects of substances like cannabis, cocaine and ecstasy. The nature of the ever-changing NPS market raises concerns about their chemical, metabolic and toxicity profiles, and the linked physical, social and mental health harms.
Over the past months, ISSUP has put together a webinar series on the topic. The recordings for the webinars can be found here. Additionally, this reading list provides links to resources, publications and research exploring the subject.
1) EMCDDA has put together a webpage that provides an overview of new psychoactive substances. As well as sharing information, the website also includes the latest events and news on the subject.
2) This early warning advisory, published by UNODC, shares an overview of new psychoactive substances, examines the risks and provides an overview of the different ways that UNODC is assisting governments in this area.
3) This review, which was published in therapeutic advances in psychopharmacology, explores the nature of NPS and the physical and mental health harms, which are commonly associated with their use.
4) This book provides an analysis of the social and economic impact of the NPS. It presents an overview of the international regulation, policy and market structure and covers topics such as organized crime, drug markets, and clinical evidence on NPS.
5) Emerging Trends in Drugs, Addictions, and Health is a new international journal devoted to the rapid publication of authoritative papers on Novel Psychoactive Substances (NPS), Addiction and associated health phenomena. You can read the new open-access journal here.
6) The Handbook of Novel Psychoactive Substances (NPS) provides an overview of the challenges that clinicians face when dealing with NPS. Written by experts in the field, the handbook provides information on symptoms, psychopathology, toxicity, and overall clinical management.
7) This document, developed by NEPTUNE, provides guidance on the clinical management of harms resulting from acute intoxication and from the harmful and dependent use of club drugs and Novel Psychoactive Substances (NPS).
8) Here, you can access training modules, developed by project NEPTUNE and the Royal College of Psychiatrists, to improve clinical practice in the management of harms resulting from the use of club drugs and novel psychoactive substances.
Challenges in Identifying Novel Psychoactive Substances and a Stronger Path Forward
The importance of non-targeted testing to keep pace with a rapidly evolving synthetic opioid market.
The synthetic opioid market…is constantly evolving. Once a new substance is identified, it may only be prevalent for three to six months before it’s replaced by something new and yet to be identified by forensic laboratories.
For example, over one weekend in July 2018, Philadelphia-area hospitals experienced a surge of more than 100 patients with suspected opioid overdoses. Following the administration of naloxone, patients would become combative – an unusual reaction for an opioid overdose.
To help local public health and public safety agencies identify what was causing this troubling trend, the NPS Discovery drug early warning system at the Center for Forensic Science Research and Education (CFSRE) acquired a sample of “Santa Muerte,” the drug linked to the large number of overdoses. Advanced mass spectrometry analysis found within the sample a combination of fentanyl, heroin, and a synthetic cannabinoid – a combination not often seen in the region. Given the unique side effects that overdose patients were experiencing, it was thought this may be a synthetic drug combination worth tracking closely.
However, substances containing fentanyl and synthetic cannabinoids did not last long and were only a fraction of the whole drug supply in the region. After about six to nine months following the July overdoses involving “Santa Muerte,” these substances were largely replaced by new synthetic drug products, primarily fentanyl cut with xylazine.
Illicit drug use in Australia during the COVID-19 pandemic (A Viewpoint)
Societal changes due to the COVID-19 pandemic, including changes in employment status, available coping strategies (eg, social support from friends and family may be more limited), and availability of drug treatment options have appeared to affect the use of illicit drugs in Australia. The procurement method of choice still appears to be predominantly face-to-face but occurring less frequently, leading to larger quantities of drugs being bought each time which is in line with pandemic restrictions attempting to reduce social contact. Many of the effects of COVID-19 on the drug market, however, may be temporary, and given the lack of government policies or red tape to contend with, the drug market could likely adapt. As a result, factors other than the pandemic may have more influence on changes in demand, drugs of choice, and procurement, including economic factors such as government budgets allocated to drug enforcement.
In conclusion, how people procure and use illicit substances once the pandemic ends and life returns to relative normality still remains to be seen. Like many behaviours that have acclimated to the “new normal”, drug-related behaviours will presumably return to something resembling pre-2020 life. The last two years have clearly shown, though, that where there is drug demand there will be a drug supply, pandemic or not. If societies want to reduce drug-related harm, then changes to legal frameworks based on evidence-based harm reduction health research are needed, with politics removed from the equation.
(This is where the term ‘overdose’ is legitimate. Any drug not legally prescribed cannot be ‘overdosed’ on. Taking these drugs is an act of self-poisoning.)
In general, barbiturates can be thought of as so-called brain relaxers. Alcohol is also a brain relaxer. The effects of barbiturates and alcohol are very similar, and when combined can be lethal. Pain medicines, sleeping pills, and antihistamines also cause symptoms similar to those of barbiturates.
People who abuse barbiturates use them to obtain a “high,” which is described as being similar to alcohol intoxication, or to counteract the effects of stimulant drugs.
In small doses, the person who abuses barbiturates feels drowsy, disinhibited, and intoxicated.
In higher doses, the user staggers as if drunk, develops slurred speech, and is confused.
At even higher doses, the person is unable to be aroused (coma) and may stop breathing. Death is possible.
It is important to note that the difference between the dose causing drowsiness and one causing death may be small. In the medical profession, this difference is called a narrow therapeutic index, which is the ratio of a drug's toxic dose to its therapeutically desirable dose. This is the reason why barbiturates are dangerous. It is also why barbiturates are not often prescribed today.
