Lectures Notes (4.5 & 4.7)
Lectures Notes (4.5 & 4.7) PSY 245
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This 15 page Class Notes was uploaded by Kristi Dorsey on Sunday April 17, 2016. The Class Notes belongs to PSY 245 at University of North Carolina - Wilmington taught by Mark Galizio in Spring 2016. Since its upload, it has received 11 views. For similar materials see Drugs and Behavior in Psychlogy at University of North Carolina - Wilmington.
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Date Created: 04/17/16
4.5.16 Dependence on Marijuana Tolerance Belief that Marijuana doesn’t show tolerance or withdrawal syndromes has been challenged Experienced users of Marijuana more sensitive to the effects of the drug 5% heavy users: 15+ joints per day – “more or less permanently stoned” – House of Lords (study in Great Britain) Cannabis Report 2000 o Heavy users in the Jamaica study were taking doses of Marijuana that most individuals would find sedative o They will report that it gives them energy and they’re able to walk In addition to reverse tolerance, heavy users develop regular drug tolerance o True in the modern era where we’re seeing really high doses of Marijuana o High level users of high dose Marijuana show ordinary drug tolerance to THC o We describe this as a pattern of drug dependence Withdrawal Syndrome (Budney, 2010) – mild to heavy users o Irritability, mood changes o Sleep disturbances o Loss of appetite, nausea o Craving DSM diagnoses requires neither tolerance nor physical withdrawal About 10% of those who use Marijuana meet DSM-IV dependence criteria (NIDA, 2008) o Heroin – 45% (of people who ever use Heroin, become dependent on it) o Tobacco – 32% o Cocaine – 20% o Alcohol – 15% o Marijuana – 10% Adverse/Chronic Effects of Marijuana Lung damage Dependence Cognitive deficits? Does using the drug chronically have an impact on the individual’s cognition? Amotivational syndrome? Cognitive Deficits Deficits on tests of memory, learning and processing speed persist 2-7 days after last use in chronic Marijuana users (Iversen, 2008), but return to control levels after this Attentional deficits may be more persistent (Solowij, 1998; Iversen, 2008) o In some individuals, there may be long term deficits, but this doesn’t seem to be a common or expected effect o Still a controversy about Marijuana and Schizophrenia Schizophrenics have very high rates of Marijuana use Their use often precedes the diagnosis of Schizophrenia Very rare – might be that in some vulnerable individuals, using Marijuana makes it more likely they will be diagnosed Schizophrenic Doesn’t mean Marijuana is playing a causal role in that Amotivational Syndrome No experimental support for this Scientific data is not strong enough to support the notion that the harm associated with Marijuana is greater than the various problems that we’ve had in the criminal justice system and funding crime for continuing to make Marijuana illegal Most scientists think that legal Marijuana would probably cause less damage than the current issues that we have keeping it illegal Developmental Stages of Drug Production Pharmaceutical firms synthesize a drug and give it a code name that usually refers to the drug/company that produced it (i.e. HU-210, JWH-018, etc.) Drug is referred to as this code name until the company decides to go on and do testing with the drug (Phase I or clinical testing) o At this point, they would give the drug a generic name o If they decided not to test it, they would leave it under the drug’s code name In the early 2000s, THC was synthesized and pharmacologists began to create analogs of THC o All chemicals that bind to the CB-1 receptor (that registers the effects of Marijuana) Synthetic Cannabinoids (one of the most concerning issues) Around 2009-2010, these compounds began to be sold legally on the internet and in various headshops Generally sold under the brand names Spice & K-2 (remain slang names for synthetic cannabinoids in general) 100+ synthetic cannabinoids have been developed by pharmacologists to date Effective when smoked; partially effective when taken orally Effects are THC-like but variable and largely unknown o Marketed to users as if it’s Marijuana (but it’s really not) o Work through the same THC receptors These drugs are far more potent agonists of the THC receptor than THC (CB-1 receptor) o THC (active chemical in Marijuana) is a really weak agonist of the CB-1 receptor (we call THC a partial agonist) o Many of the synthetic cannabinoids are full agonists and are dozens of times more potent and effective than THC Historically (and even today in many cases), the DEA has been unable to effectively prosecute people who were selling these compounds o Although they’re analogs of THC (Schedule I drug), all these products are careful to say that they’re not used for human consumption (but instead as incense) o Had to prosecute people producing or selling these compounds Synthetic Cannabinoids: Spice/K-2 DEA conducted over 400 analyses o All were laced with a synthetic cannabinoid o High variability between products, even the same label: constituents and components change within