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Psychedelic Medicine 101: The curious case of ketamine



Psychedelic Medicine 101: The curious case of ketamine

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The urban myth of ketamine as a horse tranquilizer became prominent as the drug moved into...

Ketamine is known for generating a profoundly dissociative out-of-body experience
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John Lilly and his infamous isolation tank

John Lilly and his infamous isolation tank

A psychedelic renaissance is underway in medical research as certain taboo drugs return to the hands of doctors and researchers after decades in the wilderness. Once considered illicit, with no medical value, these psychedelic compounds are now being legitimately evaluated by scientists and revolutionizing how we practice medicine.

Psychedelic medicine 101 is a series that will investigate the past, present and future medical uses of these formerly taboo substances. Our first feature examined the story of psilocybin and magic mushrooms, while this new episode documents the curious story of ketamine, initially developed to be an anesthetic before researchers and psychonauts discovered its unique and unusual effects on the brain.

The curious case of ketamine

In 1956, a chemist at pharmaceutical company Parke Davis in Detroit, Michigan was experimenting with synthesizing new compounds in an attempt to find a better anesthetic. A compound called phencyclidine was initially created, and in early animal studies it demonstrated defiantly unusual effects. Some animals exhibited a drunk-like state when administered with it, while others entered states of delirium.

Human tests quickly ruled out the compound as clinically useful with some patients exhibiting major delirious and dissociative states for prolonged periods of time. This was despite the fact the it did seem to function remarkably well as an anesthetic. In later years, phencyclidine hit the streets as a recreational drug, becoming infamous due it its violent side effects. Its street name was PCP, or angel dust.

In the early 1960s, Parke Davis researchers began searching for a phencyclidine derivative that could limit the compounds unmanageable side effects. It was here that ketamine was born and after successful animal tests it was administered to the first human subject in 1964, demonstrating remarkable anesthetic effects.

Initially approved for veterinary uses, ketamine quickly found a place as an effective short-acting anesthetic, officially passed by the FDA in 1970 for human uses. One of its first major human uses was as a battlefield anesthetic in Vietnam. It has been suggested that this initial use in the early 1970s was what led to it moving into recreational circles as veterans returned to the United States and continued using the drug.

Non-medical uses continued throughout the 1970s, culminating in several high profile publications “outing” the drug. Perhaps the most infamous of these accounts came in scientist and psychonaut John C. Lilly’s 1978 autobiography The Scientist: A Novel Autobiography.

John Lilly and his infamous isolation tank

Ketamine, sensory deprivation and alien communication

John C. Lilly is perhaps best known for his work blending LSD, isolation tanks and human-animal communications. After developing the first isolation tank in 1954, Lilly began experimenting with LSD in the tanks in the early 1960s. His extreme work sat at the boundary of conventional science, and the extraordinary 1980 psychedelic film Altered States was significantly inspired by his experiences.

It was the early 1970s, however, when Lilly first crossed paths with ketamine. Lilly had long suffered extreme migraines, almost daily, for much of his life. During an attack, a physician friend suggested ketamine may be helpful. So Lilly jumped into an isolation tank, was injected with a small dose of ketamine, and his migraine disappeared … for 20 minutes. When it roared back his physician friend gave him another injection, this time double the dose. For about half an hour the migraine disappeared, but then it stormed back, so finally the physician again doubled the dose and sent Lilly back into the tank.

After an hour Lilly got out of the tank and his migraine had gone. A month later, with his migraine still yet to return, Lilly became convinced ketamine had somehow reprogrammed his brain in ways that his earlier massive LSD experiences couldn’t. For the next few years Lilly’s personal ketamine experiments became more and more extreme.

Lilly became convinced he could communicate with a network of extraterrestrial entities he dubbed ECCO, or the Earth Coincidence Control Office. ECCO guided Lilly’s research but as he began to consume more and more ketamine he came across another, more malevolent entity called SSI, Solid State Intelligence.

SSI was a massive cosmic supercomputer, with evil intent. At one point, in the midst of an epic nearly month-long physical experiment with ketamine, consisting of injections nearly every hour, Lilly tried to contact President Gerald Ford to warn the world of a potential doomsday scenario. One of the president’s aides intervened before Lilly could reach Ford.

These stories, and others, recounted in the late 1970s, slowly added to the infamy surrounding ketamine, but they also started to pique the attention of the authorities. The peripheral clinical uses of the substance were still pervasive enough for it to not be completely regulated until the United States government moved to make it a Schedule III controlled drug in 1999. This added a degree of regulatory oversight as to how the drug was dispensed but still allowed it to be utilized for clinical purposes.

William Hurt in Altered States, a film loosely based on the experiences of John Lilly

The Russian research

In 1985, two Russian researchers hypothesized that ketamine could be a good drug to utilize in a psychotherapeutic context. It was short-acting, controllable, relatively accessible and known to induce psychedelic experiences. For the next decade, Evgeny Krupitsky and his team at the Leningrad Regional Center for Alcoholism and Drug Addiction Therapy pioneered what they called Ketamine Psychedelic Therapy.

Over the next decade, ketamine was used to treat more than 1,000 patients for an assortment of drug dependencies, primarily alcoholism. In a systemic study of the work, published in 1997, the researchers reported that the KPT process they developed resulted in zero major side effects, such as protracted psy­choses, flashbacks, agitation, or ketamine abuse. It also proved to be extremely effective in helping patients, with total abstinence rates for more than one year in KPT-treated alcoholic patients hitting around 65 percent compared to conventional treatment which was only successful in 24 percent of patients after one year.

For an extended period of time across the 1980s and early 1990s, this Russian team were extraordinarily the only researchers in the world investigating the therapeutic outcomes of ketamine. Krupitsky suggested this could be because Russia was not suffering from a culture of recreational psychedelic usage, which helped allow his work to continue for so long with no authoritative challenge.

“It seems to be an especially powerful tool in Russia, where there was no psychedelic revolution in the 1960’s and almost nobody knows what “psychedelic” means or can even imagine that this drug can be used for recre­ation,” the researchers concluded in their ten-year report.

Ketamine is known for generating a profoundly dissociative out-of-body experience

The 21st century resurgence

In the early 2000s, ketamine began to reemerge in Western research circles as a potential therapeutic agent, initially for depression. A very small studypublished in 2000 highlighted the drug’s impressive antidepressant qualities, but it was a 2006 study that really turned the tide.

The study, from the National Institute of Mental Health (NIMH), highlighted the remarkably rapid anti-depressant effects of ketamine. It was a small but strong piece of research involving a cohort of patients diagnosed with major, treatment-resistant depression. Two small doses of ketamine were administered, one week apart, and by the end of the first day 71 percent of subjects in the ketamine group reported a nearly 50 percent decline in their symptoms. Even more remarkable, after a week nearly a third of the ketamine group reported complete remission of their depressive symptoms.

