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From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs

/ Ketamine, Papers, Publications / / ,

Abstract

PCP or phencyclidine was discovered in 1956 and soon became a popular street drug. Dissociatives including PCP, ketamine, and dextromethorphan have been used non-medically for their mind-altering effects for over 60 years. Many of these compounds have also been used clinically and in legitimate research. At least 14 derivatives of PCP were sold for non-medical and illict use from the late 1960s until the 1990s. With the advent of the Internet, the drug market underwent a dramatic evolution. While initially gray-market chemical vendors offering dextromethorphan and ketamine thrived, most recently the market has shifted to legal high and online-based research chemical vendors. Starting with the first dissociative research chemical, 4-MeO-PCP in 2008, the dissociative research chemical market has rapidly evolved and currently comprises at least 12 dissociatives, almost half of which were unknown in the scientific literature prior to their introduction. Several of these, including methoxetamine, have reached widespread use internationally. A historical account of non-medical use of over 30 dissociative compounds was compiled from a diverse collection of sources. The first complete portrait of this underground market is presented along with the relevant legal, technological, and scientific developments which have driven its evolution.

Morris, H., & Wallach, J. (2014). From PCP to MXE: a comprehensive review of the non‐medical use of dissociative drugs. Drug testing and analysis, 6(7-8), 614-632. http://dx.doi.org/10.1002/dta.1620
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Psychedelische Heropleving

/ Uncategorized /

Het wetenschappelijke tijdschrift The Journal of Psychoactive Drugs heeft de eerste editie in 2014 gewijd aan de heropleving van psychedelisch onderzoek. De artikelen zijn grofweg in te delen in vijf thema’s (LSD, MDMA, ayahuasca, cannabis, onderzoekskwesties en -instituten) en gaan in op belangrijke vraagstukken binnen het onderzoek naar psychedelica en het therapeutisch gebruik van deze middelen.

Het eerste artikel is een beschouwing van de voormalige, hedendaagse en toekomstige status van lysergeenzuurdiethylamide (LSD; Smith, Raswyck, & Dickerson Davidson, 2014). In het artikel wordt op chronologische wijze beschreven hoe de psychoactieve eigenschappen van LSD tot zowel positieve als negatieve reacties hebben geleid wat betreft het therapeutische gebruik, het gebruik voor militaire doeleinden, en wat betreft het recreatieve gebruik van dit middel. Het artikel eindigt met een overzicht van hedendaagse onderzoeksprojecten. In een tweede LSD-gerelateerd artikel wordt een kwalitatief onderzoek beschreven waarin naar de lange termijn ervaringen werd gevraagd van Tsjechische psychologen en psychiaters die op zichzelf experimenteerden met LSD in de jaren 1950 – 1970 (Winkler & Csémy, 2014). In het artikel worden ook diverse argumenten vóór deze vorm van zelf-experimentatie uiteengezet.

Twee review artikelen zijn gewijd aan het afwegen van de voor- en nadelen van het gebruik van MDMA in een therapeutische setting, en aan diverse onderzoekskwesties die betrekking hebben op het “Ecstacy Paradigma” (Cole, 2014; Parrott, 2014). In een ander artikel geeft Dr. Ben Sessa, een pionier op het gebied van hedendaagse psychotherapie gecombineerd met MDMA, zijn visie op de potentiële vruchtbare combinatie van psychiatrie en psychedelica (Sessa, 2014).

In New-Mexico, de eerste staat van de Verenigde Staten waarin het medische gebruik van cannabis ter bestrijding van de symptomen van een posttraumatische stressstoornis (PTSS) werd toegestaan, verzamelden Greer, Grob, and Halberstadt (2014) retrospectief gegevens om een indruk te krijgen van de gevolgen van deze wetsaanpassing. De onderzoekers concludeerden voorzichtig dat het gebruik van cannabis geassocieerd lijkt te zijn met een vermindering van PTSS symptomen, en benadrukken de noodzaak van een onderzoek met een experimenteel karakter.

Een inspirerende bijdrage aan deze speciale editie wordt geleverd door twee artikelen waarin de geschiedenis en toekomst van het Heffter Research Institute en de Multidisciplinary Association for Psychedelic Studies (MAPS) worden belicht (Emerson, Ponté, Jerome, & Doblin, 2014; Nichols, 2014). Zoals de hoofdredacteur Terry Chambers in het voorwoord vermeldt: ‘…deze editie van het tijdschrift is géén alomvattende bundel met als doel de lezer te informeren over de eigenschappen en het gebruik van psychedelische drugs, maar geeft een indicatie van het serieuze en interessante onderzoek dat momenteel gedaan wordt over dit onderwerp.’ De heropleving is gaande, en we verwachten dat de Nederlandse wetenschap zich hier snel bij aansluit!