product label and batch-to-batch Some of this is because producers are trying to dodge changes in the laws ER poison center calls involving synthetic cannabinoid OD: o 2009 – 112 o 2010- 2915 o 2011-6968 o 2012-5230 (synthetic drug act passed) o 2013-2936 o 2014-3682 o 2015-7779 Synthetic Drug Abuse Prevention Act July, 2012 bans several cannabinoids: CP-47, 496, JWH- 018, -019, -073, -122, -398; AM-678, -2201, Sr-19, RCS-4 Those were the compounds that were most common that were showing up in 2012 (started studying these in 2014) By 2013, new synthetic cannabinoids that weren’t covered by this law were coming out 2015 Update: New Cannabinoids on the Emergency List PB-22 (QUPIC), 5-F-PB-22, AB-FUBINACA, ADB-PINACA, & dozens more not covered (no research on these) We’ve gone from well-studied, reasonably understood analogs of THC to ones that are not well understood The ones that were banned were much safer than the ones that are used now/properties unknown except by the people who are starting to use them Causing overdose deaths, ER visits; some of them may be safe, but we don’t know which ones are These rapidly passed laws which are designed to protect people may be causing more harm Synthetic Cannabinoids (Spice) Highly potent full CB-1 receptor agonists that are 100x more potent than THC (relatively weak agonist) For most of the ER visits, people are reporting: o Panic attacks o Psychotic reactions o Nausea and vomiting o Tachycardia; hypertension (numerous reported OD deaths related to these) Researchers have studied 20 of these 100+ compounds At Arizona State University, one of his former students is buying the drugs on the internet and conducting chemical analyses to figure out what’s in them and then gives them to rats to study their behavior – few have been testing in humans One of these compounds was going around at North Eastern University o 14 people in the same night ended up in the ER and 3 died Hallucinogens Complicated because it’s not just one class of drugs Pharmacologists classify these differently, but the most sensible way to understand it is to classify them by which neurotransmitter they primarily impact/affect Serotonergic: one of the most important; their principal action is on a serotonin receptor (serotonin agonists) o The name hallucinogens is best described for the serotonergic class Methylated Amphetamines: act through monoamines but their actions are more complicated than amphetamines o The most famous of them is MDMA or ecstasy Anti-cholinergic: works through acetylcholine Anesthetic: include ketamine, special K, and PCP primarily All of these drugs produce major alterations in states of consciousness and effects that are sometimes considered hallucinogenic but with ecstasy or MDMA (misclassification) Kappa-Salvia: an herbal product that also can produce hallucinations that’s become popular on the internet in recent years Serotonergic Hallucinogens Most famous of these is Lysergic Acid Diethylamide (LSD), which is a synthetic compound Actual history goes back before LSD o They are found in various plants and fungal preparations Psilocybin (shrooms) – found in Psilocybe mushrooms o Grow natively in the Americans o You can find psilocybin containing mushrooms all over the Americas o Grows as far north as the American South East o One of the most famous places to gather these mushrooms was in cow manure grown on a big farm along Military Cutoff Rd., which is now Mayfaire Shopping Center o Hallucinogenic properties of these mushrooms were discovered by Native American peoples in Central and South America o Used historically for religious and ceremonial purposes Mescaline-Peyote cactus, San Pedro Cactus o Found mostly in the American Southwest and desert regions of Mexico and Central America o Contains the hallucinogenic drug mescaline Historically, psilocybin and mescaline were the original hallucinogenic drugs o Peyote was used by Native Americans (native to Mexico and American Southwest) long before Columbus o Discovered by Spanish conquistadors and some of the American colonists who pushed west and so anthropologists have described the peyote ritual which is still practiced even today o Native American churches still practice the Peyote Ritual Slice the cactus into small pieces Dry the slices (called peyote buttons) The buttons can then be consumed o San Pedro Cactus – Peru Prepared in a similar way; slices dried out for psychoactive use Historical account of the Native American Church peyote ceremony: Individuals gather late in the evening and build a large bonfire Everyone forms a circle around the bonfire One of those peyote buttons is then inserted into each individual’s rectum Everybody sits down around the campfire and begins to chant and pray They begin to see visions, bright colors, bright lights, and they believe that these are visitations from the gods This ritual was practiced throughout the American West by Native American’s of various tribal groups o Modern use of peyote is not religious or ceremonial & has become a popular hallucinogen worldwide o Most effective when taken orally o Peyote buttons have been found by archaeologists as far north as