Side Effects of Serotonergic Hallucinogens

Side Effects of Serotonergic Hallucinogens

The most important part of the discussion about LSD concerned the adverse effects of its use. The main danger lies in the fact that, apparently, LSD causes chromosomal abnormalities. Therefore, men or women who use this drug are at risk of having inferior children. This finding is based on the discovery that LSD disrupts chromosomes in leukocytes that are artificially cultured in a laboratory. Based on this, there is a fear that LSD can damage human gametes. Although the fact that chromosomes are disturbed in leukocytes in a laboratory test tube under the influence of high doses of LSD does not prove that the same should occur in natural conditions. In the course of a serious study of this issue did not appear convincing evidence that LSD (as well as any other serotonergic hallucinogen) increases the number of descendants with congenital disorders, if taken in moderate doses. Although some risks are still possible when taking high doses, the ability of LSD to cause hereditary disorders is no stronger than that of aspirin under normal circumstances. However, as with other substances, there is a risk of damage to the fetus if the drug is taken during pregnancy.

Other adverse effects of LSD deserve a closer look. An important problem is acute panic or paranoid drug-induced reactions. These bad trips leave a person in a state of acute mental disorder in which he can hurt himself or others. It is difficult to establish the frequency of bad trips, but there were enough of them to be in the 60s. there was an extensive network of accessible crisis centers, where LSD victims could receive psychological help and, if necessary, referral to a hospital. Currently, bad trips are becoming less common, because it is better known how to prevent them. The psychological state of the drug user and his environment is important. For example, there was a case of suicide of a person who took LSD during one experiment conducted by the CIA in the 50s, but did not know about it. Being under the influence of a drug without prior knowledge of its capabilities is very dangerous, there can be disastrous consequences. A quiet, calm environment, low doses of LSD reduce the likelihood of bad trips, although they can occur under the most favorable circumstances.

Another problem that is associated with hallucinogens, similar to LSD, is the phenomenon of the “return of the past.” It consists in a sudden, unexpected re-experience of fragments from hallucinogenic trips that occurred weeks, months, years before that moment. Although, as in the case of bad trips, it is difficult to establish the frequency of this phenomenon, according to one study, 53.5% of those who use LSD experienced a “return to the past” syndrome. Although the majority do not consider them particularly destructive, but 12.9% of those who have experienced this, sought medical help. Although little is known about the causes of their occurrence, they are triggered by anxiety, fatigue, the consumption of marijuana, or sudden changes in the environment, such as at nightfall.

LSD also causes long-term mental disorders. Perhaps the most famous and terrifying example of this is Charles Manson and his “family.” In the “family” of Manson, LSD was used in large doses, but it is not known exactly what role, if any, this use played in their psychopathology, which led to mass murder. When you meet with an insane person taking LSD, it is difficult to establish whether a mental disorder has occurred as a result of taking LSD, or if this person has already been ill, and LSD has more acutely manifested these symptoms. The matter is further complicated by the fact that LSD users have previously dealt with many other drugs and it is not known what role those in turn played. It is believed that hallucinogens can aggravate or exacerbate psychosis or emotional disturbances in some sensitive individuals. LSD also causes other adverse effects. For example, there are few but alarming cases of persistent visual disturbances caused by LSD. LSD also causes long-lasting or permanent changes in the biochemistry of the brain and affects the behavior of animals in the laboratory. Thus, although LSD is not addictive, it is a potentially dangerous drug.

Subjective descriptions of the effects of LSD

Subjective descriptions of the effects of LSD

Many attempts have been made to describe the LSD experience. These descriptions are different from each other, often confusing, sometimes contradictory, although there are some common features. The following excerpts, written by the most well-known supporters of LSD, demonstrate the diversity of this experience:

I looked into a glass of water. In the depths of his whirlpool there was a whirlwind that went down to the center of the world and to the heart of time … The dog barked and its piercing howl could be like all the wolves of Tartarus … At one point I was a giant in a tiny closet, and in another dwarf in a huge hall. I was lying on my back on the floor. Then my room disappeared and I was sinking, sinking and sinking. From afar, I heard the subtle word death. I began to sink faster, moving away millions of light years from Earth. The word grew louder and more insistent, surrounding me, including me. “DEATH … DEATH … DEATH …” I remembered the horror in my father’s eyes in his last moments. In the last moments before my own death, I shouted “no.” Absolute all-consuming horror. A series of visions began. A number of images appeared in sync with the music … I saw myself at the Mongol Khan’s court … at a concert that was held in front of a huge audience … in a fantastic place … at Versailles … near the Lincoln statue … I felt swallowed by the chaotic sea …

There were several boats worn by an agitated sea … I was on one of these ships … we sailed past a huge figure, standing in foamy water to the waist … His features were full of compassion of love and participation. We knew that it was the image of God. We realized that God was also captured by the storm.

Anticholinergic hallucinogens

Anticholinergic hallucinogens

Atropine and scopolamine are acetylcholine receptor blocking agents in the brain. Although in low doses they are used for medical purposes, in high doses they have a hallucinogenic effect. They can be found in many plants growing throughout the world, they have a long history of use. A few – centuries BC plants containing scopolamine were used by the ancient Greeks in the process of divination in Delphi. In the Middle Ages, healers cooked their drugs from them. Such plants as belladonna, mandragora, henbane, growing in Europe, as well as representatives of the genus Datura, growing in America, are eaten because of their hallucinogenic properties. Although now these substances are not consumed by healers, they apparently continue to form part of the powder that makes man zombies in Haiti.

Anticholinergic hallucinogens have a multifaceted effect on the body, causing dry mouth, loss of clarity of vision, motor control, increase pulse and body temperature. They can cause death, causing respiratory depression at doses slightly higher than the minimum effective. Psychologically, they can cause a hypnotic trance or stupor. The recipients of these substances seem to be delirious, unconscious, but they are able to describe their feelings if they are asked about it. A distinctive feature of drugs of this class is that after taking them, a person remembers almost nothing, he is not able to recall a single detail in his memory. Perhaps this is one of the reasons that these substances are almost not sold on the street.

Another plant worthy of consideration in this part is the red mushroom. The red fly agaric contains several different chemical compounds with a hallucinogenic effect, one of which is muscarin, which is a cholinergic agonist, and muscimol, a hallucinogen similar to LSD-like drugs. Although it is rarely used now, since it is nothing special, it is the first attempts to use hallucinogens that are associated with it. The red fly agaric is widespread in Europe and Asia, and it is possible that the mysterious drink “Soma”, described in the Indian “Rigveda” more than 2 thousand years ago, was made from it. “Rig Veda” describes a rather extravagant way of resuming the action of this substance by pouring out the urine of a poisoned person. Mustsimol is the only hallucinogen, whose properties do not change when passing through the body and are stored in the urine. Eating red amanita usually causes numbness, lasting several hours, during which a person is visited by visions, and then comes euphoria, a surge of energy, accompanied by visual hallucinations.

Methyl Amphetamines

Methyl Amphetamines

Recently, much attention has been paid to drugs of this group, in particular MDMA, better known as Ecstasy. MDMA belongs to a group of substances known as methyl amphetamines, so named because of their chemical structure (there are many drugs in this category, but the most famous are presented in table 11-2). These drugs are often combined with serotonin hallucinogens. Indeed, their chemical structure resembles that of mescaline. In addition, they affect the transmission of serotonin (as well as norepinephrine and dopamine). DOM resembles mescalin in chemical nature and causes similar effects, including visual hallucinations. However, others (MDA, MDMA, DOET) differ from the serotonergic hallucinogens discussed above in that they do not cause or cause visual hallucinations, but not to a large extent. Laboratory studies, including experiments on animals, allowed MDA, MDMA, DOET to be classified as amphetamines and to distinguish them from LSD. This is confirmed by observations of people.

MDA, MDMA produce a slight euphoria, accompanied by openness and helplessness. These properties encourage some psychotherapists to recommend the use of these substances, in particular MDMA, as an addition to therapy. Thus, these drugs can be considered as a unique category among hallucinogens. Anyway, there are reports that these substances can damage the serotonergic neurons of the brain.