This kind of rapid and immense effect was unheard of and the study hit the mainstream media, propelling ketamine into the news for something other than an illicit street use for the first time in years.

The rapid anti-depressant effect of ketamine has been a fundamental and exciting area of research in recent years with scientists slowly homing in on the extraordinarily unique qualities of how the drug operates on the brain. A 2017 study from Columbia University Medical Center revealed impressive results when examining patients suffering from acute suicidal thoughts.

The study, composed of 80 patients with clinically significant suicidal thoughts, displayed a major reduction in reducing such thoughts within 24 hours of a single low-dose infusion. A six-week follow up also found the effects impressively held for an extended duration, especially when compared to a control-group that were administered a sedative called midazolam.

A model of the ketamine molecule

But how does it work?

How the drug actually works to achieve its rapid anti-depressant effects is a hot area of research. While it has been known for several decades that ketamine blocks a protein receptor in the brain called N-methyl-D-aspartate (NMDA), it hasn’t been understood exactly where in the brain this mechanism could be operating.

A recent study from Zhejiang University in China excitingly revealed that this mechanism could be concentrated in the lateral habenula, an area of the brain often referred to as our “anti-reward center.” Overactivity in the lateral habenula has been strongly related to depression and the new study revealed that ketamine directly reduces neuronal activity in that region.

Ketamine’s broad use as a pain- and depression-relieving agent is finding burgeoning uses in treating other conditions peripherally connected to those symptoms. A growing body of anecdotal patient-driven evidence is suggesting the drug could be effective in treating fibromyalgia and chronic fatigue syndrome, two chronic conditions that are somewhat linked by widespread feelings of pain and fatigue.

In regards to fibromyalgia, some small studies have found ketamine to be incredibly effective in reducing acute pain related to the condition. The effects were frustratingly short-lived, unfortunately, but some patients have reported single infusions dulling pain for up to three weeks.

The use of ketamine to treat chronic fatigue syndrome is still in the nascent research stages, but a 2016 study revealed a fascinating insight into the drug as an anti-fatigue compound. While fatigue and depression are profoundly interlinked, the broader NMDA-blocking effects of ketamine are convincingly hypothesized to potentially improve the symptoms of patients suffering from chronic fatigue.

The 2016 study was small, and limited to patients being treated with ketamine for bipolar disorder during an episode of acute depression. It found that ketamine significantly improved symptoms of fatigue when compared to patients in the placebo group, with the anti-fatigue effects most prominent 48 hours after the initial infusion event. The study concludes by suggesting ketamine’s NMDA receptor inhibition could be a novel target for anti-fatigue interventions in a variety of conditions, including chronic fatigue syndrome.

The urban myth of ketamine as a horse tranquilizer became prominent as the drug moved into...

The rise of the ketamine clinic

Unlike other more restricted drugs, ketamine is still available for medical uses. This has led to the recent upsurge of ketamine clinics in the United States. Ketamine is legally approved for use as an anesthetic, but its off-label use for other conditions is not illegal.

Since around 2015, it is estimated that well over 100 ketamine clinics have opened up in the US. These clinics target patients looking for an alternate way to treat their depression. For up to US$1,000 a dose, patients can receive an infusion of ketamine either weekly or monthly. Different clinics have different treatment processes, from specific 10-week programs to more casual dose-by-dose appointments.

It’s the wild west of medical treatments out there, with no clear science on how long these treatments last, or how safe long-term ketamine use like this actually is. The CEO of Actify Neurotherapies, a chain of 10 treatment centers, said recently “It scares the hell out of me that this is still unregulated.”

Actify Neurotherapies is actively resisting the term “ketamine clinic,” recently rebranding itself as a mental health clinic that happens to also provide off-label ketamine treatments. While Actify is positioning itself at the more credible end of the off-label ketamine provider spectrum, it is still part of a troubling, unregulated industry with the science yet to offer real clarity on the best way this drug should be delivered.

Well over 100 ketamine clinics are operating in the United States

A little less psychedelic?

The giant hurdle facing most ketamine research is trying to find a way to overcome the often unpleasant dissociative psychedelic effects of the drug. While NMDA-receptor antagonism is looking like an exciting new pathway to treat a whole host of conditions, the side effects of ketamine are proving tricky to manage when implemented into broader clinical applications.

A recent Australian trial into a ketamine nasal spray for treating depression had to be aborted after several participants started to experience psychotic-like side effects. One of the researchers suggested the dose problems stemmed from inconsistencies in the nasal-delivery method.

“We saw a range of tolerance levels and we think it’s because one person’s blood vessels in the nose can be so different to the next person’s, and when you spray, it crosses the thin lining, gets taken into the blood and straight to the brain. Some people got huge hits.”

Several researchers are now racing to develop compounds chemically similar to ketamine that still act on NMDA receptors but can reduce the psychoactive side effects. One of the most promising new alternatives is called esketamine, and it is currently at the tail end of Phase III clinical trials.

Esketamine is an isomer of ketamine, and reportedly has slightly less dissociative characteristics compared to its sibling. It is thought to be twice as potent as ketamine, which means it is suggested that lower doses could have similar NMDA-inhibiting effects to ketamine without the equivalent hallucinogenic result.

Despite the FDA offering esketamine a breakthrough designation in 2016, suggesting the compound is highly effective and will be rapidly pushed through the trial process, results have been decidedly mixed over the past few years. Most recently, some of the early Phase III results suggest the compound is only mildly effective, and in some cases barely better than the placebo control.

Ketamine + therapy = success?

Of course, some researchers are finding ways to work with the compound’s extremely hallucinogenic properties. An exciting new trial currently underway at the University of Exeter and University College London is directly inspired by Evgeny Krupitsky’s 1980s research in Russia. The trial is called KARE – Ketamine for reduction of Alcoholic Relapse, and it is setting out to examine how well ketamine, in conjunction with psychotherapy, can reduce alcohol dependence and promote abstinence.

The rigorous study, which is double blind and placebo-controlled, involves subjects being administered one dose of ketamine a week for a period of three weeks, alongside seven sessions of cognitive behavioral therapy. The study has a six-month follow-up phase to better understand the long-term effects of this kind of ketamine-assisted psychotherapeutic treatment.

Unlike the attempts to create a less psychoactive compound, this research suggests the holistic effect of ketamine could be vital to its absolute efficacy. The often unwanted hallucinogenic effects may very well be important. And unlike some of the ketamine clinics popping up around the US, this trial offers ketamine within the context of a controlled series of psychotherapy sessions helping patients integrate their experiences into positive outcomes.

The story of ketamine is a curious one, defiantly unlike other psychedelic substances being co-opted for medical uses. Ketamine is essentially legal, prescribable, yet still wholly experimental. It works on the brain in a completely novel way and we are only just understanding its broad potential uses.