Canada Doesn’t grow in Canada (or much north of New Mexico/Arizona Were traded and were an important commodity o Some Native peoples still consider peyote buttons to be important in religion 1960s or 70s, right after the 1965 Drug Abuse Control Amendment banned these hallucinogens for the first time, the Native American Church brought suit The suit went all the way to the Supreme Court Right to peyote ritual is protected for Native Americans (affirmed in 2009 ruling in Utah) Protected by the Consitution/Separation of Church and State In Utah, the Mormons brought suit against the practice of the Native American church in Utah, but the court reaffirmed this ruling in 2009 Supreme Court approved religious use of ayahuasca tea (DMT/harmaline) for Brazillian religious Groups – Uniao do Vegetal in 2006 Serotonergic Hallucinogens Dimethyltryptamine (DMT): harmaline-ayahuasca, Yage’ – The Spirit Molecule (Documentary) o Ayahuasca is a beverage that is produced and it includes the ayahuasca vine that contains the chemical DMT o Depending on what they put in it, there can be other chemicals as well o It’s use goes back to the Pre-Columbian eras (like the peyote and psilocybin) o Important part of the religions throughout the Amazon Basin where its use continues very much as it was today o Quite possible to observe and participate in the ritual Drink the ayahuasca preparation and as you begin to hallucinate, the shaman begins to pray and chant He has two big palm frons and a big cigar like entity that he’s smoking (tobacco) and blowing the smoke on the person that needs to be purified while they are hallucinating Walks around them chanting and singing and blowing smoke on them for a period of several hours and at the end of it, the person is said to be healed spiritually o Since The Spirit Molecule Documentary, many North Americans and Europeans would like to go and experience ayahuasca in DMT In Peru, you can stop by a travel agency and shamanic healing center and there you can buy your plane tickets to fly into the jungle and stay for a week and take ayahuasca under the supervision of the shaman Ayahuasca Tourism Talked to one of the shamans that worked there He was a university of Wisconsin grad, not a real Shaman He went to school in the states, became aware of this and thought he could sell it to tourists He learned how to do the ceremony, it’s a big business now in Peru and Brazil Aldous Huxley The use of these drugs go back centuries but Europeans and Americans (westerners) were unaware of it except for a handful of anthropologists/archaeologists until about the 1950s British Novelist Aldous Huxley (Novel called Brave New World) – he traveled through Mexico (very interested in Native peoples there) and he participated in the peyote ritual and it changed his worldview and his life o He reports in his book (“The Doors to Perception: Gates to Heaven and Gates to Hell) – he describes his experiences with peyote; that book became enormously influential among the subculture in the 1960s o Jim Morrison’s Band, The Doors, got their name from the title of his book People read his book; some interest in it; began to make many Europeans and Americans aware that there were certain drugs that a person could take and it would change their vision/produce hallucinations/alter their consciousness in powerful ways Albert Hoffman Discovered LSD and launched the Psychedelic Revolution Swiss pharmacologist working in the WWII era for the Sandos Pharmaceutical Firm Hoffman was working with a group of chemicals that were derived from the ergot fungus (grows on grain, wheat, and rye, and has a lot of biologically active chemicals in it – among them a chemical ergotamine which causes smooth muscles in the gut to relax) He was interested in this because he thought if one of these were purified, they would be good treatment for abdominal cramping/menstrual cramps One day he spilled a tiny amount of one of these derivatives of the ergot fungus on his skin As he went home he began to hallucinate and he felt like he was going crazy o Began to see vivid, colorful images o Thinking very strangely, losing reality contact A few hours later, he sobered up and realized /began to wonder what happened to him Went back to lab and lab notes and realized that day he had been working with lysergic acid diethylamide/ergot derivative (LSD) o Reasoned that this compound might have been what he took) o Codename was LSD batch 25 So he decided that he might have spilled stuff on him and maybe that was responsible for his weird experiences He decided to do an experiment and it became a very famous experiment th Some of his notes in his diary was published – LSD, my problem child – 19 of April in 1943 (here he describes the experiment) In Hoffman’s time, (1940s), drugs/all known psychoactive drugs were measured in mg He was pretty smart – he knew that if this drug/LSD was what had produced his problem the day/a couple of days before, it meant that it must be really powerful stuff, so he made a tiny dose (from his perspective) that was .25 mg, 250 micrograms o Today, we measure LSD effects in microgram doses, not mg doses o A typical dose of