Symptoms of withdrawal
Symptoms of withdrawal or abstinence include tremors, difficulty sleeping, and agitation. These symptoms can become worse, resulting in life-threatening symptoms, including hallucinations, high temperature, and seizures.
Psychedelics: The New Panacea – Just Like Cannabis, it will Fix Everything, Won’t it?
Everything you need to know about psychedelics and mental illness
The science of psychedelics is everywhere – but we should treat it with serious scepticism
Research is me-search
It’s the same for psychedelics. This is just an anecdotal account, but there’s an interview with the psychedelics researcher Manoj Doss, who says that he “only know[s] one psychedelic researcher who’s never done psychedelics”, and notes (in an encouragingly self-critical way) that this is a conflict of interest. He’s right! Just as you’d feel extra-sceptical if all the research showing that pork is unhealthy was written by Muslims who’d already decided for religious reasons not to eat pork, you should be worried about the sheer number of studies by psychedelic researchers who are themselves aficionados of the drugs.
(You might wonder if they’re into psychedelics precisely because the research shows such impressive benefits, switching around cause and effect. But as we’ll see below, that evidence doesn’t exist yet. That particular horse is coming way after the cart).
This isn’t just the view of one researcher. Reading the literature on psychedelics, you continually encounter concerns about the “over-exuberance” of some scientific advocates of the drugs. There are also discussions of conflicts of the financial kind: we know that there are a lot of psychedelic-drug companies springing up all over the place, and we know they pay consultation fees to psychedelics researchers because these are disclosed in research papers (see e.g. the section near the end of this paper, which we’ll discuss in more detail below).
There are all kinds of problems—from outright publication bias to more subtle “questionable research practices”—that can creep in when researchers have a conscious or unconscious bias in one particular direction. It doesn’t take much to push the statistical results in a field towards unreliability and false-positivedom. One 2020 paper suggests methods, many of them from Open Science, that psychedelics researchers should consider using to try and reduce these biases. I doubt many papers on psychedelics use them already.
Yikes. He even lists the papers he’s reviewed on his website, so we can have some idea of which ones we might wish to be extra-sceptical about (Sessa has also been criticised on social media for a graph he made that, without clearly informing the reader, combines the results of two studies as if they were one).
But even if the specific scientist running a psychedelics trial isn’t themselves a “psychonaut”, there’s still the more mundane kind of bias, a bias that almost all scientists have: towards finding positive, cool, encouraging, exciting results (as opposed to null, shrug-inducing, disappointing, boring ones).
Here’s an example – and it happens to concern one of the most important psychedelic trials yet performed. In April 2021 the psychedelics researcher Robin Carhart-Harris (now at UC San Francisco; back then at Imperial College London where he still has an affiliation) wrote an article in The Guardian entitled “Psychedelics are transforming the way we understand depression and its treatment”. It was part of the publicity for a new randomised controlled trial (RCT) he’d co-authored, which had just been published in the world’s top medical journal, the New England Journal of Medicine.
The psychedelic in question was psilocybin, the main active ingredient from magic mushrooms. Before we get to the 2021 trial, it’s worth backtracking slightly to look at what evidence on psilocybin and depression existed beforehand. Here are the trials:
A “pilot study” from 2011 of psilocybin in advanced-stage cancer, including 12 patients, which found no statistically significant results on depression measures;
A “feasibility study” in 2016. This had 12 patients and no control group, so can only really be used to, as the authors put it, “motivate further trials”;
A double-blind RCT from 2016 in 51 patients with life-threatening cancer which found that psilocybin had very positive effects on mood that lasted for up to 6 months;
Another double-blind RCT, also from 2016, in 29 patients with life-threatening cancer that again found beneficial effects on depression symptoms over 6 months;
A final RCT from 2020, in 27 patients with major depression (of whom 24 actually finished the study) that found “large, rapid, and sustained antidepressant effects” over 8 weeks.
So, pretty tiny studies; some of them in very specific populations. The 2021 NEJM study was the first—and remains the only—study to compare psilocybin to an established, commonly-prescribed antidepressant drug – in this case the SSRI drug escitalopram. As with all the above, it was very small (59 people), but the comparison it looked at was a big deal. That’s because it’s not enough to show the psychedelic drug is better than placebo – after all, we already have treatments for depression. We need to know how it compares to those pre-existing treatments.
The harm
Anyone who’s interested in psychedelics and mental illness should listen to the New York Magazine podcast series “Cover Story: Power Trip”. Among several other stories, the podcast reports investigative work around clinical trials of MDMA (ecstasy) therapy for Post-Traumatic Stress Disorder, run by an organisation called the Multidisciplinary Association for Psychedelic Studies, or MAPS.
The crucial thing here is that it’s not just MDMA: it’s MDMA plus therapy (by the way, MDMA is only sometimes classified as a “psychedelic drug”, depending on who you talk to; but MDMA therapy is almost always classed as “psychedelic therapy”, since some of the effects overlap with drugs that are definitely psychedelics). And as described in the podcast, that therapy can get very weird.
The danger is that psychedelics can make users pliant and suggestible, leading to obvious dangers if a patient is left in the hands of anyone with less-than-noble intentions (there’s a reason so many cults over the years have used psychedelics–including MDMA–to help keep their members compliant). The podcast relates the story of Meaghan Buisson, a PTSD sufferer who underwent intense MDMA therapy with two therapists in a MAPS trial. The therapy was filmed in its entirety – and it’s grim. If you can stomach it, you should watch the video, which was uncovered in the NY Magazine investigation. But if you can’t, here’s a description:
“The therapists, Richard Yensen and Donna Dryer, guide Buisson through three long sessions with follow-ups in between. They give her the drugs and, as she recalls, coax her to relive her sexual assaults. They ask her to spread her legs, and at several points, they lie on top of her and pin her down, sometimes holding her wrists. The two then comfort Buisson by stroking her face and climbing into bed with her. There are periods in the video when Yensen is in constant physical contact with her.”