With the rise of ketamine clinics, a strange kind of clinical practice has jumped ahead of research, giving rise to a wild west of drug providers administering the compound as a magic bullet for anything and everything in an unregulated landscape. More research undeniably needs to be done before we understand this deeply mysterious and unique drug, but it is looking like it will certainly become a fundamentally important compound in a bright future of psychedelic medicine.



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Dual studies highlight ketamine’s potential to treat anxiety and addiction

New evidence suggests ketamine can reduce anxiety related to major depression, and substance abuse depression
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Two new studies suggest the psychiatric benefits of ketamine treatment may extend beyond just the targeting of depression. The research demonstrates ketamine may be helpful in targeting both anxiety- and substance abuse-related depression.

Although ketamine is a relatively old drug, originally developed in the 1950s as an anesthetic, over the last decade a growing body of research has affirmed its unique, and rapid, antidepressant effects. The anecdotal effects of the drug on depression have raced ahead of scientific research so quickly that ketamine clinics have popped up all across the United States, where the drug can be administered for up to US$1,000 a dose.

Much is still unknown about how efficacious ketamine actually is for depression. We don’t know ideal dosages, how long the treatments last, or how safe long-term usage is. Two newly published studies are adding to our knowledge about ketamine’s psychiatric uses, adding weight to the drug’s burgeoning new potential.

The first study, led by a team from Massachusetts General Hospital and Harvard Medical School, set out to study how effective ketamine is at treating patients with anxiety-based treatment-resistant depression. This is an important question to resolve, as many traditional antidepressants do not consistently improve anxiety-based symptoms in cases of major depression.

The study took 99 subjects with treatment-resistant depression, half of whom suffered from high anxiety and half of whom displayed no anxious symptoms. The study randomly administered subjects either one of four different intravenous ketamine doses, or midazolam, a general sedative that could serve as a control.

As well as demonstrating ketamine’s novel antidepressant qualities, the study revealed the drug worked equally well in both anxious and non-anxious subjects. This suggests that ketamine’s antidepressant effects are uniquely effective across different types of treatment-resistant depression, something that cannot be said for many major antidepressant drugs.

“In contrast to reports from monoaminergic antidepressants, our data suggest that patients with anxious depression respond equally as well to ketamine compared to those with non-anxious depression,” write the researchers in the published study.

The second new study comes from a team at Yale University School of Medicine. This research investigated whether ketamine could be effective in treating addiction-related depression when administered in tandem with naltrexone.

A study in 2018 offered a small but significant finding, revealing that ketamine was ineffective in treating depression when administered alongside naltrexone. These results were important because they suggested that part of ketamine’s antidepressant effects may be related to the activation of opioid receptors, which would mean long-term ketamine use may potentially result in problems with addiction, something that many researchers have long argued against.

Naltrexone, an opioid receptor blocker, is often administered effectively to combat serious substance abuse problems, so if it rendered ketamine ineffective then that would cast doubt on much research into how ketamine actually works to reduce symptoms of depression. The new Yale research was small, with a sample of only five patients, but its results strongly suggest ketamine and naltrexone do not cancel each other out.

All five subjects suffering from alcohol use disorder and depression displayed significant depressive relief from ketamine dosages despite long-term naltrexone consumption. Senior author on the study, John Krystal, says although larger studies still need to be completed the research does suggest ketamine and naltrexone may be a complimentary combination that helps treat substance abuse and its related depression.

“[The results] raise the possibility that for people who have depression complicated by substance abuse disorders, the combination of ketamine and naltrexone may be a strategy to explore in the effort to optimally treat both conditions,” says Krystal.

Although this new study only consisted of five subjects, the prior research linking ketamine to the opioid system was generated from just 12 subjects. So we are still in uncharted territory regarding ketamine’s mechanistic effects of the brain. But the Yale research should assuage some fears that ketamine may be, “merely another opioid in a novel form.”

The ketamine anxiety study was published in the journal Depress Anxiety.

The ketamine naltrexone study was published in the journalJAMA Psychiatry.

Source: Yale News

Efficacy of intravenous ketamine treatment in anxious versus nonanxious unipolar treatment‐resistant depression

Abstract

Objective

To examine the effect of high baseline anxiety on response to ketamine versus midazolam (active placebo) in treatment‐resistant depression (TRD).

Methods

In a multisite, double‐blind, placebo‐controlled trial, 99 subjects with TRD were randomized to one of five arms: a single dose of intravenous ketamine 0.1, 0.2, 0.5, 1.0 mg/kg, or midazolam 0.045 mg/kg. The primary outcome measure was change in the six‐item Hamilton Rating Scale for Depression (HAMD6). A linear mixed effects model was used to examine the effect of anxious depression baseline status (defined by a Hamilton Depression Rating Scale Anxiety‐Somatization score ≥7) on response to ketamine versus midazolam at 1 and 3 days postinfusion.

Results

N = 45 subjects had anxious TRD, compared to N = 54 subjects without high anxiety at baseline. No statistically significant interaction effect was found between treatment group assignment (combined ketamine treatment groups versus midazolam) and anxious/nonanxious status on HAMD6 score at either days 1 or 3 postinfusion (Day 1: F(1, 84) = 0.02, P = 0.88; Day 3: F(1, 82) = 0.12, P = 0.73).

Conclusion

In contrast with what is observed with traditional antidepressants, response to ketamine may be similar in both anxious and nonanxious TRD subjects. These pilot results suggest the potential utility of ketamine in the treatment of anxious TRD.

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New Drug Combo Shows Promise for Treatment of Depression and Addiction

Drug Combo Shows Promise for Depression and Addiction
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The combination of naltrexone and ketamine can help treat both symptoms of addiction and depression, a preliminary study by Yale University researchers suggests.

Substance abuse and depression are common in many patients, and efforts to treat both conditions simultaneously have had limited success. One recent study suggested that the antidepressant effects of ketamine might blunted by administration of naltrexone, used to limit cravings of those addicted to opioid drugs and alcohol.

A preliminary study of five patients suffering from both depression and substance abuse disorders suggest that isn’t the case. The study was published Jan. 9 in the journal JAMA Psychiatry.

The results “raise the possibility that for people who have depression complicated by substance abuse disorders, the combination of ketamine and naltrexone may be a strategy to explore in the effort to optimally treat both conditions,” said senior author John Krystal, Yale’s Robert L. McNeil Jr. Professor of Translational Research; professor of psychiatry, neuroscience, and psychology; and chair of the Department of Psychiatry.

Krystal and lead author Gihyun Yoon, assistant professor of psychiatry, treated the five patients suffering from depression and alcohol use disorder with a long-lasting form of naltrexone and then administered ketamine. Four of the five responded to the first ketamine dose and all five found relief from depression after multiple doses.

The study also challenges the idea that ketamine might produce antidepressant effects by stimulating opiate receptors.

Krystal cautioned that larger studies are needed to confirm beneficial effects of the combination treatment.