LSD in the modern era would be 75-100 micrograms Embedded in this, the first real description of an LSD experience shows classic effects of LSD and psychedelic drugs; Hoffman became fascinated by his experiences o Called his book LSD My problem child, because of what happened next o Hoffman believed (when he recovered from his experience) that for a period of about 8 hours, this drug had changed his brain and made him essentially psychotic o He experienced the first documented bad trip with LSD o These are symptoms that we see naturally in schizophrenia He felt that this drug had changed his brain temporarily to make him be schizophrenic o And therefore that this drug might hold the key to understanding schizophrenia o He had the Sandos companies synthesize large batches of this and he sent it out to psychiatrists and psychologists all over the world, urging them to try and study this drug All over the world in the 1950s and 1960s, psychologists and psychiatrists did try this drug and their reactions varied enormously Timothy Leary Young psychologist at Harvard University Social psychologist until he tried LSD Had a personal/spiritual experience that changed his life completely He continued to do research on the drug for a number of years at Harvard o He would invite other faculty members to his house over the weekend and they would take acid and write about their experiences o One of his colleagues, Richard Alpert (psychology professor) changed his name to Baba Ram Das shortly after one of his experiences These Cambridge LSD parties became very well celebrated o Leary began to invite movie stars, famous novelists, famous artists (including Ken Kesey, who wrote One Flew Over the Cuckoo's Nest) o He began to invite students and the Harvard Crimson (newspaper) began to publish stories about the 25-30 students who had taken the drug and hallucinated at Leary’s place; Harvard alumni became concerned about this o Leary was fired (this was protested and became a media sensation in the mid-1960’s LSD became an overnight sensation All of the major newspapers in America and Europe were featuring stories about LSD Major magazines and television media were featuring artists’ renditions of what it looks like to be UTI of LSD and it began to become popular Ken Kesey Lived in San Francisco His friend was a chemist who began producing LSD in huge doses Kesey began to perform electric koolaid acid tests o Spiked several barrels of fruit punch with LSD and took them to the Golden Gate Park in San Francisco o Every Sunday he would be passing out cups of LSD to everyone in the park o These events became very popular and musicians began to come and play for the electric koolaid acid tests Including: The Grateful Dead, The Jefferson Airplane, Jimi Hendrix, etc. All of a sudden, LSD became a hot topic (1960s) o Began to produce hysteria as well o Claims were made that taking LSD once might give you a bad trip in which you would never come back Take it 2 or 3 times and you would become Schizophrenic for life This is one of the reasons that LSD was made a Schedule I drug in the 1970s system Doses of Acid: people usually dilute it in water into a known quantity and put a drop that corresponds to that 75-100 micrograms on a blotter, sugar cube, pill, etc. Serotonergic Hallucinogens Phenethylamines (2C-B, 2C-I, etc.) o Some of them produce effects that are very much like LSD in terms of vivid, visual hallucinations and alterations of consciousness o There are hundreds of them and most are legal today o Some of them were banned by the 2012 Synthetic Drug Abuse Act o Most of them were synthesized by a chemist named Alexander Shoegin o Because they are legal, they represent another class of drugs that are sold legally on the internet and may produce curious and unknown effects 4.7.16 Serotonergic Hallucinogens Psilocybin – Psilocybe mushrooms (increasing in popularity/frequency of use) Mescaline-Peyote, San Pedro cacti (another of the Ancient hallucinogens used in Central and South America for many centuries before Columbus) Dimethyltryptamine (DMT): Ayahuasca (The Spirit Molecule; main ingredient used by Ayahuasca shamans in the Amazon Basin) o Very short-acting/rapidly metabolized Smoked: 15-30 mins Orally: 1 hour o Most hallucinogens have a duration of action that ranges between 6 and 10 hours Lysergic acid diethylamide (LSD, Acid) o Most potent (low doses produce very large effects) Phenethylamines (2C-B, 2C-I, etc.) – not all are hallucinogens, but some of them are; most likely to be sold on the internet; some legal and others illegal o Vary a lot in potency Effects of these are similar; differences have to do with potency and duration of action Naturally occurring hallucinogens are less powerful Effects of LSD, 2C-I, Psilocybin, etc. In the brain, by the 1990s we recognized that there were at least 3 different serotonin receptors and these were called Serotonin 1, Serotonin 2, and Serotonin 3 By the 2000s we recognized that the serotonin 2 receptors were a family and also had different structural compounds among the receptors that we were calling serotonin 2 o These are called serotonin 2a, 2b, etc.; found in