At other points, Yensen and Dryer blindfold Buisson, gag her with a towel, and ignore her as she screams at them to get off her. Yensen also “admitted to having sex with Buisson after the experimental sessions ended but while she was still enrolled in the clinical trial”. This is a far cry from the friendly, comfortable, hand-holding sessions you see in photos from other MDMA (and psilocybin) therapy sessions. MAPS has said that Yensen and Dryer did not stick to their therapy protocol and that they won’t be working with them again.
Rick Doblin, Executive Director of MAPS—who, incidentally, has argued that psychedelic therapy could have prevented the War in Iraq and will produce a “spiritualised humanity” by 2070, and who encourages his employees to smoke marijuana while doing certain tasks at work—was asked about the potential for sexual abuse by therapists in a recent Q&A session. He had this to say:
“We’re trying to make it so that the source of the healing is inside the patient… that will hopefully make them stronger when there is, um, y’know, pressure perhaps from therapists to, y’know, engage in a sexual relationship.”
Perhaps not ideal.
Hopefully this article has convinced you that there are a lot of red flags in the psychedelic scientific literature, and that you should perhaps set your standards higher than usual when reading about this area. To summarise everything I’ve said, we should bear the following in mind:
The reasons people are so excited about psychedelics for mental illness are not necessarily related to how much evidence there is for the treatment;
The conflicts of interest in the psychedelic research field go very deep. It’s completely plausible that these conflicts help bias the studies toward reporting more positive results than are actually true;
The discussion of psychedelic research in the media often bears only a passing resemblance to what’s actually in the trials – or at least it sounds a lot more certain and optimistic than is warranted;
Even the best-quality trials are flawed in important ways because—mainly due to problems of expectations and blinding—this is an incredibly difficult thing to study;
We shouldn’t allow our excitement for psychedelic drug trials to run roughshod over safety concerns, and we shouldn’t be so desperate for a breakthrough mental health treatment that we roll out these drugs before we’ve tested whether they work in high-quality, smartly-designed studies.
We’re nowhere near reaching peak interest in psychedelics. With all the scientific research programmes, and all the companies vying with each other to create the bestselling psychedelic product, maybe there’s a chance some of the above uncertainties will be ironed out in the coming years.
On the other hand, researchers might just continue doing low-quality, hard-to-interpret studies that back up their pre-existing beliefs, giving false hope to sufferers of mental illness. You don’t exactly have to be tripping to imagine that.
Many Teens Overdose on Meds Prescribed for ADHD, Anxiety.
(Not a Low Risk Option for the issue – What else is in Play?)
14/3/2022 (HealthDay News) -- Taken correctly, prescription drugs used to treat attention-deficit/hyperactivity disorder (ADHD) can help teens and young adults navigate their condition, but a new study finds many are dying from overdosing on these medications.
In 2019, benzodiazepines like Xanax and stimulants like Adderall accounted for more than 700 and 900 overdose deaths, respectively, in the United States, according to the U.S. Centers for Disease Control and Prevention.
"In recent years, there has been considerable attention devoted to risks of addiction associated with diverted or illicitly obtained benzodiazepines and stimulants," said senior researcher Dr. Mark Olfson. He is a professor of psychiatry, medicine and law at Columbia University Irving Medical Center in New York City.
"The new study serves as a reminder that prescription benzodiazepines and stimulants also pose overdose risks to the patients who are prescribed them… Sadly, many of the overdose deaths among teens and young adults who had prescriptions for these drugs are intentional suicides,” Olfson said.
The upshot of the finding? Doctors and parents need to be careful about prescribing and having their kids take these drugs.
Ketamine is a medication that doctors use as an anesthetic to induce loss of consciousness. Effects include sedation and reduced sensation of pain.
Street names of ketamine include:
Cat tranquilizer
Jet K
Cat valium
Purple
Kit Kat
Special La Coke
Super K
Special K
Super acid
Vitamin K
Summary: Ketamine is a general anesthetic that doctors find useful in emergency room settings when performing proceduresTrusted Source, such as reducing fractures and treating joint dislocations.
Some studies suggest the drug may have other medical uses, but more research is necessary to prove its safety and effectiveness in these areas.
It is important to distinguish between the valid medical uses and the nonmedical uses of the drug. Although people with certain heart conditions should not take ketamine, it is generally safe when a trained professional administers it in clinical settings.
When you use street or club drugs, you’re taking a lot of risks. The drugs are dangerous, and usually there’s no way to know how strong they are or what else may be in them. It's even more unsafe to use them along with other substances like alcohol and marijuana.
Here's a rundown of common street drugs and the health threats they can pose.
These designer drugs came on the scene fairly recently and became popular fast. That may be because they were easy to get and used to be hard to detect in drug tests.
They're highly addictive, and they come in a crystalline powder that users swallow, inhale, or inject.
Despite their name, bath salts have nothing in common with products you can use for a soak in the tub.
What else they’re called: Plant Food, Bloom, Cloud Nine, Ivory Wave, Lunar Wave, Scarface, Vanilla Sky, or White Lightning.