Het tijdschrift staat online gepubliceerd en de abstracts van de individuele artikelen zijn ook te vinden op onze website.

 
Referenties
Cole, J. C. (2014). MDMA and the “Ecstasy Paradigm.” Journal of Psychoactive Drugs, 46(1), 44–56. doi:10.1080/02791072.2014.878148
Emerson, A., Ponté, L., Jerome, L., & Doblin, R. (2014). History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS). Journal of Psychoactive Drugs, 46(1), 27–36. doi:10.1080/02791072.2014.877321
Greer, G. R., Grob, C. S., & Halberstadt, A. L. (2014). PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program. Journal of Psychoactive Drugs, 46(1), 73–77. doi:10.1080/02791072.2013.873843
Heffter Research Institute. 2012. Our Research. Available at: http://www. heffter.org/research-hucla.htm.
Krupitsky, E. M., Burakov, A. M., Dunaevsky, I. V, Romanova, T. N., Slavina, T. Y., & Grinenko, A. Y. (2007). Single versus repeated sessions of ketamine-assisted psychotherapy for people with heroin dependence. Journal of Psychoactive Drugs, 39, 13–19. doi:10.1080/02791072.2007.10399860
Loizaga-Velder, A., & Verres, R. (2014). Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results. Journal of Psychoactive Drugs, 46(1), 63–72. doi:10.1080/02791072.2013.873157
Nichols, D. E. (2014). The Heffter Research Institute: Past and Hopeful Future. Journal of Psychoactive Drugs, 46(1), 20–26. doi:10.1080/02791072.2014.873688
Parrott, A. C. (2014). The Potential Dangers of Using MDMA for Psychotherapy. Journal of Psychoactive Drugs, 46(1), 37–43. doi:10.1080/02791072.2014.873690
Sessa, B. (2014). Why Psychiatry Needs Psychedelics and Psychedelics Need Psychiatry. Journal of Psychoactive Drugs, 46(1), 57–62. doi:10.1080/02791072.2014.877322
Smith, D. E., Raswyck, G. E., & Dickerson Davidson, L. (2014). From Hofmann to the Haight Ashbury, and into the Future: The Past and Potential of Lysergic Acid Diethlyamide. Journal of Psychoactive Drugs, 46(1), 3–10. doi:10.1080/02791072.2014.873684
Winkler, P., & Csémy, L. (2014). Self-Experimentations with Psychedelics Among Mental Health Professionals: LSD in the Former Czechoslovakia. Journal of Psychoactive Drugs, 46(1), 11–19. doi:10.1080/02791072.2013.873158

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Psychedelic Resurgence

/ Publications /

This year’s first edition of The Journal of Psychoactive Drugs is a special issue dedicated to the resurgence of psychedelic research. In roughly five themes (LSD, MDMA , ayahuasca, cannabis, research issues and institutes) the journal provides a glance at past and present matters related to research and therapeutic uses of psychedelics.

The first article is a review of the past, present and future status of Lysergic Acid Diethylamide (LSD; Smith, Raswyck, & Dickerson Davidson, 2014). The article comprises a chronological overview of how the psychoactive properties of LSD have led to positive and negative appraisal of the substance in therapeutic research, for military purposes, and recreational use. The article finishes with an overview of contemporary research projects. Another LSD-centered article in the journal, is a qualitative study that retrospectively assesses the long-term experiences of Czech psychologists and psychiatrists that involved in self-experimentation with LSD in the 1950’s – 1970’s (Winkler & Csémy, 2014). The article also serves to present arguments for self-experimentation.

Two review papers are dedicated to address the pro’s and con’s of using MDMA in a therapeutic setting and research issues related to the “Ecstacy Paradigm” (Cole, 2014; Parrott, 2014). A consideration of how psychiatry and psychedelics can benefit from each other, is provided by dr. Ben Sessa (2014), who has been working on MDMA-assisted psychotherapy.

