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Anaesthesia and Past Use Of
177 Correspondence were using LSD. It is more popular than other commonly Anaesthesia and past use of used hallucinogens whose quoted incidence of clients are: LSD ketamine 0.1% (super-K/vitamin K.I), psilocybin and psilocin 0.6% (the active alkaloids in the Mexican "magic To the Editor: mushroom"), and 3,4 methylenedioxymethamphetamine We report the case of a 43-yr-old lady who was admitted ~MDMA" 1% (ecstasy). The effects of the concurrent to the Day Surgery Unit for release of her carpal tunnel ingestion of LSD on anaesthesia are well described. 2-4 retinaculum. During the preoperative visit, she reported The long-term effects of the past use of LSD are largely no intercurrent illnesses, drug therapy or allergies. She unknown. We wonder if the hallucinations experienced did say, however, that she was frightened of general anaes- by our patient during anaesthesia were due to her LSD thesia, since she had experienced terrifying dreams during intake many years before. We would be interested to surgery under general anaesthesia on three occasions dur- know if others have had experience anaesthetising patients ing the previous ten years. On further questioning, she who are past users of phencyclidine-derived drugs. admitted that she had used lysergic acid diethylamide (LSD) during the late 1960's, the last occasion being 1968 Geoffrey N. Morris MRCGPFRCA when she had experienced characterstic hallucinations. Patrick T. Magee MSe FRCA She had not experienced hallucinations in the ensuing Anaesthetic Department years, except on the surgical occasions mentioned. Royal United Hospital One of the three previous operations had been per- Combe Park formed at our hospital and the anaesthetic record was Bath BA1 3NG checked. -
Khat Chewing, Cardiovascular Diseases and Other Internal Medical Problems: the Current Situation and Directions for Future Research
Journal of Ethnopharmacology 132 (2010) 540–548 Contents lists available at ScienceDirect Journal of Ethnopharmacology journal homepage: www.elsevier.com/locate/jethpharm Review Khat chewing, cardiovascular diseases and other internal medical problems: The current situation and directions for future research A. Al-Motarreb a, M. Al-Habori b, K.J. Broadley c,∗ a Cardiac Centre, Internal Medicine Department, Sana’a University, Sana’a, Yemen b Biochemical Department, Faculty of Medicine, Sana’a University, Sana’a, Yemen c Division of Pharmacology, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff CF10 3NB, UK article info abstract Article history: The leaves of khat (Catha edulis Forsk.) are chewed as a social habit for the central stimulant action of their Received 9 October 2009 cathinone content. This review summarizes the prevalence of the habit worldwide, the actions, uses, con- Received in revised form 4 June 2010 stituents and adverse health effects of khat chewing. There is growing concern about the health hazards Accepted 1 July 2010 of chronic khat chewing and this review concentrates on the adverse effects on health in the periph- Available online 17 July 2010 eral systems of the body, including the cardiovascular system and gastrointestinal tract. Comparisons are made with amphetamine and ecstasy in particular on the detrimental effects on the cardiovascular Keywords: system. The underlying mechanisms of action of khat and its main constituent, cathinone, on the car- Khat Myocardial infarction diovascular system are discussed. Links have been proposed between khat chewing and the incidence of Hypertension myocardial infarction, dilated cardiomyopathy, vascular disease such as hypertension, cerebrovascular Vasoconstriction ischaemia and thromboembolism, diabetes, sexual dysfunction, duodenal ulcer and hepatitis. -
Chewing Over Khat Prohibition the Globalisation of Control and Regulation of an Ancient Stimulant