What type of drug is it? Bath salts contain manmade stimulants called cathinones, which are similar to amphetamines.
What are the effects? These stimulants increase levels of dopamine, a brain chemical that can create feelings of euphoria.
Dakota Stephenson started vaping to help manage her anxiety. When 15-year-old Dakota Stephenson first started vaping with friends after school she never imagined it could have potentially deadly consequences.
Key points:
A teenager ended up in ICU with a condition doctors suspect was linked to regular vaping
She is now speaking publicly to warn others about the potential dangers of vapes
There are mounting concerns about vaping advertisements targeting teens through social media
That's exactly what happened when the Sydney teen ended up in intensive care last September, with what doctors believe was EVALI, a new lung illness emerging among vape users.
EVALI stands for E-cigarette or Vaping product use-Associated Lung Injury, a lung condition first reported in the United States.
At the peak of her condition, Dakota was partially ventilated on full-face oxygen in the intensive care unit at the Children's Hospital at Randwick for three days, almost drowning because of her fluid-filled lungs.
Dakota Stephenson was partially ventilated in the intensive care unit for three days.
Her mother, Natasha Stephenson, said whenever Dakota took the mask off she was visibly struggling for breath so badly doctors initially thought she had COVID-19.
"She needed a high-flow face mask, she couldn't breathe without it," she said.
"It was horrendous."
Dakota had been rushed to hospital by ambulance just days before when back pain and trouble urinating turned into vomiting, rigours, rapid heartbeat and a temperature as high as 39 degrees.
"She was really struggling to breathe. She got worse and worse," Ms Stephenson said.
Within hours Dakota became hypoxic with not enough air getting into her lungs and all signs pointed to pneumonia in both lungs.
It was then she revealed to her mother that she had been secretly vaping for the past seven months, up to three times a week.
It is thought Dakota Stephenson's is the only suspected case of EVALI reported in Australia to date.
Dakota told the ABC she first started vaping in early 2020 as a way to manage her emotions.
"They kind of calmed me down in a way, like it was soothing to my anxiety," she said.
"The colours were just intriguing — all of it."
Within weeks the high school student started graduating to cartridges that also contained nicotine.
'It looks so innocent'
Dakota was released from hospital after a week, but months later the previously fit teen still struggled with basic cardiovascular exercise.
Her mother said she narrowly escaped permanent injury with some nodules still showing up on lung scans months later.
Dakota said she was speaking out to warn other teenagers about what she believes are the potential risks of vaping.
"It looks so innocent but it could kill you. It's so scary," she said.
Ms Stephenson said she was shocked to learn her daughter had been secretly vaping, saying neither she nor Dakota's father smoked and were very anti-smoking.
"The hardest part was definitely when they said they had to take her to the Children's Hospital," she said.
"Words can't describe as a parent how it made me feel."
Pill-checking/Testing, Helping or Harming – What is the Subtext?
The phenomenon of semantic contagion is a fascinating one, and it is has been used relentlessly in propaganda measures to recalibrate thinking around fixed ideas in all sorts of arenas.
A brief (an one aspect) take on this is, a process of reframing a word, term, phrase or principle for purposes of harnessing it for another focus, other than it’s intended specificity. It is often not necessarily a blatant misuse of the term, rather a re-tasking to suit an agenda not originally meant for the term.
Harm Reduction is just such a term that has been so engaged and recalibrated over recent years.
This important Pillar of the National Drug Strategy was set in place in an attempt to reduce the burden of disease, disorder and/or death of those caught in the tyranny of drug addiction,of drug addiction, whilst simultaneously assisting them to exit the drug use that is causing said dysfunctional states.
A useful meme employed by many proponents of this framework is, ‘You cannot rehabilitate a dead drug user.’ Again, a useful linguistic tool for a semantic contagion strategy, because whilst it is true, and using absolute and dramatic terms like ‘death’, lends a certain urgency (as it should), that is not the final agenda of the pro-drug advocate.
Of course, no Harm Reductionist who hates drugs and wants drug users off these life diminishing toxins wants a user to die. However, the pro-drug use proponent will hide behind the hijacked nomenclature of ‘preventing death’ (only one of many other lifedestroying harms of drug use), not for the purpose of exiting drug use and develop full humanity, instead it is to continue drug use whilst managing as many ‘harms to the high’ that can be mustered.
Again, the important Harm Reduction platform was set up to assist those current drug users, reduce the activity that is causing harm, not just the ‘harm’ of the self-destructive activity they are now – if dependant – trapped in. The intent of this was always, reduce use, reduce harm, and exit drug use.
However, this well-meaning platform, when employed by those who not only want to, by deliberate design, move into illicit drug use, but endeavour to normalize their ‘recreational’ choices, have – using semantic contagion – (among other strategies) to give their agenda some traction.
Nowhere is this more evident that with Pill Checking program promotion.
You will note there have been zero harmful incidents over the consumption of illicit substances at any music festivals for around 18 months. This is confirming at least one fact, that these events are a contagion in and of themselves for the potential of the Non-Communicable Drug Disease (NCD) of substance use. These events heighten and do not diminish both the exposure and susceptibility factors in aetiology that exacerbates this NCD.
That aside, the well-meaning agenda of the genuine Harm Reductionist, may be to
Minimise adulterants to the illicit psychotropic toxin being courted
Even advise of the risks of ‘uncut’ pure illicit psychotropic toxins
It is the more potent and tangible messaging of such a (if permitted by law) mechanism that undermines the other two priority pillars of the National Drug Strategy – Demand and Supply Reduction. This vehicle tacitly affirms the act of seeking out a ‘party enhancement’ substance – undermining Demand Reduction. This demand consequently only adds to the supply driver – undermining Supply Reduction. Both actively undermining these priority pillars of the National Drug Strategy.