History and epidemiology

For the first time, DOM was talked about in the late 60s, when its powerful hallucinogenic effects and rather long duration of action (about 24 hours) caused many bad trips. MDA also attracted attention at about the same time, but met a warmer welcome. He was called the Soft American Drug because he had a weaker effect and less pronounced sensory effects than LSD. He was also called the Drug of Love, because his use evoked positive feelings for others, developed sympathy. The use of MDA as well as LSD decreased in the 70s, while another drug, MDMA, became popular. It is estimated that in 1976 about 10,000 doses of MDMA were sold on the street. In 1985, the DEA estimated that only 30,000 doses were sold in Texas in a month. What explains such a significant increase in consumption? The spread of information about its beneficial therapeutic effects made it attractive. His use did not disturb the public and he received the nickname “Ecstasy”. Moreover, until 1985 he remained a legal drug. Although MDA was a drug of Group N1 (see Appendix N1), MDMA, which is very similar in structure, was not classified according to this system. Thus, drug dealers preferred the least risk and began to sell ecstasy. Anyway, in the face of the growing use of MDMA, followed by animal studies proving brain damage, in 1985, MDMA was classified as a Group N1 drug. As soon as MDMA came under control, distributors started selling DOET, a very similar drug to MDMA, which is now also controlled by the DEA Act of 1986. These decisions are controversial because they prohibit further testing of MDMA and similar compounds in psychiatry.

Effects of PCP

Effects of PCP

The effects of PCP are rather peculiar. A moderate dose (1-10 mg) causes euphoria and numbness, resembling alcoholic intoxication. Speech becomes slurred and usually a lack of coordination of movements. The object can become inhibited and numb, with a blank look, or become aggressive and overly active. Observed sweating, increased heartbeat, increased blood pressure, rapid, involuntary movements of the eyeballs, called nystagmus. Blurred vision is often tested, the recipient of a drug begins to double in the eyes, but visual hallucinations are rare. Tactile sensations are much more common.

The most frequently experienced hallucination is that parts of the body appear to be either very small or very large. You can imagine yourself small enough to go through a keyhole, or suddenly it seems that the arm is twice as long as the whole body. The following fragment gives a brief description of the condition of a person who has taken ketamine:

“In Donna’s ketamine eyes, the corridor leading to the toilet looked like a tunnel stretching for miles. The matter was complicated by the fact that Donna felt no more than two feet tall …”
These effects usually last from two to eight hours, but they are quite diverse and, especially after high doses, can last for several days or weeks. Overdose (more than 20 mg) can cause an attack, prolonged coma, and sometimes death from suffocation. PCP often causes bad trips, which occur in 50% – 80% of cases of use. Toxic psychosis caused by PCP is most often characterized by paranoia, a flash of rage, and can last for several days. In addition, PCP often exacerbates long-term attacks of psychosis and depression, which last from seven to thirty days or more. In these cases, physical limitations and intensive medical treatment are often necessary. More often than all the other hallucinogens, PCP causes medical and psychiatric complications. Often, psychosis caused by PCP numerically exceeds the number of psychosis caused by schizophrenia or alcoholism.

Drug Abuse Prevention

Posted on November 3, 2018  in Medical news

Information about alcohol and drugs, their effects, their use and abuse. This led us to our last chapter on drug abuse prevention.
Unfortunately, historically, neither the efforts of professionals, nor directed funding could make the prohibition of drugs the main public task. The reasons for this are not determined, but there are two possible explanations. One is that the efforts to prevent abuse in the past have brought only modest results. The second explanation for this is that currently the abuse of various substances is particularly noticeable and finds a faster response in human and financial resources. Whether such an approach is short-sighted is a very controversial issue.

Although prevention has always received less attention than treatment, now is the time when the study and development of prevention is on the rise. Perhaps the most significant factor that caused this change is the association of the problem of drug addiction with the problem of AIDS. Intravenous drug users constitute the second largest group of people infected with HIV in the United States and Europe. In addition, the influence of drugs in some cases can provoke promiscuous sex, increasing the risk of contracting AIDS.
Most still agree that prevention should be an important component in the modern approach to solving the problem of abuse of various substances. The first step in this chapter is a review of definitions related to prevention. Then the main models of prevention and the associated difficulties are discussed. There will also be considered several examples of preventive programs and their results.