Krystal and Yoon have provisional patents on the use of ketamine and naltrexone to treat comorbid depression and substance abuse.

The study was primarily funded by the U.S. Department of Veterans Affairs.

Publication: Gihyun Yoon, et al., “Association of Combined Naltrexone and Ketamine With Depressive Symptoms in a Case series of Patients With Depression and Alcohol Use Disorder,” JAMA Psychiatry, 2019; doi:10.1001/jamapsychiatry.2018.3990

At NOVA Health Recovery, we do use Ketamine and other combinations to treat Alcoholism and Opioid and Pain pill addiction using Ketamine Treatment. Dr. Sendi is Board Certified in Addiction Medicine. Call 703-844-0184 Today. Fairfax, Va 22304.



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Radical ketamine therapy could treat alcohol addiction

There is a growing body of research to support the idea that ketamine, a horse tranquiliser, can be used to disrupt harmful patterns of behaviour.
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A one-off dose of the drug could help alcohol addicts reduce their intake by ‘erasing’ drink-related memories, say psychologists testing treatment.
There is a growing body of research to support the idea that ketamine, a horse tranquiliser, can be used to disrupt harmful patterns of behaviour

Scientists believe that a radical treatment involving the tranquilliser ketamine could help overcome alcohol addiction by “erasing” drink-related memories.

Psychologists based at University College London are testing whether a one-off dose of the drug could help hazardous drinkers who are trying to reduce their alcohol intake. Alcohol addiction is notoriously difficult to treat, and there are few effective therapies available.

First ‘gold-standard’ trial of ketamine’s anti-depressant effects launched

 Read more

Using a recreational drug to treat addiction may sound counterintuitive, but the researchers say there is a growing body of research suggesting that ketamine can be used to disrupt harmful patterns of behaviour.

Ravi Das, one of the lead researchers, said: “There is evidence that it could be useful as a treatment for alcoholism.”

Crucially, ketamine can disrupt the formation of memories, and scientists believe that this property could be harnessed to over-write the memories that drive addiction and harmful patterns of behaviour.

“Memories that you form can be hijacked by drugs in some people,” said Das. “If you were an alcoholic you might have a strong memory of being in a certain place and wanting to drink. Those memories get continuously triggered by things in the environment that you can’t avoid.”Advertisement

For instance, seeing a glass of beer, hearing the clinking of glasses or even arriving home from work may trigger memories of the rewarding sensation of taking a drink – and might prompt a person to follow this urge.

“The main problem is the really high relapse rate after treatment,” said Das. “People can successfully quit using over the short term while they’re being monitored in the hospital … but when they return home they’re exposed to those environmental triggers again.”

There is increasing evidence, however, that memories are less stable than once assumed and may be open to manipulation.

Each time our brain accesses a memory, the neural connections that encode it are temporarily destabilised, meaning that our recollection can be slightly altered before it goes back into storage. This is one reason why, in everyday life, people can recall wildly different versions of the same events.

In the clinic, scientists believe this short period of instability, represents a window of opportunity. Ketamine blocks a brain receptor called NMDA, which is required for the formation of memories. So the logic is that giving someone the drug just as a memory has been destabilised could help weaken the memory, or even erase it.

 Read more

A similar approach with a different drug was shown to eradicate people’s phobia of spiders. And research in rats that were made to be addicted to cocaine showed that the memories underpinning their addiction could be completely wiped out using a similar strategy (although this involved injecting a chemical into the brain).

In the UCL trial, the scientists will intentionally trigger alcohol-related memories by placing a glass of beer in front of the participants, who are all heavy drinkers. They will then disrupt the memory, by surprising the participant (the team is not disclosing the exact details as this could bias the results).

Participants will then be given either a ketamine infusion, with a concentration equivalent to a high recreational dose, or a placebo. The team will follow up the people for a year and monitor whether their drinking has changed and by how much.

In total the scientists are aiming to include 90 people in the trial and more than 50 have already taken part. It involves people who drink harmful quantities of alcohol, but excludes anyone who meets the clinical criteria for alcoholism. The participants were drinking at least 40 units a week for men (equivalent to four bottles of strong wine) and 28 units for women, and drinking on at least four days. The UK needs common sense about ketamine

Nikki, 31, who works as a consultant in London said she decided to take part in the study when she had some time off between jobs and realised she was drinking more than she wanted to. “It’s just in the culture, that’s what all my friends are like. Everyone drinks to excess,” she said.

She described the experience of being given the ketamine as “overwhelming and intense”, but not unpleasant. “My body felt like it was melting away,” she said. “It was quite psychedelic, I felt untethered from my body.”

In the week after the session, she said, she felt in an “incredibly positive mood” and that since taking part she has been more conscious about deciding whether to have a drink, although said this could also be linked to starting a new job and taking up meditation. “In the past, there were occasions where I would be drinking and I’d be on autopilot ‘Let’s get another drink’,” she said.

If the trial yields promising results, the team hope that the approach could form the basis for therapy sessions targeted at alcoholics and people who are drinking unhealthily. However, they acknowledge that there may be resistance to the use of a recreational drug to treat people with addiction.

“There’s just the general social attitude that everything that’s illegal is terrible. There will obviously be that kind of narrow-sighted pushback,” said Das. “But if it’s safe and effective enough it should be recommended.”

Andrew Misell, a spokesman for Alcohol Concern, said: “The researchers have quite rightly highlighted what a lot of people in recovery from alcohol problems know from experience, namely that cues or triggers like the smell of beer can cause a relapse even after long periods of abstinence. Any work looking at how people can overcome these pitfalls is going to be useful.”

However, he added, no drug-based therapy is risk-free “and that certainly includes ketamine”.

Professor Michael Saladin, of the Medical University of South Carolina, is looking at similar approaches to help people quit smoking. “There is a vast animal research literature that suggests memories can be manipulated following reactivation,” he said. “I am convinced that there is sufficient evidence to believe that memory reconsolidation can be harnessed for clinical purposes.”

Problematic alcohol use is a big public health problem in the UK, but could ketamine help?
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January 2018 has come to an end and with it the month that people increasingly use to abstain from alcohol. It is still unknown whether Dry January has a lasting effect on drinking behaviours, and people with an alcohol dependency problem should always seek support from their GP before going through detox. Nonetheless, Dry January undoubtedly drives a critical conversation about alcohol use and provides an opportunity for us to reconsider our relationship with alcohol (one of the main goals of the charity Alcohol Concern, who support the challenge).

While overall alcohol consumption in the UK is falling, alcohol abuse still represents the fifth biggest risk factor for illness, death and disability across all ages. With current treatments often failing to prevent relapse in the long term, researchers are investigating the possibility of using ketamine combined with psychological therapy to help people stay dry, and not just for January. Despite its often cited use as a recreational drug and “horse-tranquilizer” ketamine is also the most widely used anaesthetic in humans. Administered appropriately in a controlled and safe medical environment, ketamine may also have benefits in the treatment of drug problems.

