DRUG INFORMATION RESOURCES - INTERNATIONAL
World Drug Day 2021: Get the Facts for Your Healthy Life and Community
Inhalants – Not just a ‘kid issue’!
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.
What are magic mushrooms and psilocybin?
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.
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.
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
- distorted thinking
- visual alteration and distortion, such as halos of light and vivid colors
- dilated pupils
- impaired concentration
- muscle weakness
- lack of coordination
- unusual body sensations
- ‘spiritual’ awakening
- frightening hallucinations
World Drug Report 2020 (Exective Summary) UNODC
For all reports go to World Drug Report 2020 (unodc.org)
UNODC – Strategy 2021-25 (United Nations Office Drugs & Crime)
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.
(Dalgarno Institute Comment: It is important to note the ‘recalibrating’ of both brain and cellular memory is motivated by behavioural action, not chemical engagement - See also Humpty Dumpty Resiliency Ed. S. 6: Rebellion & Experimentation P2: From Thermometer to Thermostat (https://nobrainer.org.au/images/humpty-dumpty/RewardExploration_-_Part_Two.pdf )
Harms of Prescription Opioids – TGA is finally starting the Fix!
Governments have now quantified just some of the short and long term harms of misuse of prescription opioids, particularly in the OST (Opioid Substitute Treatment) Arena. It is way past time to look at evidence-based and successful drug-use exiting recovery therapies.
Ecstasy Deaths – Red Card on Pill Testing
DRUGS OF ABUSE 2020 Guide
Concerns About CBD?
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.
Dank Vapes…That Can Put You in a Coma
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.
This is what the perpetual promotion of drug use leads to! Permission, not Prohibition Models are systematically driving ever increasing drug us! #preventdontpromote https://www.mirror.co.uk/news/uk-news/victims-monkey-dust-ravaged-faces-18956597
SAMHSA’s 15th Annual Prevention Day Afternoon Plenary Recording (February 4, 2019)
- The importance and efficacy of Prevention & Demand Reduction mechanisms
- Focusing on the real dangers of Marijuana, Kratom and E-Cigarettes (Vaping)
Longitudinal changes of amygdala functional connectivity in adolescents prenatally exposed to cocaine
- • 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.
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
(MDMA)-related fatalities in Australia:
Demographics, circumstances, toxicology and major organ pathology
MDMA and 5-HT neurotoxicity:
the empirical evidence for its adverse effects in humans – no need for translation
“Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence. Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising.” By Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University. (2018)
Pills will kill, but testing them is not yet the answer
But it won’t work and is fraught with dangers. What if we don’t know what we are testing for? New psychoactive compounds are being developed all the time. In any case, is the drug we’re testing for consistent throughout the pill? We could easily miss it by scraping a little from the surface. And perhaps the deadly threat lurks in unidentified contaminants.
There is much to be considered — maybe first is the fact no forensic toxicologist I know recommends pill testing or believes it is practical.
Fitzgerald states the risks of pill testing appear to be minimal. That is curious. In a recent toxicology publication, a leading forensic scientist reported there was great concern in the US that these novel illicit substances typically are outside the scope of routine drug testing by hospitals and laboratories or below the sensitivity levels for detection. If major forensic facilities have difficulty in identifying these substances, it stands to reason that on-site pill testing could not adequately identify most of the potentially lethal components in a pill scraping.
In another recent publication, Australian forensic laboratories noted there were about 740 new psychoactive substances reported to the UN Office on Drugs and Crime from 2009 to 2016.
Again, leading Australian forensic institutions using high-resolution mass spectrometry struggle to keep up with ever-increasing variations in synthetic substances. Pill testing may identify some of these within the time and scope of the on-site facility, but the risk of an adverse or fatal episode remains with several hundred substances not detected.
Fitzgerald reckons there is a strong case from more than two decades of experience in Europe, but that’s ignoring the exponential increase in deadly adulterants.