Series on Legislative Reform of Drug Policies Nr. 17 January 2012 Chewing over Khat prohibition The globalisation of control and regulation of an ancient stimulant By Axel Klein, Pien Metaal and Martin Jelsma 1 In the context of a fast changing and well documented market in legal highs, the case of khat (Catha edulis) provides an interest- ing anomaly. It is first of all a plant-based substance that undergoes minimal transfor- mation or processing in the journey from farm to market. Secondly, khat has been consumed for hundreds if not thousands of years in the highlands of Eastern Africa and Southern Arabia.2 In European countries, khat use was first observed during the CONCLUSIONS & RECOMMENDATIONS 1980s,3 but has only attracted wider atten- Where khat has been studied exten- tion in recent years. sively, namely Australia, the UK and until Discussions about appropriate regulatory recent-ly the Netherlands, governments systems and the implications of rising khat have steered clear of prohibition because 4 use for European drug policies should take the negative medical and social harms do cognizance of social, demographic and not merit such controls. cultural trends, and compare the existing Strict bans on khat introduced ostensi- models of control that exist in Europe. Khat bly for the protection of immigrant com- provides a unique example of a herbal munities have had severe unintended stimulant that is defined as an ordinary negative consequences. vegetable in some countries and a con- trolled drug in others. It provides a rare Khat prohibition has failed to further the opportunity to study the effectiveness, costs integration, social incusion and economic and benefits of diverse control regimes. -
The Ethics of Psychedelic Medicine: a Case for the Reclassification of Psilocybin for Therapeutic Purposes
THE ETHICS OF PSYCHEDELIC MEDICINE: A CASE FOR THE RECLASSIFICATION OF PSILOCYBIN FOR THERAPEUTIC PURPOSES By Akansh Hans A thesis submitted to Johns Hopkins University in conformity with the requirements for the degree of Master of Bioethics Baltimore, Maryland May 2021 © 2021 Akansh Hans All Rights Reserved I. Abstract Our current therapeutic mental health paradigms have been unable to adequately handle the mental illness crisis we are facing. We ought to ‘use every tool in our toolbox’ to help individuals heal, and the tool we should be utilizing right now is Psilocybin. Although it is classified as a Schedule I drug, meaning that it is believed to have a high potential for abuse, no accepted medical uses, and a lack of safety when used under medical supervision, Psilocybin is not addictive and does not have a high potential for abuse when used safely under medical supervision. For these reasons alone, Psilocybin deserves a reclassification for therapeutic purposes. However, many individuals oppose Psilocybin-assisted psychotherapy on ethical grounds or due to societal concerns. These concerns include: a potential change in personal identity, a potential loss of human autonomy, issues of informed consent, safety, implications of potential increased recreational use, and distributive justice and fairness issues. Decriminalization, which is distinct from reclassification, means that individuals should not be incarcerated for the use of such plant medicines. This must happen first to stop racial and societal injustices from continuing as there are no inherently ‘good’ or ‘bad’ drugs. Rather, these substances are simply chemicals that humans have developed relationships with. As is shown in this thesis, the ethical implications and risks of psychedelic medicine can be adequately addressed and balanced, and the benefits of Psilocybin as a healing tool far outweigh the risks. -
Evidence for the Involvement of Spinal Cord 1 Adrenoceptors in Nitrous
Anesthesiology 2002; 97:1458–65 © 2002 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Evidence for the Involvement of Spinal Cord ␣ 1 Adrenoceptors in Nitrous Oxide–induced Antinociceptive Effects in Fischer Rats Ryo Orii, M.D., D.M.Sc.,* Yoko Ohashi, M.D.,* Tianzhi Guo, M.D.,† Laura E. Nelson, B.A.,‡ Toshikazu Hashimoto, M.D.,* Mervyn Maze, M.B., Ch.B.,§ Masahiko Fujinaga, M.D.ʈ Background: In a previous study, the authors found that ni- opioid peptide release in the brain stem, leading to the trous oxide (N O) exposure induces c-Fos (an immunohisto- 2 activation of the descending noradrenergic inhibitory chemical marker of neuronal activation) in spinal cord ␥-ami- nobutyric acid–mediated (GABAergic) neurons in Fischer rats. neurons, which results in modulation of the pain–noci- 1 In this study, the authors sought evidence for the involvement ceptive processing in the spinal cord. Available evi- Downloaded from http://pubs.asahq.org/anesthesiology/article-pdf/97/6/1458/337059/0000542-200212000-00018.pdf by guest on 01 October 2021 ␣ of 1 adrenoceptors in the antinociceptive effect of N2O and in dence suggests that at the level of the spinal cord, there activation of GABAergic neurons in the spinal cord. appear to be at least two neuronal systems that are Methods: Adult male Fischer rats were injected intraperitone- involved (fig. 1). In one of the pathways, activation of ally with ␣ adrenoceptor antagonist, ␣ adrenoceptor antago- 1 2 ␣ nist, opioid receptor antagonist, or serotonin receptor antago- the 2 adrenoceptors produces either direct presynaptic nist and, 15 min later, were exposed to either air (control) or inhibition of neurotransmitter release from primary af- 75% N2O. -