different parts of the brain/do different things; know little about them Mechanism of Action: all agonists of the Serotonin 2a receptor (5-HT2a) o All serotonergic hallucinogens are neurochemically similar in that they bind to and are agonists of the Serotonin 2a receptor o Elevating serotonin per se does not produce hallucinogenic effects; if you selectively elevate activity just in this 2a pathway, that’s what’s necessary to trigger the effects These 5-HT receptors are not all located in the visual/occipital cortex (visual projection area of the brain); occurring at a lower level o Reticular formation – where the visual input is ascending, before it even gets to the visual cortex; that’s where we think LSD and these related compounds are altering the signal and that’s where 5HT2a receptors are pretty abundant o These drugs are affecting your visual system early on as the eye tries to communicate and project to the occipital cortex; visual hallucinations are the effects that are very unique to these serotonergic hallucinogens o The other hallucinogens that we’ll talk about later don’t really have that power to produce visual hallucinations o When most people think about hallucinogenic drugs, it’s really these serotonergic drugs that they’re thinking of Sympathomimetic: Cocaine, amphetamines, caffeine, nicotine (all the stimulants) Increased heart rate, blood pressure, sweating, blood flows away from gut an internal organs; more blood goes to brain and big muscle groups in arms and brain; pupil dilation (occurs even in bright, ambient light) – physical changes that you get with a sympathomimetic drug Very potent sympathomimetic/physical effects (more-so than the amphetamines) Visual Hallucinations What we have are self-reports People write about their experiences under the influence of these drugs Artists have tried to paint the things that they experience on these drugs Research: back in the 1960s, primarily before the drug became schedule I, Arkae Seagull at the University of California Los Angeles conducted a series of studies in which LSD was administered to students and basically they sat in a lab room and described their experiences while the experimenter reported them; that’s basically what we know about these experiences Altered consciousness o Individuals report a variety of experiences o They feel that their conscious experience has been changed to some sort of different level, often hard to describe o Very often described as spiritual or mystical o Most of the uses of psychoactive drugs that are ancient in origin have always been tied up in spiritual or mystical experiences Research: From 1965 to 2008/2009, it was almost impossible to do research on any of these hallucinogenic drugs; Still hard to do work with LSD Spiritual/Mystical Experiences Roland Griffiths et al. (2011) – 94% rated psilocybin experience as among the 5 most significant spiritual events in their lives 1 year after experiment o Healthy volunteers were allowed to take psilocybin o Person takes it along with an experimenter who tries to talk them through any distress or anxiety o They are at the forefront of the psychedelic therapy movement Potential value of psychotherapy used as an aid or an adjunct o One of the things they did with their volunteers is asked them to describe some of their experiences We tend to interpret these changes in visual sensations and conscious experience as spiritual and mystical in nature o In all the focus on the visual experiences, what many of the users talk about is the aftermath of having these visual changes Experiencing these old consciousness alterations, but they’re also having some significant visions or experiences relevant to their life that are meaningful for them in ways that are described as spiritual or mystical Tolerance/Dependence Tolerance is often associated with dependence and we think of them as intertwined o EX: An individual who’s drinking a lot develops a tolerance to alcohol If they abruptly stop drinking, the person will experience some withdrawal symptoms True of most drugs With these hallucinogens, we don’t see much evidence of drug dependence with tolerance o Not common for people to take one dose and take a second dose soon afterwards After an individual takes a dose of a serotonergic hallucinogen, 24 hours later, they will see no or little effects (acute tolerance) No true withdrawal symptoms per se – experience psychological discomfort trying to make sense of their trip (doesn’t seem to be true withdrawal symptoms) Visual Hallucinations Enhanced color perception (one of the most commonly reported experiences by individuals UTI of these drugs is a great enhancement of color perception) o Natural colors are seen as more intense and more vivid than usual o Alteration of the natural visual experience o Also true that individuals will perceive color in the absence of color – will see colors that are not there o EX: look at the lab wall and report a kaleidoscopic array of bright, intense colors Flickering of the visual field (second, very commonly reported effect) o Described by users as a strobe light effect (looks as if a light is flashing on and off) o The