You do not ‘extinct’ behaviour by endorsing, equipping and enabling it. That no longer seems to be a focus with illicit drug use by a small, but noisy cohort. Yet in the same National Drug Strategy, the cessation focus is the only model for tobacco, and with remarkable success.
So, why is this actively avoided in the illicit drug use space? We’ll let you investigate this incongruence at your leisure.
Those permission models, particularly for punters who wants to experiment, is a green light hard to resist, especially when ‘nestled in’ among other contagions, such as peer pressure, ‘psycho-naut’ propaganda and the parochial permission of this now ‘drug law free’ arena called a Music Festival.
All of this does not eliminate the risk of drug use harm – even of the now ‘checked and permitted’ variety, if for no other reason than illicit substances are toxins and unpredictably idiosyncratic in nature and impact.
Death, whilst a drastic and instantly permanent outcome of substance use is tragic, there are other harms that can be incurred, some of which are also not only debilitating, but can be permanent and ‘endorsement’ mechanisms that permit activities that can facilitate those harms is not good public health practice.
Governments of civil society are supposed to provide safe, healthy and productive environments for their citizens. Environments that are protective, not mere ‘risk mitigating’ spaces.
Whilst some citizens may seek to live counter to such priorities and expect to create a culture that not only undermines best health and well-being practice, but extol its ‘virtues’, they still continue to look to the same government for assistance when things go ‘pear shaped’. Often with a view to maximize their well-being whilst choosing to remain in a drug use – and a consequently self-harming – context.
Legislatively endorsed pill-checking is incongruent with best-practice health strategies and clearly current illicit drug laws. The simple mantra, ‘they’re gunna do it anyway’ has never been a credible precedent for best practice strategies, at least in an ethically focused civil society.
It is important that all the semantic texts and subtexts are investigated.
International research shows ‘strong evidence’ linking vaping to cigarette smoking
People under 20 who used vapes were more than three times as likely to have ever smoked tobacco cigarettes, and more than twice as likely to have smoked cigarettes in the previous month, according to a review of 25 studies globally.
Serene Yoong, an associate professor at Swinburne University of Technology in Melbourne and the study’s lead author, said the findings pointed to the need for youth prevention programs and better regulation of e-cigarette products.
“Every single study showed an association between [e-cigarette] use among non-smokers and increased use of cigarettes at follow-up,” she said.
History has shown that stimulant epidemics follow opioid epidemics. In recent years…Methamphetamine poses its own set of risks: addiction, damage to the body and brain, overdose, and increasing contamination with fentanyl and other toxic adulterants. Like cocaine, methamphetamine is highly reinforcing. Administration fuels binge use and often leads to major health problems in addition to craving and substance use disorder. The treatment for methamphetamine overdose has not advanced very much in the last 50 years and life-saving options remain limited. Because of these factors, prevention is the more important intervention while more effective treatments are developed for those with methamphetamine use disorder.
Methamphetamine use has both short- and long-term effects on the brain and body. Methamphetamine is toxic to the brain — studies have found that methamphetamine can cause similar damage to brain tissue as traumatic brain injuries. Acute use can cause short-term psychiatric symptoms, such as anxiety, hyper ability, disturbed speech patterns, and aggression. For some people these symptoms are not temporary. Long-term use can cause methamphetamine-induced psychosis, which includes hallucinations, delusions, and paranoia that can persist after long periods of abstinence. This methamphetamine-induced psychosis has similar symptoms to naturally occurring psychosis but does not respond as well to standard treatments.
In terms of its effects on the body, methamphetamine is rapidly absorbed by many organs and chronic use can harm the heart, lungs, and kidneys, among other organs. Intravenously injecting methamphetamine increases one’s risk of contracting infections such as Hepatitis C and HIV which are spread through shared injection supplies like needles.
Effect of intermittent exposure to ethanol and MDMA during adolescence on learning and memory in adult mice
Nearly a decade ago, the alarm was sounded to the wider public on the long-term dangers of alcohol and MDMA on young brains. The need to reduce demand is grown even more, and measures to promote or permit use, particularly of MDMA is incredibly disturbing. All energies should be put into diminishing, not endorsing or worse, enabling use.
Conclusions: The present findings indicate that the developing brain is highly vulnerable to the damaging effects of EtOH and/or MDMA, since mice receiving these drugs in a binge pattern during adolescence exhibit impaired learning and memory in adulthood.
Association of 1 Vaping Session With Cellular Oxidative Stress in Otherwise Healthy Young People With No History of Smoking or Vaping-A Randomized Clinical Crossover Trial
A single 30-minute vaping session can significantly increase cellular oxidative stress. Middlekauff et al demonstrated that vaping is associated with adverse changes in the body that can presage future health problems
Like tobacco cigarette (TCIG) smoking, long-term electronic cigarette (ECIG) vaping in young people is associated with elevated cellular oxidative stress (COS), which is important in the pathogenesis of many diseases, including atherosclerosis.1 As with TCIG smoking,2 even infrequent ECIG use may be associated with adverse biological effects with implications for future health risks. Importantly, the proportion of high school students who have used ECIGs within 1 month of the time of study has skyrocketed, approaching 30% in the US.3,4 The purpose of this study was to evaluate the association of a single session of ECIG vaping on COS in immune cells in young people who do not smoke or vape compared with young people with long-term TCIG or ECIG use.