Say Why To Drugs – does alcohol put our health on the rocks?

Evidence for this originally came from a research group in Russia in the 1980s. In this study, patients who had alcohol problems were given three weekly ketamine treatments in conjunction with psychological therapy. After one year, 66% of patients who underwent this treatment regime were abstinent, in comparison to 24% of patients who received treatment as usual, without any ketamine. This abstinence rate is much greater than those documented with any other relapse prevention method.

Inspired by the promising results seen in Russia, we are now conducting the KARE trial (Ketamine for reduction of Alcoholic Relapse) at the University of Exeter and University College London. In this trial participants who have made the decision to abstain are administered ketamine once a week for three weeks. Participants also receive seven sessions of cognitive behavioural therapy to aid their quit attempt and are followed up for six months. Unlike the earlier study, this trial is placebo controlled, thus participants have an equal chance of receiving either ketamine or a matched placebo as well as either cognitive behavioural therapy or alcohol education as a placebo for therapy. It is also double-blind, meaning neither the participant nor the researcher know whether the active treatment or a placebo treatment are administered. This controls for placebo effects and bias due to expectancies of the researcher – putting the original findings to the test with a more rigorous research design.

 The media has a problem with alcoholism – and it’s stopping people getting help

James Morris Read more

Why might ketamine help people stay sober? Recent studies have demonstrated that ketamine has rapid and powerful anti-depressant properties, while people with alcohol problems often also experience symptoms of depression. The direction of the relationship between alcohol problems and depression is not clear, but depressive symptoms are thought to be a common trigger for relapse. Treating people who have alcohol problems with ketamine, therefore, could help them to remain abstinent for longer by lifting their mood.

Furthermore, laboratory research has demonstrated that ketamine promotes the growth of new neurons and connections in the brain. These processes are essential to learning and memory, and are suggested to be impaired in both depression and problematic alcohol use. Thus ketamine might make people more receptive to new information and able to plan effectively for the future, which in turn may enhance the effect of psychological therapy.

We do not yet know how effective the ketamine treatment will be. However, well-designed research studies, such as the KARE trial, could be critical in helping people achieve their abstinence goals.

https://www.pharmaceutical-journal.com/news-and-analysis/features/the-secret-life-of-ketamine/20068151.article?firstPass=false

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Why not just purchase Ketamine off of someone on the street? It’ s just like heroin – it may be laced with fentanyl or not what you think it is: Look below:

Warning over super-strong ketamine drug ‘which makes users think they’re dead’

A super-strength drug which users have described as making them think they’re dead is being sold as ketamine in Britain, experts have warned. The drug, 2-FDCK, or 2-Fluorodeschloroketamine, is similar to ketamine, but much stronger – and the effects can last two to three times as long. On trip-report site Erowid, one user said, ‘My room looked like a cartoon. I thought I was dead and I was afraid about this, but then I understood this new way of existing wasn’t terrible.’ Be careful out there (Getty) The chemical was spotted by drug-testing organisation The Loop in a club in Durham – which found ‘multiple samples’. The drug is a ‘new psychoactive substance’ (NPS), a chemical derivative similar to those sold as legal highs – and often made abroad in illicit labs and bought online by dealers. First picture of man charged with stabbing dad to death on Surrey train Such substances can be much stronger, and more dangerous, than the drugs they are based on, experts warn. The Loop said that it found ‘2-FDCK (2-fluorodeschloroketamine) sold as ketamine. The new chemical is much stronger than ketamine (Getty) The organisation said, ‘Tested by The Loop in Durham, UK. ‘About 1.5x more potent than ketamine with 2-3x longer duration.’

Read more: https://metro.co.uk/2019/01/07/warning-super-strong-ketamine-drug-makes-users-think-dead-8317393/?ito=cbshare

Mandatory Credit: Photo by Henry Iddon/PYMCA/REX/Shutterstock (935228a) A person holding up a bottle of Ketamin Horse tranquilliser UK 2006 STOCK

2-Fluorodeschloroketamine

Also similiar but definitely not the same as Ketamine: Deschloroketamine

Super-strength fake ketamine 50% stronger than normal arrives in UK for first time

Ketamine

A dangerous new designer drug has been discovered in the UK for the first time.

Super-strength fake ketamine was found when students fell ill after taking a substance they thought was the Class B drug.

Fiona Measham, a criminology professor and director of drug safety testing group The Loop, revealed the findings after samples were brought into a mobile testing centre in Durham.

She said the 2-FDCK substance was 50 per cent stronger than ketamine and lasted up to three times as long – raising fears users could be put at risk.

Ms Measham said: “It was first identified in Europe in 2016. It is the first time that this drug has been identified in the UK.”

The Loop believes the fake drug may also be on sale in Manchester.

The organisation said sales of the fake drug mirror the supply of fentanyl, a stronger chemical copy of heroin which has led to tens of thousands of deaths in the US.


Professor Fiona Measham said the drug first appeared in Europe

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The Effects of Intranasal Ketamine on Treatment-Resistant Depression

As I have previously reported, off-label use of ketamine for treatment-resistant depression has resulted in numerous anecdotal reports regarding its unique mechanism of action and overwhelming success in symptom reduction among treatment-resistant and suicidal patients.

This is an important finding because approximately one-third of patients with major depressive disorder (MDD) do not respond to currently available antidepressants. As a result, The American Psychiatric Association (APA, 2016) had issued guidelines for psychiatrists who wish to use ketamine for this purpose. At the time, a slow intravenous infusion was the primary delivery system used to attain the reported results. There are of course numerous challenges and costs associated with this delivery system, including the use of a clinical facility with available advanced life support systems in place.

What Is Ketamine?

Ketamine was developed and FDA approved more than 50 years ago as a fast-acting anesthetic with an impressive safety profile. It is still used today in anesthesiology on both pediatric and adult patients and animals. Ketamine in higher doses also has unique dissociative properties, which explains its popularity as a club drug known as “Special K” in the U.S. It is currently a highly abused club drug in southern Asia today.

Intranasal Ketamine Clinical Trial

In this well-designed original research conducted by Daly and colleagues, a phase 2, double-blind, doubly randomized, placebo-controlled study was employed to assess the efficacy, safety and dose-response of intranasal esketamine hydrochloride (ketamine) in patients with treatment-resistant depression (TRD). The primary positive endpoint was a statistically significant change from baseline to day eight during each study period, measured by the total score on the Montgomery-Åsberg Depression Rating Scale (MADRS).