Drug prevention

Posted on October 30, 2018  in Medical news

Prevention is broadly related to the avoidance or alleviation of problems related to substance use. Due to this non-strict definition, attempts at prevention can have different goals. For example, the goal of efforts to prevent the use of illegal drugs is to stop incidents of their use. One way or another, an additional goal of such activities may be to minimize the effects of the use of illegal drugs, which is taking place. If so, then the approaches chosen for the implementation of the intended goals may be different. Therefore, when it comes to the prevention of drug use, it is important to clarify what exactly is being prevented: onset of use, repeated use, negative impact on society, health problems, or something else.

Prevention of substance abuse is traditionally divided into three stages. The first is primary prevention, which is the avoidance of drug abuse before an abuse at all has a chance to occur. For example, one of the goals of such prophylaxis would be to prevent the initial use of a substance. Without ever starting a drug use, you will not have any problems with it. At the core of this approach is the principle “Just Say No”, when, especially young people, a drug is offered. Another goal of primary prevention may be to develop a responsible attitude and / or a culture of substance use. The best example of this is a responsible drinking attitude. Numerous advertising posters and television programs should pay more attention to the fact that you can not get behind the wheel while intoxicated or allow drunken friends to get behind the wheel.

Secondary prophylaxis deals with already started abuse. This type of prophylaxis is similar to early treatment, when drug problems only surfaced. Secondary prophylaxis is often used by the legal system responsible for the misuse of substances. For example, a person arrested for drunk driving may be sent to special courses, training on which should prevent a repetition of the situation. In some parts of the United States, this is the case with juvenile offenders detained for drug possession. In both cases, emphasis is placed on the problem nip in the bud. Central to such efforts is the early detection of such problems.

The third form of prevention, which is called tertiary, is the treatment of people who already fully use drugs and are completely dependent on them. Its purpose is to stop drug use and avoid further deterioration in the human body. Tertiary prevention and treatment of drug addiction are the same, but prevention is usually said when the incident happens for the first time, and treatment when relapses occur. In the remainder of this chapter, we focus our attention on primary and secondary prevention.

Problems of abuse of various substances.

Posted on October 26, 2018  in Medical news

The sociocultural aspect of understanding abuse is that social norms directly affect substance use or abuse. This model was mainly used in efforts to prevent the use of alcohol. In this case, the model consists of three main components:
– underlining cultural standards
– the need to include the adoption of alcohol in socially significant activities
– focus on developing a culture of drinking alcohol
The main efforts of this model are aimed at changing attitudes towards taking alcohol within a culture.
One of the most significant defenders of the sociocultural approach. Rupert Wilkinson believes that drinking alcohol can be influenced by well-planned policies. Wilkinson notes that there are examples of alcohol use that are not associated with any problems, and that these examples can be used as guidelines for rooting a similar drinking culture.

During his fruitful work in 1970, Wilkinson identified five proposals for changing the culture of drinking alcohol. The first involves creating a low level of emotionality associated with alcoholic beverages in society, while at the same time bringing clarity to conflicting ideas about alcohol consumption. Emotionality surrounding alcohol, according to Wilkinson, creates pressure on a person, as well as an environment in which discussion and changing the culture of drinking alcohol are simply impossible. A more thoughtful and well-coordinated approach will increase the benefit by clarifying inconsistencies and provide greater clarity about drinking norms.