5-HT2A and 5-HT2C/2B Receptor Subtypes Modulate
5-HT2A and 5-HT2C/2B Receptor Subtypes Modulate Dopamine Release Induced in Vivo by Amphetamine and Morphine in Both the Rat Nucleus Accumbens and Striatum Grégory Porras, M.S., Vincenzo Di Matteo, Ph.D., Claudia Fracasso, B.S., Guillaume Lucas, Ph.D., Philippe De Deurwaerdère, Ph.D., Silvio Caccia, Ph.D., Ennio Esposito, M.D., Ph.D., and Umberto Spampinato, M.D., Ph.D. In vivo microdialysis and single-cell extracellular neuron firing rate in both the ventral tegmental area and recordings were used to assess the involvement of the substantia nigra pars compacta was unaffected by SR serotonin2A (5-HT2A) and serotonin2C/2B (5-HT2C/2B) 46349B (0.1 mg/kg i.v.) but significantly potentiated by SB receptors in the effects induced by amphetamine and 206553 (0.1 mg/kg i.v.). These results show that 5-HT2A morphine on dopaminergic (DA) activity within the and 5-HT2C receptors regulate specifically the activation of mesoaccumbal and nigrostriatal pathways. The increase in midbrain DA neurons induced by amphetamine and DA release induced by amphetamine (2 mg/kg i.p.) in the morphine, respectively. This differential contribution may nucleus accumbens and striatum was significantly reduced be related to the specific mechanism of action of the drug by the selective 5-HT2A antagonist SR 46349B (0.5 mg/kg considered and to the neuronal circuitry involved in their s.c.), but not affected by the 5-HT2C/2B antagonist SB effect on DA neurons. Furthermore, these results suggest 206553 (5 mg/kg i.p.). In contrast, the enhancement of that 5-HT2C receptors selectively modulate the impulse accumbal and striatal DA output induced by morphine (2.5 flow–dependent release of DA. -
3,4-Methylenedioxymethcathinone (Methylone) [“Bath Salt,” Bk-MDMA, MDMC, MDMCAT, “Explosion,” “Ease,” “Molly”] December 2019
Drug Enforcement Administration Diversion Control Division Drug & Chemical Evaluation Section 3,4-Methylenedioxymethcathinone (Methylone) [“Bath salt,” bk-MDMA, MDMC, MDMCAT, “Explosion,” “Ease,” “Molly”] December 2019 Introduction: discriminate DOM from saline. 3,4-Methylenedioxymethcathinone (methylone) is a Because of the structural and pharmacological similarities designer drug of the phenethylamine class. Methylone is a between methylone and MDMA, the psychoactive effects, adverse synthetic cathinone with substantial chemical, structural, and health risks, and signs of intoxication resulting from methylone pharmacological similarities to 3,4-methylenedioxymeth- abuse are likely to be similar to those of MDMA. Several chat amphetamine (MDMA, ecstasy). Animal studies indicate that rooms discussed pleasant and positive effects of methylone when methylone has MDMA-like and (+)-amphetamine-like used for recreational purpose. behavioral effects. When combined with mephedrone, a controlled schedule I substance, the combination is called User Population: “bubbles.” Other names are given in the above title. Methylone, like other synthetic cathinones, is a recreational drug that emerged on the United States’ illicit drug market in 2009. It is perceived as being a ‘legal’ alternative to drugs of Licit Uses: Methylone is not approved for medical use in the United abuse like MDMA, methamphetamine, and cocaine. Evidence States. indicates that youths and young adults are the primary users of synthetic cathinone substances which include methylone. However, older adults also have been identified as users of these Chemistry: substances. O H O N CH3 Illicit Distribution: CH O 3 Law enforcement has encountered methylone in the United States as well as in several countries including the Netherlands, Methylone United Kingdom, Japan, and Sweden. -
Hallucinogens