This study consisted of four phases:

  1. Screening
  2. Double-blind treatment (days 1-15), composed of two 1-week periods
  3. Optional open-label treatment (days 15-74)
  4. Post-treatment follow-up at 8 weeks

The results are impressive. Change in MADRS total score in all three esketamine groups was superior to placebo (esketamine 28 mg: −4.2 (2.09), P = .02; 56 mg: −6.3 (2.07), P = .001; 84 mg: −9.0 (2.13), P < .001), with a significant ascending dose-response relationship (P < .001). Even more impressive is the continuous reduction of depressive symptoms despite reduced dosing frequency during the open-label phase.

Why Does This Matter?

First, the mortality rate for untreated and undertreated depression is between 15 and 20%. Moreover, depression and suicidality are increasing in the U.S., most notably among children and adolescents. Ketamine is thought to inhibit the N-Methyl-D-Aspartame (NMDA) system, which is unrelated to our 50-year-old catecholamine hypothesis, suggesting that the inhibition of NDMA is a viable, and perhaps primary, target for future intervention. In addition, there is growing anecdotal data suggesting that ketamine may also be a viable treatment for pain and perhaps even addictive disease.

Second, the results of this important study show that esketamine has a significant effect on symptom reduction among patients with TRD (Montgomery- Asberg Depression Rating Scale) after only one week of twice-weekly administration, which is substantially faster than the SSRIs or SSNRIs. It is also of interest that esketamine is well tolerated with few adverse effects, evidenced by the fact that a mere 5% of participants discontinued treatment during the double-blind phase. In addition, the use of an intranasal delivery system allows lower dosage compared to oral administration by avoiding first-pass hepatic metabolism.

Third, because of its low molecular weight (238 Daltons), esketamine is a good candidate for intranasal delivery because lower molecular weight improves nasal mucosa absorption. This route will get the dose to the brain rapidly, and for reasons that remain unclear, the therapeutic effect remains when using a twice-per-week dosing system.

All this is to say that compared to currently available oral antidepressant medications, which have a poor adherence rate, esketamine should vastly improve treatment adherence. Combined with few reported adverse effects, more people will get well. This is good day to be a neuroscientist.

Reference:
Ella J. Daly, MD; Jaskaran B. Singh, MD; Maggie Fedgchin, PharmD; Kimberly Cooper, MS; Pilar Lim, PhD; Richard C. Shelton, MD; Michael E. Thase, MD; Andrew Winokur, MD, PhD; Luc Van Nueten, MD; Husseini Manji, MD, FRCPC; Wayne C. Drevets, MD Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression. A Randomized Clinical Trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3739. Published online December 27, 2017.

Additional resource for Gambling disorders. Financial costs for loss from this disorder as for any addiction add up quickly. Here is a link to a resource:

Financial strategies for loved ones of problem gamblers

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Poor mood and coping skills makes recovery that much harder. Consider using Happify – there is a science behind happiness.

Overcome stress and negative thoughts. 
Build resilience.

Happify is the single destination for effective, evidence-based solutions for better emotional health and wellbeing in the 21st century.

I thought this was an interesting concept for mental-health wellness: Happify

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Addiction on PBS | 703-844-0184 | Opiate Addiction Treatment | Fairfax, Va 22304 | Addiction treatment Center

https://www.pbs.org/wgbh/nova/video/addiction

A new documentary premiering Wednesday on PBS takes a deep look at how opioid addiction affects the brain.

The film, “Addiction,” created by the team at Boston-based Nova, weaves the stories of impacted families alongside the work being done by scientists to understand and treat the nationwide epidemic, which killed more than 63,600 people in 2016 alone.

Sarah Holt, the film’s writer, director, and producer, told Boston.com she hopes the documentary will help to shed light on the stigma associated with addiction as well as help those seeking ways to assist loved ones struggling with dependance on drugs.

The most challenging aspect of making the documentary was finding people willing to share their stories on camera, she said. Even those who had years of recovery behind them were unwilling to speak about their struggles, fearful of what would happen once others found out.

“I think the stigma is huge, even in the language we use,” Holt said. “We call people ‘clean’ or ‘dirty.’ You’d never say, if somebody had diabetes and had high blood sugar, that they were dirty.”

In making the film, Holt, whose previous work includes “Can Alzheimer’s be Stopped?”, said she wanted to cover how people fall into addiction, why the disease is considered a brain disorder and chronic condition, and what effective treatment looks like. Helpingpeople who are addicted should be part of the medical system, she said, and what those struggling with dependency on opioids need is support and compassion.

“People would say to me, ‘Oh it must be so depressing, working on a film about addiction,’” Holt said. “And I really think the most important point is that it wasn’t depressing because I could see that once people get the right treatment, they get better. I want people to know that addiction is a treatable medical condition — it’s not a hopeless diagnosis. And we really need to be stepping up to the plate and trying to help people get the help they need.”

“Addiction,” which is narrated by Joe Morton, premieres at 9 p.m. on PBS. Watch a clip from the film below:

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Intranasal Ketamine for Treatment-Resistant Depression

Call 703-844-0184 For a Ketamine Treatment Evaluation | Fairfax, Va 22304

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There is an urgent need for better medications that work quickly for treatment of major depression and bipolar disorder. The treatment should also be tolerable and work for depressed patients who have not responded to conventional treatments, ie, who have treatment-resistant depression (TRD).

Ketamine is a medication that is used intravenously for anesthesia, but multiple controlled trials have now demonstrated a rapid antidepressant response to a single intravenous infusion of ketamine. Controlled studies of regular infusions appear promising, but the need for regular IV infusions is not something that is appealing to most patients and often results in non-compliance. And, oral ketamine is extensive broken down by the liver before it can be absorbed by the body, so oral therapy is not a viable option. Therefore, the intranasal route has been investigated.

Intranasal drug delivery offers a route to the brain that bypasses problems related to gastrointestinal absorption, first-pass metabolism, and the blood-brain barrier; and the onset of therapeutic action is rapid. Intranasal medications avoid the inconvenience and discomfort of IV therapy. Intranasal medications have been used to treat migraine, acute and chronic pain, Parkinson’s disease, cognitive disorders, autism, schizophrenia, social phobia, and depression.

In a randomized, double-blind, placebo-controlled, crossover trial conducted in 20 patients with major depression, physicians and researchers at the Icahn School of Medicine at Mount Sinai, New York, tested the safety, tolerability, and efficacy of intranasal ketamine in patients with depression who had failed at least one prior antidepressant trial. The researchers found that a single intranasal dose of ketamine (50 mg) outperformed placebo; the response rate was 44% versus 6%, respectively. Anxiety ratings also decreased significantly more with ketamine. Patients showed significant improvement in depressive symptoms at 24 hours after ketamine compared to placebo. Intranasal ketamine was well tolerated with minimal psychotomimetic or dissociative effects and was not associated with clinically significant changes in hemodynamic parameters like blood pressure.

Intranasal ketamine represents a promising advance in treatment-resistant depression (TRD) therapeutics. Most studies report a duration of response up to 7 days and remission up to 3-5 days after a single dose. “Most adverse events … subsided spontaneously by 60 to 90 minutes post dose,” said Vanina Popova, MD. In addition, “there was no pushback” to the nasal delivery system. “The route of administration was well received, and it was certainly more convenient than intravenous administration,” she said.