In a qualitative study, Loizaga-Velder and Verres (2014) explored the therapeutic effects of ritual ayahuasca use in the treatment of substance abuse. In line with other studies that yielded promising results in exploring the competence of psychedelics in treating addiction (Heffter Institute, 2012; Krupitsky et al., 2007), the main finding was that participation in ritual ayahuasca sessions facilitated substance dependence treatment.

In New-Mexico, the first state that authorized the use of medicinal cannabis for releasing symptoms of Post-Traumatic Stress Disorder (PTSD), Greer, Grob, and Halberstadt (2014) acquired retrospective data in order to portray the result of this law adjustment. The researchers tentatively conclude that cannabis is associated with PTSD reduction in some patients, and express the need for a study with an experimental design.

An inspiring contribution to this special issue, are two articles dedicated to the past and present of the Heffter Research Institute and the Multidisciplinary Association for Psychedelic Studies (MAPS; Emerson, Ponté, Jerome, & Doblin, 2014; Nichols, 2014). As the editor of the journal, Terry Chambers, expresses in the introduction: ‘…this issue of the Journal is not a comprehensive presentation of the activity of those attempting to understand the properties and uses of psychedelic drugs, but it is an indication of the serious and interesting research being done on this subject.’ The resurgence is happening, and we expect that Dutch scientists will follow soon.

The journal is published online and the abstracts can be freely retrieved from our website.

 
References
Cole, J. C. (2014). MDMA and the “Ecstasy Paradigm.” Journal of Psychoactive Drugs, 46(1), 44–56. doi:10.1080/02791072.2014.878148
Emerson, A., Ponté, L., Jerome, L., & Doblin, R. (2014). History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS). Journal of Psychoactive Drugs, 46(1), 27–36. doi:10.1080/02791072.2014.877321
Greer, G. R., Grob, C. S., & Halberstadt, A. L. (2014). PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program. Journal of Psychoactive Drugs, 46(1), 73–77. doi:10.1080/02791072.2013.873843
Heffter Research Institute. 2012. Our Research. Available at: http://www. heffter.org/research-hucla.htm.
Krupitsky, E. M., Burakov, A. M., Dunaevsky, I. V, Romanova, T. N., Slavina, T. Y., & Grinenko, A. Y. (2007). Single versus repeated sessions of ketamine-assisted psychotherapy for people with heroin dependence. Journal of Psychoactive Drugs, 39, 13–19. doi:10.1080/02791072.2007.10399860
Loizaga-Velder, A., & Verres, R. (2014). Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results. Journal of Psychoactive Drugs, 46(1), 63–72. doi:10.1080/02791072.2013.873157
Nichols, D. E. (2014). The Heffter Research Institute: Past and Hopeful Future. Journal of Psychoactive Drugs, 46(1), 20–26. doi:10.1080/02791072.2014.873688
Parrott, A. C. (2014). The Potential Dangers of Using MDMA for Psychotherapy. Journal of Psychoactive Drugs, 46(1), 37–43. doi:10.1080/02791072.2014.873690
Sessa, B. (2014). Why Psychiatry Needs Psychedelics and Psychedelics Need Psychiatry. Journal of Psychoactive Drugs, 46(1), 57–62. doi:10.1080/02791072.2014.877322
Smith, D. E., Raswyck, G. E., & Dickerson Davidson, L. (2014). From Hofmann to the Haight Ashbury, and into the Future: The Past and Potential of Lysergic Acid Diethlyamide. Journal of Psychoactive Drugs, 46(1), 3–10. doi:10.1080/02791072.2014.873684
Winkler, P., & Csémy, L. (2014). Self-Experimentations with Psychedelics Among Mental Health Professionals: LSD in the Former Czechoslovakia. Journal of Psychoactive Drugs, 46(1), 11–19. doi:10.1080/02791072.2013.873158

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Classical hallucinogens as antidepressants? A review of pharmacodynamics and putative clinical roles

/ Anxiety Disorders / PTSD, Depressive Disorders, Mushrooms / Psilocybin, Neuroscience, Papers, Psychology, Publications / / , , ,