The issue of pill testing should be decided on forensic science. The ability to identify a wide range of components in a compound depends on the ability to test a representative portion of the substances, and that representation is incumbent on the pill being homogeneously mixed when produced. If the pill has not been manufactured to ethical pharmaceutical standards then there is a risk of the pill tester missing the more toxic ingredients of the substances.
If pill testing were trialled, you would need sophisticated instrumentation such as high-resolution mass spectrometry to rapidly analyse the contents of the unknown substance. Such instrumentation is not amenable to on-site music festival venues. Critically, operators of the instrumentation would need to ensure their database of compounds is up to date. As newer synthetic drugs are regularly entering the market, forensic laboratories are struggling to obtain appropriate and expensive analytical reference material to identify unequivocally all ingredients in a pill.
To date, analytically trained experts have yet to explain adequately the complexity of attempting to test pills reliably and quickly at an on-site venue to be reasonably confident they can eliminate minute amounts of potentially lethal ingredients such as the deadly carfentanil.
Before moving ahead with a policy to trial pill testing, we need some sobering facts. The efficacy of pill testing is best left to forensic scientists, while the value of pill testing as a means of harm reduction is the domain of researchers into behavioural patterns of users and their potential for risk-taking. A 2004 study by the National Drug and Alcohol Research Centre into risk factors and risk perceptions found that those who perceived the possibility of getting caught or being involved in accidents were less likely to drive while impaired. Conversely, the perception of not getting caught or having an adverse reaction contributed to their drug-taking behaviour..
John Lewis is honorary associate at the Centre for Forensic Science at the University of Technology Sydney
'She was an alcohol girl': Friends of FOMO music festival fatality say she 'never took drugs and just wanted to try it once'
Daily Mail January 15, 2019
A 19-year-old who died of a suspected drug overdose at a Sydney music festival never took drugs and 'just wanted to try it', according to her friends. For more Pill Testing Would NOT have Stopped This!
New drug MDPV or ‘monkey dust’, found in Australia. What is it and what are the harms?
What does MDPV do?
An oral dose of MDPV is estimated to be around 5-20 milligrams (compared to 100-150 milligrams for MDMA). The main psychoactive effects last two to three hours, and side-effects persist for several additional hours.
Side-effects, particularly at high doses, can include anxiety and paranoia, delusions, muscle spasms, and an elevated heart rate. In extreme cases, MDPV has been linked to rhabdomyolysis (rapid muscle breakdown), brain injury, and death.
Like other cathinones, MDPV is a stimulant and shares some effects with other stimulants such as amphetamine, cocaine and MDMA. MDPV produces its effects by inhibiting the reuptake of two important signalling molecules (neurotransmitters) in the brain; norepinephrine and dopamine.
Norepinephine is generally responsible for preparing the brain and body for action in the so-called “fight or flight response”, while dopamine is involved in more complex functions such as arousal, motivation, reward and motor control.
By blocking the ability of certain brain cells (neurons) to reabsorb these neurotransmitters, MDPV effectively increases the intensity and duration of norepinephrine and dopamine signalling. Cocaine works in a similar way, but in a lab test, MDPV was a much more potent inhibitor than cocaine.
Other norepinephrine-dopamine reuptake inhibitors (NDRIs) include pharmaceuticals such as methylphenidate (known as ritalin and used to treat ADHD) and buproprion (an antidepressant). But the psychoactive and stimulant effects of MDPV are much stronger than pharmaceutical NDRIs.
Pyrovalerone – a hybrid of mephedrone and MDPV – is an approved appetite suppressant used medically for weight loss. However, it’s rarely used due to its potential for abuse.
Studies in laboratory animals highlight the stimulating effects of MDPV, and also its potential for dependence. Mice trained to identify MDPV find it similar to both MDMA and methamphetamine. MDPV stimulates movement in rats approximately ten times more potently than cocaine, and rats will readily self-administer MDPV, suggesting it’s addictive.