Intranasal ketamine is not commercially available, but the clinical use of intranasal ketamine is increasing internationally. Research has concluded that the drug formulation, the delivery device, the technique and individual patient factors play an important role in tolerability and efficacy when using intranasal ketamine for Treatment Resistant Depression.

Intranasal ketamine has been reported in studies to help depressed patients who have not responded to conventional therapy with minimal side effects. Ask our pharmacist for more information about compounded intranasal ketamine. We customize medications to meet each patient’s specific needs.http://www.novahealthrecovery.com/NOVA Health Recovery Ketamine Treatment Center | 703-844-0184 | Alexandria, Va 22306

References:
Depress Anxiety. 2016 Aug;33(8):698-710. 
Gen Hosp Psychiatry. 2015;37(2):178–184. 
J Clin Psychiatry. 2015 May;76(5):e628-31. 
Biol Psychiatry. 2014 Dec 15;76(12):970-6. 
American Psychiatric Association (APA) 2018. Abstracts P7-065 and P8-054, presented May 8, 2018.
Psychiatry Clin Neurosci. 2018 May 10. 
J Clin Psychiatry. 2017 Jun;78(6):e674-e677. 
CNS Drugs. 2018 May 7. [Epub ahead of print]
J Psychopharmacol. 2018 Apr;32(4):397-407.

Ketamine 25mg – 100 mg Nasal Spray

BACKGROUND: The N-methyl-D-aspartate glutamate receptor antagonist ketamine, delivered via an intravenous route, has shown rapid antidepressant effects in patients with treatment-resistant depression. The current study was designed to test the safety, tolerability, and efficacy of intranasal ketamine in patients with depression who had failed at least one prior antidepressant trial.
METHODS: In a randomized, double-blind, crossover study, 20 patients with major depression were randomly assigned, and 18 completed 2 treatment days with intranasal ketamine hydrochloride (50 mg) or saline solution. The primary efficacy outcome measure was change in depression severity 24 hours after ketamine or placebo, measured using the Montgomery-Åsberg Depression Rating Scale. Secondary outcomes included persistence of benefit, changes in self-reports of depression, changes in anxiety, and proportion of responders. Potential psychotomimetic, dissociative, hemodynamic, and general adverse effects associated with ketamine were also measured.
RESULTS: Patients showed significant improvement in depressive symptoms at 24 hours after ketamine compared to placebo (t = 4.39, p < .001; estimated mean Montgomery-Åsberg Depression Rating Scale score difference of 7.6 ± 3.7; 95% confidence interval, 3.9-11.3). Response criteria were met by 8 of 18 patients (44%) 24 hours after ketamine administration compared with 1 of 18 (6%) after placebo (p = .033). Intranasal ketamine was well tolerated with minimal psychotomimetic or dissociative effects and was not associated with clinically significant changes in hemodynamic parameters.
CONCLUSIONS: This study provides the first controlled evidence for the rapid antidepressant effects of intranasal ketamine. Treatment was associated with minimal adverse effects. If replicated, these findings may lead to novel approaches to the pharmacologic treatment of patients with major depression

Link

Link to Intranasal Ketamine

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5 Common Signs of Drug Misuse in Its Early Stages

There is a point between casual drug usage and troubling drug misuse that happens before addiction fully sets in that needs to be addressed. Recreational drug use has been a facet of society for as long as history has existed. Drugs of all kinds, from opioids to alcohol, have always found their way into the lifestyles of the upper-class, as well as those who are stricken by poverty. Just like addiction, drug misuse doesn’t belong to a particular “type” of person or demographic, even though some people may be predisposed to addiction or drug use based on genetics and their surrounding environment. The focus of drug misuse is the bridge between experimentation and continued use into eventual dependency and addiction. Recognizing troublesome misuse early on can potentially stop cases of addiction in their tracks which is why it’s important to be aware of the signs.

 What Is Drug Misuse?

There are many different phrases when talking about the use of drugs but what is “misuse”?

  • The use of illicit drugs: Experimentation can quickly go from a one-time use to habitual use, even if it doesn’t occur every day. The recreational use of illicit substances is always a risk since there is no way to fully know what a person is ingesting when a drug is acquired “off the street.”
  • Incorrect use of medication: Even legal, prescription drugs can be a part of drug misuse, especially when the person taking these drugs is using them outside of medical reasons without a doctor’s discretion or in dosage amounts that exceed the doctor’s instruction. This also occurs when someone is taking medication that does not belong to them.
  • Overuse of legal drugs: For example, just because caffeine and alcohol are legal doesn’t mean they cannot be misused. Regular or binge use of these substances can pose serious health concerns and result in potentially fatal consequences once a level of dependency is reached.

Drug misuse is a willful act which, when done continuously, can lead directly to dependency and unintended addiction. When someone habitually disregards the negative effects of drug misuse it’s likely they have crossed from misuse into addiction. The following are signs that someone has reached the stage of drug misuse:

1) Making Drugs A Priority

When someone starts planning their days, evenings, or entire weekends about obtaining and consuming drugs, misuse is likely a factor. Typically this begins shortly after the first or second experimental experiences they’ve had with a drug and become curious to try more. This can also become somewhat of a ritual. Leisure time is no longer to relax; it begins to focus solely on using the drug of choice in excess until there is no more left or more needs to be acquired. When social outings or gatherings seem to be exclusively dependent on having the drug available, misuse is in play.

2) Drastic Changes in Social Circle

Sometimes people are exposed to drugs and begin to experiment as a way to get acquainted with new friends. Usually, this involves someone new entering a social circle that opens members to a particular drug where its use becomes more and more prevalent. When someone drastically changes their social habits and social circle to include only other people who participate in the use of that drug, it’s more than likely they are misusing the drug regularly. They are most likely associating with people who can give them access to more of the drug.

3) Decline in Health or Appearance

When someone misuses drugs, their body typically experiences neglect or  mistreatment. If someone is showing signs of:

  • constant fatigue
  • confusion
  • lethargy
  • Other unusual outward behavior due to their excessive “partying”

it’s likely they are misusing drugs in their free time. People who are usually ‘put together’ may come stumbling into work or class looking disheveled or ill to hide a hangover or may be struggling through the “come down” from a high from the night before. Mysterious “illnesses” will also be a common excuse as to why they are frequently feeling sick from the misuse of drugs, or the effects that follow after a large dose.

4) Normalizing Drug Use

While some circles may treat recreational drug use lightly, the complete normalization of drug use every time someone goes out or socializes could be a sure sign of drug use. When people no longer attempt to hide the frequency of their consumption of drugs and begin to use them freely around other people, they have completely normalized the misuse of these drugs. Speaking fondly of the drug and their many adventures while using the drug can also be a sign that their use is has moved past the experimental or recreational phase into more serious use. If someone grew up in a household where drug misuse was frequent, this puts them at a much higher risk of drug misuse.