environment is brightly illuminated or dark in an alternating way which makes everything seem like it is occurring in slow motion Perception of Motion o Things that are stationary appear to be in motion o Part of this seems to be due to an after image-like effect o Objects seem to be leaving trails behind them o Descriptions like a visual after-image you might see when a bright flashbulb has gone off and you see a persistent image o Moving your finger across the vision field, the user will report a trail of color left in wake of the moving object o Even though the object is not moving, your eyes are moving Synesthesia o Individual reports a stimulus (usually that’s presented in some non-visual modality – i.e. auditory), but they’ll report it as a visual stimulus (EX: “I can see the music” or “I see her words”) o Regardless of modality, you experience it visually Form Constants (R.K. Seagull) – argued that when individuals start experiencing these visual alterations, they tend to organize the visual hallucinations in terms of particular forms o Lattice Pattern (very, very common) Designed to represent experiences during peyote ritual Cross-hatched pattern; lattice refers to cross-hatch The pattern is very vivid/colorful If you’re in a lab looking at a wall, you might report a color pattern on the wall that’s a fence or lattice that’s colorful/ checkerboard kind of pattern Perhaps begins to move perhaps – wall said to be moving or breathing The lattice is a theme no matter what you’re seeing in a lot of these experiences o Tunnel/Vortex Pattern You’re looking at the wall and it may break into colors, but you see a hole or a tunnel opening up in the wall Instead of 2-dimensions, it suddenly becomes a 3-dimensional object; appears like you could put your arm into it Vortex – the perception of this 3-dimensional space might be moving/spinning like a vortex as well o Spiral Explosion: Most often seen in migraine sufferers before they get a migraine o These 3 are all abstract (not necessary, but common) Bright, visually intense, abstract objects What can begin to happen as the drug experience goes on is that the individual, as their consciousness becomes altered, begins to make something out of these experiences As the person constructs a vision/narrative/experience, it’s composed of these bright colors, moving objects, and the form constants Even in one individual who has taken these drugs multiple times, they don’t have the same experience every time Influenced by frame-of-mind and environment that you’re in Thought these were especially interesting because they occur not just with serotonergic hallucinations, but they also occur when hallucinations are produced for other reasons People hallucinate when they have high fevers (fever delirium) – people will report vivid hallucinations; sometimes they show some of these very same form constants People will report visual changes just before a seizure (epilepsy) Migraine aura – see visual changes just before you get a migraine Try to produce hallucinations without a drug using sensory deprivation After about 20-30 minutes of this, it starts to feel uncomfortable and many people start reporting hallucinations The visual hallucinations that you get also show these same form constants that he identified o He argued that these may be properties that tell us something about how visual systems work Adverse Effects: Myth & Reality Birth Defects/Chromosome Damage - MYTH o Serotonergic hallucinogens do cross the fetal barrier, which can certainly damage the fetus (should be avoided during pregnancy) o The idea that the drug would cause chromosome damage making it likely to have effects in the future, doesn’t appear to be true Acute Psychosis/Bad Trips – REALITY o Common and not well understood o Depends on environment and state of mind you’re in o Things can become threatening or frightening o All of the hallucinogens can do this o Best predictor of a bad trip vs. a spiritual or beneficial one is dose (> doses, > bad trips) Use 7 times and you’ll be legally insane - MYTH o Origin of this myth is attributed to a mass-murdered Charles Manson Assembled a cult following, mostly of young women and the Manson family as they were called lived together and engaged in a wide variety of bizarre practices, but they were very heavy users of LSD Each member of this cult has used LSD well over 100 times and they were very psychotic Everyone was diagnosed with a severe mental disorder (paranoid schizophrenia for Manson) The connection b/ween insanity and LSD became entrenched in the popular imagination, with that, that horrifying scenario There is no magic number – the link between LSD and other severe mental disorders (such as Schizophrenia) is still controversial and speculative Residual Psychosis (rare; not certainly related to LSD) o Might be beneficial in psychotherapy o A big concern is the possibility that users who experience one of these bad trips might not come back o Is there/what are the data about a psychosis that’s precipitated by LSD or some of these other drugs o Rare: it is true that in some cases an individual will be hospitalized for a bad trip and the next