Adolescent Brain Development: WEBINAR - Ken C. Winters (Ph.D. is a Senior Scientist at the Oregon Research Institute )

VAPING CRISIS Info Sheet

In prior work, it’s been noted how psychosis can follow methamphetamine use and last into abstinence. Varying levels of methamphetamine use can induce psychosis, depending in part on an individual’s background, and it can develop quickly or after 20 years of use. This psychosis can be quite similar to Schizophrenia - in some cases, violent behaviors have been connected to methamphetamine psychosis as well. A study of Japanese prisoners found that a subgroup of methamphetamine users experienced chronic psychosis. Lingering cognitive problems may cause other health complications, difficulty thinking or concentrating at work, and increasingly risky behavior, in addition to higher relapse rates. Furthermore, later-in-life stress can also revive psychotic symptoms. More research on methamphetamine and cognitive problems can help treatment providers understand these hidden tripwires for patients.

Some of the strategies currently used to treat traumatic brain injuries may be helpful, as may use of exercise, dance, and transcranial magnetic stimulation. Post drug abstinence psychoses may not be as reversible by medications used for naturally-occurring psychoses.

With methamphetamine this is even more important as medication assisted therapies do not exist. Time of abstinence, rehabilitation with healthy thinking, eating, sleeping, and diet are easier to prescribe or advise than find. Time of abstinence is of the essence as it appears that methamphetamine induces a drug use disorder with binges, relapses and cravings but also with loss of brain function and evidence of something that looks like a traumatic brain injury. Treating it like a neurological injury in addition to traditional addiction treatment, may be an idea worth looking at too.

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Treating major depressive disorder remains an important challenge worldwide. The disorder impairs productivity, social functioning, and overall health, reducing life expectancy and burdening health care systems.1 Although many treatments exist, at least a third of patients do not have a response after two or more trials of antidepressant drugs and are considered to have treatment-resistant depression.2 Such patients have an increased risk of suicide relative to both the general population and patients with nonresistant major depressive disorder; at least a third of them attempt suicide.3 

The FDA recently approved the S-enantiomer of ketamine, esketamine, a rapidly acting drug shown to be effective in patients with treatment-resistant depression.

Balancing these potential risks with the benefits of an effective drug for a serious disease for which there is substantial unmet need, the FDA approved esketamine with a Risk Evaluation and Mitigation Strategy (REMS). The intent of the REMS is to mitigate the risk of serious adverse outcomes resulting from sedation, dissociation, and abuse and misuse, while providing access to this effective treatment for treatment-resistant depression. Esketamine will be dispensed and administered to patients only in a medically supervised health care setting where they can be monitored for adverse reactions for at least 2 hours; pharmacies that dispense esketamine must ensure that the drug is dispensed only to clinics and hospitals that are certified in the REMS.

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Published 22.5.19

Australians have access to mass amounts of potent drugs online, equivalent to "billions of doses" every day, according to a new study from The Australian National University (ANU).

The report found "alarming" amounts of synthetic opioids such as fentanyl and carfentanil available on the dark web. 

Carfentanil is not for human use and was originally designed to sedate elephants. 

The researchers say the report lifts the lid on a significant new synthetic opioid market on the dark web. 

"We are on the brink of a new opioid epidemic driven by synthetics like fentanyl and carfentanil that are driving a greater risk of overdose deaths," said lead author Professor Roderic Broadhurst, from the ANU Cybercrime Observatory.

"Fentanyl is a designer synthetic opioid about 100 times more powerful than morphine," said Professor Broadhurst.

"The average dose of fentanyl is 200 micrograms. We found millions of doses of fentanyl available to buy every day.

"Carfentanil is 10,000 times more powerful than morphine and there are alarming amounts of it available online." 

"We were shocked by the amount of Carfentanil we found. Billions of doses are available online on any day." 

Professor Broadhurst says fentanyl is being used by criminal networks to lace heroin and create synthetic heroin that is changing the landscape of narcotic sales.

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