The genotoxicity of Cannabis has long been suspected, even acknowledged, be it only in part. Research over the last 5 to 10 years has confirmed the case. Much of this important research has been ‘buried’ in the deluge of ‘hopeful’ and even spectacular claims of the potential therapeutic capacity of cannabis.
Claims and promises that have persisted for well over 20 years, yet with little to nothing to show for it.
However, the harms associated with the use of this now heavily engineered plant/product are mounting, and the research is not only monitoring, but discovering these harms.
If science and health matter, then all research must be thorough and properly vetted to ensure that health is advanced, not mere ‘symptom abated’ whilst disease, disorder or other harms grow.
Not only is it an exercise in Russian Roulette it also has potential to increase harms. Beyond that it is yet another key strategy of the pro-drug lobby to further ‘normalize’ drug use. Don’t just understand the data and approaches, understand the deception in the agenda. (Pill Testing Unpacked)
Nitrite ‘Poppers’: Here’s Why FDA Warned Against Their Use For Fun, Sex
Nitrite “poppers” are not the same as chicken poppers, pizza poppers, or cheesy corn poppers. While you can still use the latter three for recreation or sexual enhancement, the U.S. Food and Drug Administration (FDA) is warning that you should not use nitrite “poppers” for such purposes. That’s because nitrite “poppers” can lead to all sorts of bad health effects, including death. And death, for most people, is not good for sex.
Relaxing your smooth muscles with “poppers” can be hazardous though. After all, your body is more than just your anus or vagina. Dropping your blood pressure can mean that different parts of your body may not get enough blood and oxygen. Alkyl nitrites can lead to methemoglobinemia too. This is where your body produces an abnormal amount of methemoglobin. Methemoglobin is a form of hemoglobin. Hemoglobin is the protein in red blood cells (RBCs) that normally picks up oxygen from your lungs, carries it via the bloodstream, and then releases the oxygen to your body tissues. The problem is the methemoglobin form of hemoglobin, in the words of Mariah Carey, can’t let go. It can’t really release the oxygen to your body tissues, effectively starving these tissues of oxygen.
Therefore, it’s not a complete surprise that the FDA has, in their words, “observed an increase in reports of deaths and hospitalizations with issues such as severe headaches, dizziness, increase in body temperature, difficulty breathing, extreme drops in blood pressure, blood oxygen issues (methemoglobinemia) and brain death after ingestion or inhalation of nitrite ‘poppers.’” Death will, of course, really relax your anus and vagina but has other consequences.
The risk of bad effects jumps even higher when you combine poppers with other substances that can also dilate your blood vessels. These substances include blood pressure medications, sildenafil (Viagra), and alcohol. But, of course, no one mixes alcohol or Viagra with sex, right?
The FDA warned specifically about using nitrite “poppers”for recreational purposes or sexual enhancement.
In a recent article in Queensland’s Courier Mail, It literally melts kids’ brains the issue of ‘chroming’ or inhalant use has been put back on the public radar. Whilst this issue has never disappeared, it does come to public attention when harms grow.
Hospitalisations for teenagers suffering from chroming sickness have increased for the fifth straight year as a teacher’s call to ban an aerosol deodorant linked to the devastating habit goes unheard.
Hospitalisations have increased by 40 per cent among people under 19 and are up 11 per cent overall from the 2018/19 to 2019/20.
There were 115 people put in Queensland hospitals 157 times due to chroming, 63 of them were 19 years and under.
Queensland Children’s Hospital Emergency Physician Dr Daniel Bodnar has seen the increase first-hand with children as young as 12 hospitalised for chroming related illness.
“What really worries me is the long-term effects, these solvents are like paint strippers, and much like a paint stripper melts the paint off a paint brush, that’s what it does to people’s brains,” Dr Bodnar said.
“It literally melts the special lining of the nerve cells in the brain which leads to major problems down the track like they can’t think properly and their IQ goes down,” he said.
“The brain is very slow to heal and the idea is the more exposed to it the more likely long term damage will be done,” he said.
“It’s just horrible, you can actually see evidence of it on scans.”
Inhalant issues can come and go, depending on several influencing factors and their potential influence on use. For example, the 2007 ‘Graffiti Prevention Act’ (Victoria that came into effect in 2008) saw the restrictions on sales of spray paint to minors. The term ‘Chroming’ was synonymous with inhalant activity with spray paint products being the primary, but not sole source of inhalant activity.
Dalgarno Institute staff have had firsthand experience with young people who used inhalants extensively prior to this injunction, and the fatal capacity of inhalant use, with one young 16 y.o client dying on a train station platform after a single inhalant episode.
Other factors can contribute to decline in use, such as easier access to other illicit drugs or cheaper and easily accessible alcohol. If other substances are either more readily available, cheaper, or easier to access, this can divert from inhalant use.
Of course, determinants of engagement with inhalant or another our mood/mind altering substance remain many and varied.
Whilst trauma, neglect and abuse can be key social determinants of use, so are other factors such as tacit permission modes for substance engagement that pro-drug advocates are promulgating via ‘inevitability’ and even ‘right’ messaging on substance use. Also underlying much of the substance engagement issue remains, meaninglessness, purposelessness and the boredom and hedonic activities these can precipitate.
‘Grown Ups’ and Inhalants.
Inhalant use is not the purview of the hapless teen alone. There are more ‘sophisticated versions’ of inhalant use in the marketplace parading as psycho-social and psycho-sexual enhancement vehicles. One common genre is ‘Poppers’.