But many of these deaths involved extreme doses, repeated dosing (“bingeing”), intravenous use or additional drugs. In fatal cases involving a single synthetic cathinone, death has been attributed to complications arising from extremely high body temperatures or damage to the vessels of the heart. Fortunately, specialised drug testing can detect MDPV and its derivatives.
CHASING AFTER THE WIND! (Must have book!)
In a brutally honest account Kerryn Redpath describes the terrifying scenes she witnessed as what began as "a bit of fun" spiralled into a shocking journey through the dark world of drug addiction. Chilling stories of drug overdoses, precious lives lost, drug and alcohol fuelled fights, months spent gravely ill in hospital, at one point being given less than two hours to live, will have the reader gripped to every page….This is a compelling story that takes the reader through one person’s journey from the depths of despair to the realms of hope and is hard to put down until the final page is read.
This is a story that should be read by all - young and old, parents, teenagers and current or past addicts of all persuasions.” - Associate Professor Peter Ryan
Why Ecstasy is more harmful than alcohol (whatever Professor Nutt says)
By Professor Andy Parrott one of the world’s leading experts on MDMA, Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University.
Comparing alcohol with MDMA.Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence (Professor Nutt, 21st May). Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising. Yours etc . . .
In the next few paragraphs, I have provided more information on this topic. What is the basis for Professor Nutt claiming that MDMA is a safer drug than alcohol? This statement was based primarily on a survey he published in the Lancet (Nutt et al, 2007, vol 369; 1047). However this article contains some astounding errors. Indeed when I was first shown it, I contacted the Lancet stating that they needed to publish a detailed reply from me, since it was important to point out these errors. After some email exchanges with one of the Lancet editors, the journal decided not to publish my letter. However I presented some of my criticisms as a conference paper (Parrott, 2009. ‘How harmful is Ecstasy/MDMA: an empirical comparison using the Lancet scale for drug-related harm’. Journal of Psychopharmacology, vol 23, page 41).
I have listed below my main criticisms:
- Nutt stated that ‘for drugs which have only recently become popular such as Ecstasy or MDMA, the longer term health consequences can only be estimated from animal toxicology at present’. This statement was grossly incorrect. Numerous articles (indeed several hundred) had been published before 2006 by various research groups worldwide, including many papers from my own group. These papers revealed a wide range of adverse health and related problems.
- One of the Nutt harm scales was ‘intensity of pleasure’, since it is well documented that the most powerful mood enhancers also cause the most problems. Nutt’s article gave heroin and cocaine the maximum scores of 3.0, while nicotine was rated at 2.3, whereas MDMA was given the surprisingly low rating of 1.6. This made MDMA one of the least pleasurable of all their drugs (16th lowest out of their 20 drugs). This low pleasure score for MDMA is simply incomprehensible. How can anyone with even a rudimentary knowledge of human psychopharmacology state that Ecstasy/MDMA is less pleasurable than a cigarette? Yet this low rating was apparently given by Nutt’s group of experts! Recreational Ecstasy/MDMA users would certainly be very surprised at this low rating. It should be noted that this very low ‘pleasure’ score contributed directly to MDMA’s low ‘harm’ score.
- Drug ‘injection potential’ was another scale, with heroin and cocaine again being given maximum scores of 3.0. In contrast MDMA was given a score of 0.0. This zero score was again bizarre, since MDMA is injected by some heavy users, and they suffer from the problems typically associated with drug injecting. This practice has been noted in various academic papers. Hence the injection score for MDMA should have been similar to that given for cocaine – namely 3.0. The zero score in Nutt et al may be difficult to comprehend, but again it was crucial for generating MDMA’s low overall harm score.
- In my commentary paper (Parrott, 2009, see above), I provided harm estimates based on the empirical literature, and MDMA rose from 18th to 5th in the list of most damaging drugs. Hence the position of 18th given by Nutt et al in their Lancet paper is extremely misleading – and has no basis in science.
- So what exactly are the problems caused by MDMA?