morning the symptoms are still there In the 1970s and 80s, that would automatically be diagnosed as a drug-induced psychosis Since then, people have actually followed up and studied this have questioned whether in fact the drug produced or induced the disorder o In most of these cases there is evidence that the individual was experiencing severe psychological problems even before the drug experience brought them to the ER o Individuals who have schizophrenia become a great deal worse, their symptoms become more florid if they take LSD or any of the other serotonergic hallucinogens These drugs will worsen those symptoms if they’re present Most widely accepted in psychology – These drugs will make the symptoms worse If you’re at a borderline situation, they may make them significantly worse to the point where you come to medical attention and then the diagnosis is made Not clear that these drugs will cause this condition Is it stored in the spine? MYTH o Early theories: maybe LSD (like THC) is stored in the body We know this isn’t true because we can study receptor binding by rendering a transmitter mildly radioactive and delivering it into the system to measure where the compound is bound o Radioactive LSD is cleared from rat’s brains within 24 hours (you can’t measure it at all; is not stored in your brain or your spine) o Explanation? Most researchers view it as a psychological flashback (not unlike the flashbacks people with PTSD experience) Flashbacks Fairly common among heavy users The person re-experiences or feels as if they are on the drug again but they’re not (days, week, months after last use) Report that they feel as if they are on the drug again in the here and now What predicts a flashback? The best predictor is how often you’ve used the drug There seems to be triggers for it – two most common triggers were 1. Suddenly walking into a dark room and 2. Smoking Marijuana For some people, flashbacks are constant (exceptionally rare, but it’s documented and it’s in DSM-V) o Called hallucinogen persisting perception disorder o In some individuals who are heavy users, primarily with LSD, the seemed to have done damage to their visual system so that they’re constantly experiencing trails; the kinds of trails they might experience during the acute exposure to the drug and just alterations in their visual field that are distressing and don’t go away o Visual system damaged in some relatively permanent way **** First Aid for someone experiencing a bad trip Essentially you try to get the person remembering that they’re on a drug, because at the time they’re hysterical/screaming/in a panic, or they’re catatonic If you can get them out of the hallucinations enough to hear you, then you can try to get the person knowing that the drug is going to wear off If you can get the person to discriminate between what they’re experiencing in reality, they’ll usually calm down and be okay If you can’t because they’re hysterical and may hurt themselves, there is one group of drugs that will tend to bring them out of it – antipsychotic medications or medications used to treat Schizophrenia o Albert Hoffman argued that maybe these alterations in serotonin have something to do with schizophrenia o The fact that antipsychotic medication does seem to help a person come out of a bad trip may be supportive of that o However, there’s something wrong with Hoffman’s hypothesis – when a person takes LSD, Hoffman believed that they are experiencing the symptoms of schizophrenia for 8 hours o Schizophrenic hallucinations are dominantly auditory, not visual – whatever the similarities might be, the experience is very different IMPORTANT about acute/bad trips: they are acute – they last while you’re under the influence of the drug and when the drug wears off, in most cases the person is pretty shaken up by it because they can remember what they experienced and it might worry them, but they’re no longer psychotic when the drug wears off People who describe themselves are more spiritual/religious are more likely to interpret their serotonergic drug experiences as an experience too Phenethylamines There are a ton of them (2C-B, 2C-I, 2C-T-2, T7) Many of them are LSD or psilocybin like and two of the famous ones are 2C-B and 2C-I (street names like smiles and bees and nexus) Most of these drugs are chemically similar to MDMA but effects can be LSD-like or MDMA-like Alexander Shulgin (chemist at the University of California/retired now) spent his career studying these PEAs o Synthesized and experimented with hundreds of these compounds (PEAs) Interestingly, most of these chemicals are psychoactive and in most cases there’s only 2 people that have taken them (Alexander Shulgin and his wife) He would synthesize these drugs and then he would take a couple doses of them and write about his experiences Pihkal – A Chemical Love Story (book he wrote) o In the preface to this book he points out that the acronym of his book stands for Phenethylamines I have known and loved o All these drugs are legal/were at the time he synthesized them o Many of them have been made illegal since
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