This chemical amyl nitrite has been prescribed by doctors in the past to people with heart conditions. Whilst currently it is used to treat cyanide poisoning.
Yet, this inhalant may also be ‘embellished’ with various chemicals and can be cryptically marketed as a ‘room deodorizers’ or ‘leather cleaners’. However, in certain jurisdictions, it can be sold as a ‘party supplement’ such as Jungle Juice Platinum or Double Scorpio Honey.
In the summary of a 2020 Medical News Today Article, the risks of harms from this substance are very concerning;
Poppers can cause serious side effects, and some reactions can be fatal. Considering the possible adverse effects, the best option is not to use poppers. The risks outweigh the short-lived high of the drug.
Personal stories of short and long-term harms of this inhalant are real, growing, and disturbing.
One website dedicated to warning against this inhalant use is The Truth About Poppers and is aimed at not only creating awareness but providing a forum for those who have experienced the harms of this dangerous practice and want to warn their friends and loved ones of the harms of this substance.
Psilocybin is a hallucinogenic substance people ingest from certain types of mushrooms that grow in regions of Europe, South America, Mexico, and the United States.
Risks
People who have taken psilocybin in uncontrolled settings might engage in reckless behavior, such as driving while intoxicated.
Some people may experience persistent, distressing alterations to the way they see the world. These effects are often visual and can last anywhere from weeks to years after using the hallucinogen.
Physicians now diagnose this condition as hallucinogen persisting perception disorder, also known as a flashback. A flashback is a traumatic recall of an intensely upsetting experience. The recollection of this upsetting experience during hallucinogen use would be a bad trip, or a hallucination that takes a disturbing turn.
Some individuals experience more unpleasant effects than hallucinations, such as fear, agitation, confusion, delirium, psychosis, and syndromes that resemble schizophrenia, requiring a trip to the emergency room.
In most cases, a doctor will treat these effects with medication, such as benzodiazepines. These effects often resolve in 6 to 8 hours as the effects of the drug wear off.
Finally, though the risk is small, some psilocybin users risk accidental poisoning from eating a poisonous mushroom by mistake – Symptoms of mushroom poisoning may include muscle spasms, confusion, and delirium. Visit an emergency room immediately if these symptoms occur.
Because hallucinogenic and other poisonous mushrooms are common to most living environments, a person should regularly remove all mushrooms from areas where children are routinely present to prevent accidental consumption.
Most accidental mushroom ingestion results in minor gastrointestinal illness, with only the most severe instances requiring medical attention.
Psilocybin as a treatment for depression
Discussions are ongoing about whether psychological specialists can use psilocybin and similar hallucinogens as a treatment for depression.
Two studies have looked at psilocybin as a treatment. One study examined the ability of psilocybin to reduce depression symptoms without dulling emotions, and the other assessed the relationshipTrusted Source between any positive therapeutic outcomes and the nature of psilocybin-induced hallucinations.
While some researchers are looking into some therapeutic uses for psilocybin, they still, at present, regard psilocybin as unsafe and illegal.
Effects
The effects of psilocybin are generally similar to those of LSD. They include an altered perception of time and space and intense changes in mood and feeling.
Possible effects of psilocybin include:
quickly changing emotions
derealization, or the feeling that surroundings are not real
depersonalization, or a dream-like sense of being disengaged from surroundings
euphoria
distorted thinking
visual alteration and distortion, such as halos of light and vivid colors
Students Who Turn To Adderall To Cram For Tests May Be Hurting Their Developing Brain
Easy A’s Now Means Struggles Down The Road
A common belief among students is that taking their friend’s Adderall will help them stay awake and be able to retain information better, but studies on academic performance and Adderall find there is no proof of benefit when used that way.
Conversely, they are damaging the prefrontal cortex, the part of the brain that stores long-term memories, according to Begdache, who began researching Adderall abuse in 2009 when a student asked her about it. She said the brain does not fully develop until age 25, and most college students are between the ages of 18 and 24.
But the dangers don’t end there. Adderall abuse can affect a person’s mood, leading to short-term side effects like paranoia, insomnia and anger. Continuing to abuse the drug can lead to dependency on other drugs such as THC (the chemical in marijuana) and alcohol. Dependency may become so severe that one could not perform daily responsibilities without it.
“When someone consumes unprescribed medications, it can place them at risk for adverse reactions. There can also be risks with consuming counterfeit pills that have been adulterated,” said Kelly Truesdell, assistant director of health promotion and community outreach at the University of Georgia.
Disrupting Cocaine Memories Prevents Return to Cocaine Use in Rats February 2021
Many people who use cocaine and other drugs return to drug use even after prolonged abstinence. Resumption of drug use often is driven by drug-associated memories that are retrieved when the person is exposed to drug cues. The results of a recent study in rats suggest that some neuronal connections (i.e., synapses) that encode cocaine-associated memories are not static but weaken for approximately 6 hours after they are retrieved and that holding these synapses in their weakened state may reduce return to cocaine use.
Pill Testing Increases Festival Goers Intention to Use Ecstasy.
Conclusion – Based on the evaluation, pill testing represents a real and present danger to the community, especially considering that generally, those who reported moderate levels of intention to use a drug before entering the pill testing service, increased their intention to use a drug after using the pill testing service. This is the exact opposite to what our Members of Parliament, the community and the media have been led to believe. Mr. Waterman said, this is absolutely damning evidence and confirms what I have said from the start, Pill testing normalises drug use and will likely lead to an increase in drug use as a result.