Abstract

Hallucinogens have been part of spiritual practice for millennia, but controversy surrounding their mind-manifesting effects led to their proscription by the mid-20th century, largely without evidence of harm or toxicity and despite nascent data suggesting therapeutic utility in treating depressive illnesses. This review explores their pharmacodynamic actions and the current limited data on their clinic effectiveness. These drugs appear to exert their psychedelic effects through their agonist or partial agonist activity at the serotonergic 5-HT2A receptor, though they also have affinity for other metabotropic serotonin receptors. Hallucinogen binding affects a wide range of intracellular signalling pathways, the precise nature of which remains incompletely understood. They alter the serotonergic tone of brainstem raphe nuclei that project through the brain; they interact with receptors in the prefrontal cortex altering connectivity patterns and intracellular functioning; and they disrupt inhibitory control of sensory input via the thalamus to the cortex. The serotonergic system has long been implicated in anxiety and depressive disorders, and is a major target of most existing antidepressants. Classical hallucinogens alter the functioning of this system, but not in the same way current medications do: whilst there are identified receptors and neurotransmitter pathways through which hallucinogens could therein produce therapeutic effects, the neurobiology of this remains speculative at this time. There is currently an extremely limited but growing literature on hallucinogen safety and clinical application. The drugs appear well tolerated by healthy controls and clinical populations, and the rapid tolerance to repeated administration might reduce the possibility of dependency. Clinical trials reported over the past decade have generally shown positive therapeutic potential, but they are notably few in number. Legislative policy has had a freezing effect on evaluation of these compounds, a better understanding of which might improve our knowledge of the processes involved in consciousness, the neuropathology of depression, and potentially open up new pharmacological therapies.

Baumeister, D., Barnes, G., Giaroli, G., & Tracy, D. (2014). Classical hallucinogens as antidepressants? A review of pharmacodynamics and putative clinical roles. Therapeutic Advances in Psychopharmacology, 4(4), 156-159. http://dx.doi.org/10.1177/2045125314527985
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PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program

/ Anxiety Disorders / PTSD, Papers, Psychology, Publications / / , ,

Abstract

Background: New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. Methods: The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Results: Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Conclusions: Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

Greer, G. R., Grob, C. S., & Halberstadt, A. L. (2014). PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program. Journal of Psychoactive Drugs, 46(1), 73–77. http://dx.doi.org/10.1080/02791072.2013.873843
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Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results

/ Ayahuasca, Biology & Ethnobotany, Neuroscience, Papers, Psychology, Publications, Substance Use Disorder / / ,

Abstract

This qualitative empirical study explores the ritual use of ayahuasca in the treatment of addictions. Ayahuasca is an Amazonian psychedelic plant compound created from an admixture of the vine Banisteriopsis caapi and the bush Psychotria viridis. The study included interviews with 13 therapists who apply ayahuasca professionally in the treatment of addictions (four indigenous healers and nine Western mental health professionals with university degrees), two expert researchers, and 14 individuals who had undergone ayahuasca-assisted therapy for addictions in diverse contexts in South America. The study provides empirically based hypotheses on therapeutic mechanisms of ayahuasca in substance dependence treatment. Findings indicate that ayahuasca can serve as a valuable therapeutic tool that, in carefully structured settings, can catalyze neurobiological and psychological processes that support recovery from substance dependencies and the prevention of relapse. Treatment outcomes, however, can be influenced by a number of variables that are explained in this study. In addition, issues related to ritual transfer and strategies for minimizing undesired side-effects are discussed.

Loizaga-Velder, A., & Verres, R. (2014). Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results. Journal of Psychoactive Drugs, 46(1), 63–72. http://dx.doi.org/10.1080/02791072.2013.873157
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Why Psychiatry Needs Psychedelics and Psychedelics Need Psychiatry

/ Anxiety Disorders / PTSD, Depressive Disorders, LSD, MDMA, Mushrooms / Psilocybin, Papers, Psychology, Publications, Substance Use Disorder / /

Abstract

Without researching psychedelic drugs for medical therapy, psychiatry is turning its back on a group of compounds that could have great potential. Without the validation of the medical profession, the psychedelic drugs, and those who take them off-license, remain archaic sentiments of the past, with the users maligned as recreational drug abusers and subject to continued negative opinion. These two disparate groups—psychiatrists and recreational psychedelic drug users—are united by their shared recognition of the healing potential of these compounds. A resolution of this conflict is essential for the future of psychiatric medicine and psychedelic culture alike. Progression will come from professionals working in the field adapting to fit a conservative paradigm. In this way, they can provide the public with important treatments and also raise the profile of expanded consciousness in mainstream society.