The second basis of the Wilkinson sociocultural model is that a clear line should be drawn between the normal use of alcoholic beverages and drunkenness. The challenge is to clearly define what is acceptable drinking and what is drinking. Unfortunately, to come to such clarity is far from easy.
Wilkinson’s third principle: after certainty has been reached about where the drunkenness begins, a strict ban must be imposed on it. The fourth, central principle is that alcohol should be integrated into the social context in the broad sense of the word. In other words, the use of alcohol should not be the meaning of life or a single party, but instead should simply be an addition to other activities.
In conclusion, Wilkinson concludes that society can afford to drink alcohol only when it is accompanied by eating food. He believes that when there is a snack, alcohol consumption ceases to be the only meaning of activity. Moreover, food slows down the absorption of alcohol and potentially helps reduce intoxication.
Together, these principles create an idea of ​​acceptable and unacceptable use of alcohol and, thus, form the desired pattern of responsible behavior. Such a pattern must then be rooted in ordinary family life and other social activities. It is noteworthy that the aim of the sociocultural approach is not to stop the use of alcohol in general, but to change the social norms relating to this use. Thus, his strategy is not focused on the prohibition, and many believe that the main mistake of this approach is that it supports the use of alcohol.

The main criticism of this approach is that it cannot be widely applied. In many countries, such as the United States and Canada, there are simultaneously different types of cultures and subcultures, so the customs and values ​​adopted in one of them may not be suitable or rejected by the other. The second direction of criticism is that the sociocultural approach, with an emphasis on moderate consumption, does not take into account how much pleasure is given to excessive drinking. The third doubt is that a change in attitude will lead to the desired change in behavior. In conclusion, they draw attention to the fact that the sociocultural approach does not take into account the physiological problems associated with the use of alcohol (cancer, diseases of the liver and stomach). Therefore, many believe that the introduction of a sociocultural model will cause the predominance of physiological problems, even if social problems are resolved simply due to the widespread use of alcohol.
Contrary to these doubts, the sociocultural model does not lose its influence in the United States.Currently, this is perhaps the most dominant strategy. It applies and has a large scope of activities. Examples of this are advertising and educational approaches to the problem of drunk driving.
The socio-cultural model is mainly used to solve problems related to alcohol abuse, but it is also a cornerstone in preventing many problems associated with the use of other drugs. As noted above, an example of the latter is the campaign “Just Say No”, which calls on everyone, but especially the young, to refuse the offer to try drugs. Another example of this type of advertising campaign is the Drug America Rescue Partnership. This campaign, focused on marijuana, cocaine and crack, is trying to reduce the social acceptability of drug use among young people and warns those who are already using them or are only going to try, about the dangers of using. Mainly this campaign is carried out on television. However, to date, their effectiveness has not been documented. In addition, the effectiveness of this campaign can be reduced due to the fact that it is aimed at young people of middle and upper social classes who are less exposed to this danger. The only main difference in the application of the sociocultural model to drug abuse, as compared to alcohol abuse, is that in the first case an attempt is made to make abuse a norm, and in the second to form reasonable norms of use.

Consumer model

Posted on October 22, 2018  in Medical news

This model is based on a statistical study of alcohol use in various cultures. The first work in this area was the study of the French mathematician Sally Liderman in the 50s. The type of model has changed dramatically over the next several years under the influence of international studies.

There are three main provisions of this model. The first is that the percentage of people who drink heavily from a given population directly depends on the average level of alcohol consumption in a given society. Therefore, the number of alcoholics is growing in a society where alcohol consumption is growing. In connection with this dependence, it can be predicted that a decrease in alcohol consumption in a given culture will be accompanied by a decrease in the number of chronically ill alcoholics.

The second proposition is that the increase in strong alcohol consumption increases the likelihood of associated negative effects in the spiritual, physical and social spheres. Therefore, as soon as the average alcohol consumption in a society increases, the number of alcoholics increases, and, accordingly, an increase in such adverse effects can be expected.

The essence of the third statement is that society should try to reduce the negative effects of alcohol consumption by limiting its accessibility. It is argued that limiting the availability of alcohol, especially by raising the cost of alcoholic beverages, will reduce alcohol consumption, and, accordingly, the associated consequences. Other ways – reducing the working hours of bars and snack bars with alcoholic beverages, control over the retail sale of alcohol, raising the age limit for purchasing alcoholic beverages.