Pill Testing Deception- Push for Pill Testing and Absolute Farce!
Coroners Report Does Not Recomment Pill Testing in Tasmania
Chief Executive Officer, of Rural Health Tasmania, Robert Waterman, came out today with further evidence that the push to trial pill testing in Tasmania is based on a deliberate deception.
Patrick DeGrave’s brother was still in a medically induced coma in a Wisconsin hospital when he spoke to the local news. Standing before a crew from FOX 6 Milwaukee, he was ready to go public, and the vaporizer cartridge he held up for the cameras was the reason for his brother’s significant heart and lung damage.
The vapor product DeGrave showed to reporters was distilled from cannabis. But it was also apparently made by the “company” Dank Vapes — an elusive, black-market brand that’s as tricky to pin down as vapor.
They all seem to tell a similar story — that Dank Vapes may be fake. It’s a black-market “brand” that has inspired loyalty online but comes with serious risks.
“They act like a cannabis company, but they actually don’t exist. They’re in the packaging industry,” Mark Hoashi, founder of the Doja app, which is “Yelp for the cannabis industry,” tells Inverse.
“These are just people filling cartridges as ‘Dank Vapes.’ It’s not a singular facility. It’s just people in their garages filling them and selling them.”
Myron Ronay, the CEO of BelCosta Labs, a cannabis testing lab in California, tells Inverse that they often see black-market products that contain unsafe levels of myclobutanil — a fungicide. When myclobutanil is heated, it releases toxic fumes, one of which is hydrogen cyanide. Small amounts of HCN are released when smoking cigarettes, but larger doses are lethal. HCN was a major component of Zyklon-B, the gas used in Nazi gas chambers. Unregulated products, like black-market Dank Vapes, have no one checking to see where that line is drawn.
“That’s one of the most commonly discussed pesticides. That’s definitely one that we see frequently in the underground market,” says Ronay.
Victims of 'monkey dust': Ravaged faces of 23 lives ruined by psychotic £2 drug
Monkey dust - which is highly addictive - has seen users turn to a live of crime to fund their addiction and can be bought for as little as a few pounds
THE 23 FACES WHO HAVE BEEN RAVAGED BY MONKEY DUST - Shocking photos show the ravaged faces of those whose lives have been ruined by 'monkey dust'. The drug, which can be bought for a mere £2 has led users to a dark path of crime, as well as violent and psychotic episodes. Some users, dubbed 'dustheads', have been responsible for a whole spectrum of offences - from petty shoplifting to brutal stabbings and terrifying rooftop sieges.
Longitudinal changes of amygdala functional connectivity in adolescents prenatally exposed to cocaine
Highlights
• Prenatal cocaine exposure (PCE) is associated with long-term arousal dysregulation.
• PCEs and controls were scanned with rfMRI at the mean ages of 14.3 and 16.6 years.
• Amygdala connectivity changed oppositely with age in the PCE and control groups.
• Amygdala connectivity in rest predicted emotional interference in task state.
• PCE may contribute to increased emotional arousal in adolescent development.
Abstract
Background: Prenatal cocaine exposure (PCE) is associated with arousal dysregulation, but interactions between exposure and age are rarely investigated directly with longitudinal study designs. Our previous study had examined task-elicited emotional arousal and noted persistently high amygdala activations in the development of adolescents with PCE. However, while externally imposed emotional arousal could be considered a “state” effect depending on specific task stimuli, it is still unclear whether similar developmental alterations extend to intrinsic functional connectivity (FC), reflecting more of a “trait” effect.
Conclusions: These results provided additional data directly characterizing developmental changes in the emotional network of adolescents with PCE, complementing and extending the notion of a PCE-associated long-term teratogenic effect on arousal regulation.
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
“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.
Dangers
MDPV has been involved in dozens of deaths in Europe, detailed in a report by the European Monitoring Centre for Drugs and Drug Addiction, as well as in the United States, Australia, and elsewhere.
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.
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.
(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.
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
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.
World Federation Against Drugs (W.F.A.D) Dalgarno Institute is a member of this global initiative. For evidence based data on best practice drug policy in the global context.
The Institute for Behavior and Health, Inc. is to reduce the use of illegal drugs. We work to achieve this mission by conducting research, promoting ideas that are affordable and scalable...
Drug Free Australia Website. Drug Free Australia is a peak body, representing organizations and individuals who value the health and wellbeing of our nation...
(I.T.F.S.D.P) This international peak body continues to monitor and influence illicit drug policy on the international stage. Dalgarno Institute is a member organisation.
The National Alliance for Action on Alcohol is a national coalition of health and community organisations from across Australia that has been formed with the goal of reducing alcohol-related harm.
RiverMend Health is a premier provider of scientifically driven, specialty behavioral health services to those suffering from alcohol and drug dependency, dual disorders, eating disorders, obesity and chronic pain.
Medical professionals are calling for tighter restrictions on the sale of nitrous oxide gas cartridges, colloquially known as ‘nangs’, due to potentially serious harm for users including lasting neurological damage. Nitrous oxide or ‘laughing gas’ is normally used by dentists and medical professionals to provide sedation and pain relief to patients undergoing minor procedures. It’s also a food additive, used to aerate whipped cream, and sold in gas cartridges online and in convenience stores.
Association of 1 Vaping Session With Cellular Oxidative Stress in Otherwise Healthy Young People With No History of Smoking or Vaping-A Randomized Clinical Crossover Trial