Sessa, B. (2014). Why Psychiatry Needs Psychedelics and Psychedelics Need Psychiatry. Journal of Psychoactive Drugs, 46(1), 57–62. http://dx.doi.org/10.1080/02791072.2014.877322
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MDMA and the “Ecstasy Paradigm”

/ MDMA, Neuroscience, Papers, Psychology, Publications / /

Abstract

For nearly 30 years, there has been a steady flow of research papers highlighting the dangers of MDMA and the implications for ecstasy users. After such a long time, it would be reasonable to expect that these dangers would be obvious due to the large number of ecstasy users. The available evidence does not indicate that there are millions of ecstasy users experiencing any problems linked to their ecstasy use. The “precautionary principle” suggests that, in the absence of knowing for certain, “experts” should argue that MDMA be avoided. However, this may have been taken too far, as the dire warnings do not seem to be reducing with the lack of epidemiological evidence of clinically relevant problems. The “ecstasy paradigm” is one way of articulating this situation, in that the needs of research funders and publication bias lead to a specific set of subcultural norms around what information is acceptable in the public domain. By digging a little deeper, it is easy to find problems with the evidence base that informs the public debate around MDMA. The key question is whether it is acceptable to maintain this status quo given the therapeutic potential of MDMA.

Cole, J. C. (2014). MDMA and the “Ecstasy Paradigm”. Journal of Psychoactive Drugs, 46(1), 44–56. http://dx.doi.org/10.1080/02791072.2014.878148
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The Potential Dangers of Using MDMA for Psychotherapy

/ Anxiety Disorders / PTSD, MDMA, Neuroscience, Papers, Psychology, Publications / /

Abstract

MDMA has properties that may make it attractive for psychotherapy, although many of its effects are potentially problematic. These contrasting effects will be critically reviewed in order to assess whether MDMA could be safe for clinical usage. Early studies from the 1980s noted that MDMA was an entactogen, engendering feelings of love and warmth. However, negative experiences can also occur with MDMA since it is not selective in the thoughts or emotions it releases. This unpredictability in the psychological material released is similar to another serotonergic drug, LSD. Acute MDMA has powerful neurohormonal effects, increasing cortisol, oxytocin, testosterone, and other hormone levels. The release of oxytocin may facilitate psychotherapy, whereas cortisol may increase stress and be counterproductive. MDMA administration is followed by a period of neurochemical recovery, when low serotonin levels are often accompanied by lethargy and depression. Regular usage can also lead to serotonergic neurotoxicity, memory problems, and other psychobiological problems. Proponents of MDMA-assisted therapy state that it should only be used for reactive disorders (such as PTSD) since it can exacerbate distress in those with a prior psychiatric history. Overall, many issues need to be considered when debating the relative benefits and dangers of using MDMA for psychotherapy.

Parrott, A. C. (2014). The Potential Dangers of Using MDMA for Psychotherapy. Journal of Psychoactive Drugs, 46(1) , 37–43. http://dx.doi.org/10.1080/02791072.2014.873690
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History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS)

/ Anxiety Disorders / PTSD, LSD, MDMA, Papers, Publications / / , , ,

Abstract

This article describes the teenage vision of the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) that humanity’s future would be aided by the therapeutic and spiritual potential of psychedelic substances. The article traces the trajectory of MAPS from inception in 1986 to its present, noting future goals with respect to research, outreach, and harm reduction. MAPS was created as a non-profit psychedelic pharmaceutical company in response to the 1985 scheduling of 3,4-methylenedioxymethamphetamine (MDMA). Overcoming many hurdles, MAPS developed the first double-blind, placebo-controlled trial of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) and plans for FDA prescription approval in 2021. MAPS’ program of research expanded to include a trial of lysergic acid diethylamide (LSD)-assisted psychotherapy for anxiety when facing life-threatening illness, observational studies of ibogaine in the treatment of addiction, and studies of MDMA for social anxiety in people with autism spectrum disorders. MAPS meets the challenges of drug development through a clinical research team led by a former Novartis drug development professional experienced in the conduct, monitoring, and analysis of clinical trials. MAPS’ harm-reduction efforts are intended to avoid backlash and build a post-prohibition world by assisting non-medical users to transform difficult psychedelic experiences into opportunities for growth.

Emerson, A., Ponté, L., Jerome, L., & Doblin, R. (2014). History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS). Journal of Psychoactive Drugs, 46(1), 27–36. http://dx.doi.org/10.1080/02791072.2014.877321
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Psyche & Praxis Forum: Working at the Edge of Medicine and Mysticism - January 29

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