Hallucinogens What Are Hallucinogens? Hallucinogens are a diverse group of drugs that alter a person’s awareness of their surroundings as well as their thoughts and feelings. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Both types of hallucinogens can cause hallucinations, or sensations and images that seem real though they are not. Additionally, dissociative drugs can cause users to feel out of control or disconnected from their body and environment. Some hallucinogens are extracted from plants or mushrooms, and others are synthetic (human-made). Historically, people have used hallucinogens for religious or healing rituals. More recently, people report using these drugs for social or recreational purposes. Hallucinogens are a Types of Hallucinogens diverse group of drugs Classic Hallucinogens that alter perception, LSD (D-lysergic acid diethylamide) is one of the most powerful mind- thoughts, and feelings. altering chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other Hallucinogens are split grains. into two categories: Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) comes from certain classic hallucinogens and types of mushrooms found in tropical and subtropical regions of South dissociative drugs. America, Mexico, and the United States. Peyote (mescaline) is a small, spineless cactus with mescaline as its main People use hallucinogens ingredient. Peyote can also be synthetic. in a wide variety of ways DMT (N,N-dimethyltryptamine) is a powerful chemical found naturally in some Amazonian plants. People can also make DMT in a lab. -
Street Names: Khat, Qat, Kat, Chat, Miraa, Quaadka) September 2019
Drug Enforcement Administration Diversion Control Division Drug & Chemical Evaluation Section KHAT (Street Names: Khat, Qat, Kat, Chat, Miraa, Quaadka) September 2019 Introduction: User Population: Khat, Catha edulis, is a flowering shrub native to East Abuse of khat in the United States is most prevalent among Africa and the Arabian-Peninsula. Khat often refers to the immigrants from Somalia, Ethiopia, and Yemen. Abuse of khat is leaves and young shoot of Catha edulis. It has been widely highest in cities with a substantial population of these immigrants. used since the thirteenth century as a recreational drug by the These cities include Boston (MA), Columbus (OH), Dallas (TX), indigenous people of East Africa, the Arabian Peninsula and Detroit (MI), Kansas City (MO), Los Angeles (CA), Minneapolis (MN), throughout the Middle East. Nashville (TN), New York (NY), and Washington D.C. Licit Uses: Illicit Distribution: There is no accepted medical use in treatment for khat in Individuals of Somali, Ethiopian, and Yemeni descent are the the United States. primary transporters and distributors of khat in the United States. The khat is transported from Somalia into the United States and distributed Chemistry and Pharmacology: in the Midwest, West and Southeast (Nashville, Tennessee) regions Khat contains two central nervous system (CNS) of the United States. According to the National Drug Intelligence stimulants, namely cathinone and cathine. Cathinone (alpha- Center, Somali and Yemen independent dealers are distributing khat aminopriopiophenone), which is considered to be the principal in Ann Arbor, Detroit, Lansing and Ypsilanti, Michigan; Columbus, active stimulant, is structurally similar to d-amphetamine and Ohio; Kansas City, Missouri; and Minneapolis/St. -
Adverse Reactions to Hallucinogenic Drugs. 1Rnstttutton National Test
DOCUMENT RESUME ED 034 696 SE 007 743 AUTROP Meyer, Roger E. , Fd. TITLE Adverse Reactions to Hallucinogenic Drugs. 1rNSTTTUTTON National Test. of Mental Health (DHEW), Bethesda, Md. PUB DATP Sep 67 NOTE 118p.; Conference held at the National Institute of Mental Health, Chevy Chase, Maryland, September 29, 1967 AVATLABLE FROM Superintendent of Documents, Government Printing Office, Washington, D. C. 20402 ($1.25). FDPS PRICE FDPS Price MFc0.50 HC Not Available from EDRS. DESCPTPTOPS Conference Reports, *Drug Abuse, Health Education, *Lysergic Acid Diethylamide, *Medical Research, *Mental Health IDENTIFIEPS Hallucinogenic Drugs ABSTPACT This reports a conference of psychologists, psychiatrists, geneticists and others concerned with the biological and psychological effects of lysergic acid diethylamide and other hallucinogenic drugs. Clinical data are presented on adverse drug reactions. The difficulty of