- In 2011 I was asked by the USA Deputy Attorney General to be an expert witness in a court case, which debated the issue of the most appropriate sentences for Ecstasy/MDMA drug traffickers. I was asked to write a comprehensive report, based on all the available scientific research. This was later expanded into a comprehensive review (Parrott, 2013, Neuroscience and Biobehavioral Reviews 37: 1466-1484). The following brief summaries are based on that review, and many of my more recent papers.
- MDMA is damaging when taken acutely, since it heats up the brain, impairs thermal control, increases neurotransmitter release, and generates extreme mood changes. It also leads to cognitive confusion, and a marked increase in neurohormonal activity. Death rates from acute abreactions are comparatively rare (around 60 per year in the UK), but have been increasing due probably to the increasing levels of MDMA in Ecstasy tablets (see reports by Professor Fabrizio Schifano for the UK, with similar increases reported within mainland Europe).
- MDMA is also damaging when taken repeatedly. It leads to alterations and/or deficits in brain activity which may be permanent, with reductions in memory ability, reductions in problem-solving skills, deficits in complex visual abilities, impairments in some psychomotor skills, various health impairments, increased levels of depression, increased levels of aggression, and other deficits. Young women should certainly avoid MDMA if there is any possibility of pregnancy – since it can lead to impairments in subsequent child development (Professor Lynn Singer, et al, Neurotoxicology and Teratology, vol 54, pages 22-28).
- I could go on describing more of the problems caused by MDMA – but will limit myself to one final point. MDMA has been medically tested for cancer therapy, since it can damage/kill human cells. The medical term for this is apoptosis, and it was first demonstrated in laboratory animals, but has subsequently been confirmed in human cells (the relevant medical papers were cited in Parrott, 2013, Human Psychopharmacology, vol 28, pages 289-307).
- In summary, alcohol is certainly a damaging drug, and when misused it causes massive problems to individual drinkers, their families, and wider society. However the majority of alcohol drinkers are able to use it safely over their lifetimes. In contrast, MDMA is a far more powerful and damaging drug. Current evidence suggest that its regular usage is not only damaging to many young users, but that this damage may endure for several years following drug cessation (Taurah et al, 2013, Psychopharmacology vol 231, pages 737-751).
Similar to other fentanils, the most serious acute health risk from using carfentanil is likely to be rapid and severe respiratory depression, which in overdose could lead to apnoea, respiratory arrest, and death (Dahan et al., 2010; EMCDDA, 2017; Lindsay et al., 2016; Pattinson, 2008; Wax et al., 2003; White and Irvine, 1999). Factors that may exacerbate this risk include: the difficulty in diluting the substance, which can lead to a toxic dose being inadvertently used; the use of routes of administration that have high bioavailability (such as injecting, insufflation, and inhalation); a lack of experience with its effects and dosing; the use of other central nervous system depressants at the same time (such as other opioids, benzodiazepines, gabapentanoids, and alcohol); no or limited tolerance to opioids; and, using the substance alone (such as at home) which would make it more difficult for users to call for help in the case of poisoning. In addition, as discussed below, as carfentanil is being sold as or in heroin and other illicit opioids, many users will not be aware that they are using carfentanil.
The Global SMART
(Synthetics Monitoring: Analyses, Reporting and Trends)
Programme improves the capacity of targeted Member States to generate, manage, analyse, report and use information on illicit synthetic drugs. The SMART programme was launched in September 2008 in Bangkok.
Why Australia Should Not Decriminalise Drugs
By Drug Free Australia
Australia21 and NDARC, two Australian entities sympathetic towards the use of illegal drugs, are pushing our politicians and media to advocate for the decriminalisation of all illegal drugs, including heroin and ice. But decriminalisation mostly increases drug use and Australians want LESS use. Convicting users is a major deterrent to drugs while encouraging rehab. When users can show they are clean for 3-5 years, then, and not before, is the time to wipe their conviction
The Journal of Global Drug Policy & Practice
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.