5) Facing Negative Consequences

When wild, drug-fueled events or nights out start leading to unwanted ramifications like constantly being late for work, receiving bad grades, or ruining close relationships, misuse is likely at the source. When people begin to take bigger and bigger risks to consume their drug of choice, it’s likely that their misuse has become full-fledged and they are now starting to see consequences of their decision-making. When someone starts dealing with constant social problems that are a direct result of their drug use, it may lead them to rethink their actions, but those who are misusing drugs at a constant rate may be lacking the self-awareness to correct their behavior.

Without addressing misuse, we cannot effectively make efforts stop addiction in its early phases. There is a period between experimentation and addiction that is the cornerstone of how people develop a substance use disorder. No matter what drug is being misused, the behaviors and subsequent consequences that result in misuse are what can turn a healthy, vibrant person into a shell of their former selves. We cannot ignore the fact that the attitude towards recreational drug misuse in society is troubling and sending the wrong message. While we fail to address misuse, people who fall victim to substance use disorders that once started as occasional misuse will still have to deal with the awful stigma attached to addiction. We can’t ignore something until it becomes an uncontrollable problem while blaming those who have succumbed to it. Prevention can and will help many if the message is clear. Discussing topics like misuse could potentially save many lives before they ever begin to experiment with addictive substances.Explore the links below for more information, resources and support:Addiction Forum Treatmenthttp://atforum.comMethadone Pregnancy Informationhttp://www.methadoneandpregnancy.com/Narcotics Anonymoushttps://na.org/NAMA Resourcehttp://methadone.orgNational Institute on Drug Abusehttps://www.drugabuse.gov/Substance Abuse and Mental Health Services Administrationhttps://www.samhsa.gov/Center for Substance Abuse Treatmenthttps://www.samhsa.gov/about-us/who-we-are/offices-centers/csatAmerican Association for the Treatment of Opioid Dependencehttp://www.aatod.org/Faces and Voices of Recoveryhttps://facesandvoicesofrecovery.org/Decisions in Recovery: Treatment for Opioid Use Disorderhttps://archive.samhsa.gov/MAT-Decisions-in-Recovery/Make the Connection: Resources for Veteranshttps://maketheconnection.net/___________________________________________________________________________________

What Makes Recreational Drug Use Dangerous?

According to SAMHSA, in 2016, 28.6 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans overall (10.6%) but ranges as high as 1 in 4 for young adults aged 18 to 25. An estimated 11.8 million people misused opioids in the past year, including 11.5 million pain reliever misusers and 948,000 heroin users. Additional information is gathered in NSDUH for the misuse of pain relievers in the past year. Among people aged 12 or older who misused pain relievers in the past year, about 6 out of 10 people indicated that the main reason they misused pain relievers the last time was to relieve physical pain (62.3%), and about half (53.%) indicated that they obtained the last pain relievers they misused from a friend or relative.

With recreational drug use in America on the rise, it’s important to understand the risks involved with drugs that can lead to addiction. There is a very short amount of time between the experimental phase of recreational drug use and the next steps towards losing control. Based on statistics, recreational drug use is common among a wide range of ages and socioeconomic classes because addiction does not discriminate. Knowing the potential dangers of drug misuse can help educate others to prevent them from using drugs that could lead them down a dark path.

Drug Use that Leads to Addiction

While growing up, many of us are exposed to scare tactics that are used by school programs to help steer us away from drugs and alcohol. While their intentions are good, curiosity, peer pressure, and underlying risk factors that make people prone to addiction tend to override these measures.  According to the National Institute on Drug Abuse (NIDA), about 24% of 12th graders have used illicit drugs in the last month. While the general attitude towards teenagers is that we expect them to rebel, drug misuse at an early age can severely affect young developing brains. The prefrontal cortex controls the flow of dopamine in their brains, helping with logical decision making. This area doesn’t fully develop until mid-to-late 20s. When a young person has access to drugs during these developmental stages, it can acutely increase their risk of drug use disorder. The most common drugs teenagers are using that can quickly lead to addiction are opioids, methamphetamines, cocaine, and various forms of ecstasy.

From Recreational Use to Addiction

Most commonly, people who consume drugs recreationally do so when they want to let loose and party, whether it be at special events, concerts, or other social situations. Under these circumstances, it’s important to closely consider when use has become a problem, like when they can no longer enjoy themselves if they are not under the influence. Red flags are raised when they begin to consume much more than their friends or even begin to use when alone, outside of social situations. When personal responsibilities fall by the wayside, and drug use becomes the focus, it’s time to seek treatment. Once the line has been crossed, and the addiction has taken over, it’s very difficult to successfully recover without the help of a drug treatment program that can help assist with many different levels of care.

Phases of Misuse

Typically, the steps from recreational use to addiction are gradual. The typical process stems from early curiosity and can potentially lead to something much more serious.

  1. Experimental: Usually this step occurs while still young. Peer pressure builds, and they want to fit in with friends who are doing it too. It can affect adults too. Some people experiment with drugs for a change of pace. It can also appear to help ease social anxiety or negative emotions surrounding an event or incident.
  2. Recreational: Consumption of drugs becomes more frequent during this phase. Every month there’s an occasion where drugs are consumed socially. Usually, there is thrill-seeking involved. There usually aren’t many negative consequences at this phase other than feeling worn out and depleted after using.
  3. Regular Misuse: Drugs have become commonplace every weekend and sometimes on weekdays. Things are dull when not experienced while high and using and obtaining more of the drug becomes a focus. Their social circle begins to mostly include people who use as well, and former friends have slowly pushed
  4. Risky Use: Higher doses become the norm. There are consequences at stake, yet drug use trumps them all. Financial problems start to set in as most funds are used towards obtaining drugs. Usually, run-ins with the law like DWIs or worse are involved at this level.
  5. Dependence: Drugs have taken control over their life, and most relationships have deteriorated with loved ones and close friends. Their body has become physically dependent and needs a constant stream of drugs to function normally.
  6. Addiction: A high is no longer achievable, but the main purpose of ingesting drugs is to simply ward off withdrawal symptoms. Most significant areas of life have been heavily impacted by drug use, and they are holding onto life by a single thread, whether it is blatantly obvious or not from the outside.

Taking drugs recreationally may seem harmless, but it’s one step towards addiction. While some people can experiment with substances without losing control, there are many other factors involved in what makes someone more prone to addiction. Once the wheels towards addiction are set in motion, it’s hard to stop them.

If you find yourself questioning whether or not your drug use is truly recreational, or whether or not you have reached the level of addiction with your drug use, consider taking an assessment at a treatment center to help stop addiction in its tracks with the help of trained professionals.

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