determining the causes of adverse reactions is discussed, as are different methods of therapy. Data are also presented on the psychological and physiolcgical effects of L.S.D. given as a treatment under controlled medical conditions. Possible genetic effects of L.S.D. and other drugs are discussed on the basis of data from laboratory animals and humans. Also discussed are needs for futher research. The necessity to aviod scare techniques in disseminating information about drugs is emphasized. An aprentlix includes seven background papers reprinted from professional journals, and a bibliography of current articles on the possible genetic effects of drugs. (EB) National Clearinghouse for Mental Health Information VA-w. Alb alb !bAm I.S. MOMS Of NAM MON tMAN IONE Of NMI 105 NUNN NU IN WINES UAWAS RCM NIN 01 NUN N ONMININI 01011110 0. -
Nicotine and Neurotransmitters
Module 2 —Legal Doesn’t Mean Harmless Overview Overview Summary This module focuses on how two drugs, nicotine and alcohol, change the functioning of the brain and body. Both drugs are widely used in the community, and for adults, using them is legal. Nonetheless, both alcohol and nicotine can have a strong impact on the functioning of the brain. Each can cause a number of negative effects on the body and brain, ranging from mild symptoms to addiction. The goal of this module is to help students understand that, although nicotine and alcohol are legal for adults, they are not harmless substances. Students will learn about how nicotine and alcohol change or disrupt the process of neurotransmission. Students will explore information on the short- and long- term effects of these two drugs, and also learn why these drugs are illegal for children and teens. Through the media, students are exposed to a great deal of information about alcohol and tobacco, much of which is misleading or scientifically inaccurate. This module will provide information on what researchers have learned about how nicotine and alcohol change the brain, and the resulting implications for safety and health. Learning Objectives At the end of this module: • Students can explain how nicotine disrupts neurotransmission. • Students can explain how alcohol use may harm the brain and the body. • Students understand how alcohol can intensify the effect of other drugs. • Students can define addiction and understand its basis in the brain. • Students draw conclusions about why our society regulates the use of nicotine and alcohol for young people. -
Nicotine Improves Working Memory Span Capacity in Rats Following Sub-Chronic Ketamine Exposure
Neuropsychopharmacology (2011) 36, 2774–2781 & 2011 American College of Neuropsychopharmacology. All rights reserved 0893-133X/11 www.neuropsychopharmacology.org Nicotine Improves Working Memory Span Capacity in Rats Following Sub-Chronic Ketamine Exposure Samantha L Rushforth1, Thomas Steckler2 and Mohammed Shoaib*,1 1 2 Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, Newcastle, UK; Janssen Research & Development, Beerse, Belgium Ketamine, an NMDA-receptor antagonist, produces cognitive deficits in humans in a battery of tasks involving attention and memory. Nicotine can enhance various indices of cognitive performance, including working memory span capacity measured using the odor span task (OST). This study examined the effects of a sub-chronic ketamine treatment to model cognitive deficits associated with schizophrenia, and to evaluate the effectiveness of nicotine, antipsychotic clozapine, and the novel mGlu2/3 agonist, LY404039, in restoring OST performance. Male hooded Lister rats were trained in the OST, a working memory task involving detection of a novel odor from an increasing number of presented odors until they exhibited asymptotic levels of stable performance. Sub-chronic ketamine exposure (10 and 30 mg/kg i.p. for 5 consecutive days) produced a dose-dependent impairment that was stable beyond 14 days following exposure. In one cohort, administration of graded doses of nicotine (0.025–0.1 mg/kg) acutely restored the performance in ketamine-treated animals, while significant improvements in odor span were observed in control subjects. In a second cohort of rats, acute tests with clozapine (1–10 mg/kg) and LY404039 (0.3–10 mg/kg) failed to reverse ketamine-induced deficits in doses that were observed to impair performance in the control groups.