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Missed Opportunities? Beneficial Uses of Illicit Drugs
Published in Ross Coomber, The Control of Drugs and Drug Users, 2020
Lester Grinspoon, James B. Bakalar
There are about a half dozen natural psychedelic drugs and scores of synthetic ones, most of them variants on a few chemical structures. The best known natural psychedelics are mescaline, derived from the peyote cactus, and psilocybin, found in over a hundred species of mushrooms. Among synthetic psychedelics, the best known and most potent is lysergic acid diethylamide (LSD), which is chemically related to certain alkaloids found in morning glory seeds, the lysergic acid amides. This class of drugs also includes the natural substances harmine, harmaline, ibogaine, and dimethyltryptamine (DMT), as well as a large number of synthetic drugs that are chemically described as tryptamines or methoxylated amphetamines. A few of these are diethyltryptamine (DET), 3,4,-methylenedioxyamphetamine (MDA), and 2,5-dimethoxy-4-methylamphetamine (DOM, also known as STP). Recently much attention has been focused on 3,4,-methylenedioxymethamphetamine (MDMA).
Stimulants and psychedelics
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
MDMA (3,4-methylenedioxymethamphetamine) is known by a variety of names, including ecstasy and XTC. It was first patented by Merck in 1912 as a possible appetite suppressant and pharmacological studies were undertaken in the late 1920s (Karch, 2011).
Stimulants and mental health
Published in David B Cooper, Practice in Mental Health—Substance Use, 2018
Richard Orr McLeod, Philip D Cooper
Stimulants provide the professional with some of the most difficult challenges, and can have a significant impact on the individual’s physical, psychological and social well-being. Anecdotally, many health professionals count stimulants as the most damaging to mental and physical well-being, as well as presenting some of the most challenging situations. In the UK, while the overall use of illicit substances has remained relatively stable, the use of certain stimulants, notably cocaine and crack cocaine, has increased in recent years.1 The availability of stimulants, especially 3,4-Methylenedioxymethamphetamine (MDMA — ecstasy) and its derivatives, plus the marked reduction in cost, both actual and relative, of MDMA and cocaine has exacerbated the problems encountered by professionals, and the significant difficulties for the individual, family and carers.
An MDMA cluster and the utility of illicit drug blood sampling
Published in Clinical Toxicology, 2022
Andrew Kozman, Jessamine Soderstrom, Francois Oosthuizen, Daniel Fatovich
Illicit drugs are involved in 7% of emergency department (ED) presentations, however the identification and measurement of blood concentrations is unavailable to the emergency physician [1]. Relying on clinical impressions can be inaccurate affecting further diagnostic evaluation and treatment in these patients. An approach based on the Western Australian Illicit Substance Evaluation (WISE) study developed at our hospital, overcomes this through the collection, storage and analysis of blood samples using Liquid Chromatography-Quadrupole-Mass Spectrometry [2]. If a clinician suspects that a patient has taken an illicit drug, then a blood sample can be collected. Knowledge of the causative agent in the clinical context may allow management to be tailored, particularly in life threatening ingestions and clusters (defined as aggregation of cases close in time and place) of poisoning. A cluster of patients with suspected 3, 4-methylenedioxymethamphetamine (MDMA) poisoning illustrates the value of blood testing to detect or exclude illicit drugs as a cause of the patient’s presentation.
Psychedelic Knowledge and Opinions in Psychiatrists at Two Professional Conferences: An Exploratory Survey
Published in Journal of Psychoactive Drugs, 2022
Brian S. Barnett, Yvan Beaussant, Franklin King, Rick Doblin
Following decades of slow progress secondary to stigma, regulatory barriers, and limited research funding, medicinal psychedelic research has begun accelerating in recent years (Reiff et al. 2020). Psilocybin has shown promise in treating anxiety and depression (Agin-Liebes et al. 2020; Carhart-Harris et al. 2021), and Phase 2 trials are currently investigating its treatment potential for both major depressive disorder (Business Wire 2019) and treatment-resistant major depressive disorder (Compass Pathways 2018). Recent results of a randomized, double-blind, placebo-controlled Phase 3 study of 3,4-Methylenedioxymethamphetamine (MDMA)-assisted therapy revealed that it is an efficacious, safe, and well-tolerated treatment for Posttraumatic Stress Disorder (PTSD) (Mitchell et al. 2021). With another successful Phase 3 study, MDMA could receive regulatory approval in the United States (U.S.) as early as 2023. Though not yet as intensively investigated, ayahuasca, ibogaine, and lysergic acid diethylamide (LSD), have also shown treatment potential for substance use and psychiatric disorders (Begola and Schillerstrom 2019; Vollenweider and Kometer 2010).
Blood concentrations of synthetic cathinones
Published in Clinical Toxicology, 2021
Synthetic cathinones first appeared on the drug market in 2004 and since then their number has increased. At present, they are the second largest and the second most frequently seized group of new psychoactive substances in Europe [1]. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) currently monitors 138 synthetic cathinones [1]. These substances have stimulating and emphatogenic actions, and are used as alternatives to amphetamine and 3,4-methylenedioxymethamphetamine (MDMA), as well as cocaine. Synthetic cathinone use is often associated with health and life risks. Their toxic effects include aggression, agitation, paranoia, and delusions. The synthetic cathinone ingestion can result in seizures, hyperthermia, rhabdomyolysis, renal and hepatic failure, and can led then to death [2].