Although this model examines in detail the ways of prevention, it is also criticized. There is an opinion that this model is entirely descriptive and does not reveal the underlying causes – why people drink or how the environment in which a person exists affects his attitude to alcohol. The problem was examined in more detail, and it was noted that the model should be improved by introducing sociocultural variables such as the environment. There is also a criticism that “normal” drinkers in a social group may react differently to efforts to reduce the availability of alcohol than chronic alcoholics. The criticism is again based on the fact that sociocultural and psychological variables are not included in the consumer model. For example, the differences between moderate drinkers and alcoholics can be decisive in trying to predict behavior. Thus, the reaction of alcoholics to an increase in the price of alcohol and other measures aimed at reducing the use of alcohol is less predictable. In this regard, there may be situations in which such measures will be ineffective. If, for example, the price of alcohol grows very strongly, the result of this will immediately manifest itself in the growth of home production and the spill of alcoholic beverages and the mysterious image surrounding alcohol consumption. As can be seen from the above, the task of reducing the average level of alcohol consumption is very difficult.

Takes a moral position in solving the problems of the use of various substances. Its essence is that if there is no use of the substance, then therefore there is no problem itself. If a person uses a substance, it is not seen as a social problem, but a product of some kind of human nature flaw. If so, then the objectives of the prohibiting model are (a) to prohibit accessibility and (b) to abstain from use.
The inhibitory model applies to both alcohol and drugs. The most famous embodiment of this model for alcohol in practice is the Prohibition in the USA in 1921-1932. However, this model is more applicable to drug abuse. For decades, there was a strict ban on the use of drugs, mainly marijuana and heroin, and later cocaine. The prohibiting model in the 30s, 40s in America was very much manifested in films, newspapers, and magazine articles aimed at a mass audience. Sensational stories about the upsurge of crimes caused by marijuana, became known thanks to newspaper publications and films of those years “Crazy marijuana cigarette”, “Killer of youth”, “Marijuana: grass with roots in hell.” Then, as now, the “key” to such companies was that “good” people do not use drugs.

Although the prohibiting model remains popular, it has not made a significant contribution to the prevention of problems associated with drug use. It is well known that the Dry Law did not produce the desired results, and the problems of using other drugs also continue.

Zero Tolerance to Drugs

Posted on October 18, 2018  in Medical news

Among the most recent methods of prohibiting drug abuse is the well-known “zero tolerance” policy used by some states and federal agencies. Its essence lies in the development of zero tolerance to any drug in any quantity, anywhere, at any time. The purpose of this policy is to attack the demand for drugs and thus make drug addicts responsible for their role in drug distribution.
As part of this policy, which was actively covered in the media in the late 80s and early 90s, cars, ships, luxury yachts were withdrawn from private property if they found at least a small dose of the drug. In just one month, the coast guard confiscated 27 vessels. One yacht, the “Royal Ship”, was confiscated when the guards discovered several seeds and a stalk of marijuana in the dressing table and in the garbage can. On another yacht, the Coast Guard inspectors found one twenty-eighth of an ounce of marijuana. These two yachts were returned to their owners after paying fines and the value of the property confiscated. These are just the two most famous cases. Smaller items of property such as cars and luggage were also confiscated, and many of these cases are still found in legal practice.
Some officials believed that the principle of zero tolerance should be extended. Edwin Meese III, the minister of justice in Ronald Reagan’s office, called for all workers in the country to be subjected to a drug test, and positive tests would mean immediate dismissal. According to Miz, the zero tolerance testing policy is an “absolute necessity” in dealing with the problem of drug abuse. Supporters of observance of the rule of law noted that the constitutional issues relating to such testing, especially those proposed by the government, would obviously prevent its wide dissemination.
Officials from the Reagan and Bush administrations thought that such methods could reduce drug abuse. However, many others are not so optimistic. They noticed that if even a small percentage of those who use drugs are arrested, the judicial system will simply get bogged down, even if the majority of them admit their guilt. It is believed that more need to deal with manufacturers and traffickers.
The elaboration of a national policy, for example, a policy of zero tolerance, is, of course, a function of the chief officials of the government, and it would be very interesting to study in greater detail the strategy of the Clinton administration in this matter. Clinton expressed his willingness to devote large resources to combating the demand for drugs with methods of prevention and treatment of drug addiction. The effects of such a policy will be visible very soon.