Use Of Hallucinogens Research Articles

Use of hallucinogens in Slovakia: Does it differ from global trends?

People have been using hallucinogens for thousands of years and interest in these substances has grown in recent years. The aim of this study was to determine the basic socio-demographic data, preferences, experiences, and attitudes associated with hallucinogen use in Slovakia. A cross-sectional research design was used whereby an online survey included participants who had had at least one experience with hallucinogens (N=422, age M=27.78; SD=7.84; SE=0.38; 35.1% females). Due to the illegal, intimate, and minority nature of the phenomena studied, data was collected using the snowball sampling method via an online social network in groups that declared a drug focus. Users of hallucinogens were mostly employed (61,8%) and in some form of partnership (57,6%); they usually have a high school diploma (46,68%) or a university degree (45,41%). They most often use psilocybin mushrooms, while the age of initial use (M=19,61; SD=5,39) as well as lifetime frequency use (M=18,26; SD= 24,21; Median= 10) are similar to global trends. Free use without rituals was preferred to ceremonial use. In general, our sample of hallucinogen users considered the integration of psychedelic experiences to be simple rather than challenging. Concurrently, they tended to see hallucinogens as useful to humans, but realised that they are not without risk and can be somewhat dangerous. Males used hallucinogens for the first time at a younger age (p < .05, r=-.12), used more hallucinogens during their lifetime (p <.001, r=-.23), and demanded decriminalisation and legalisation more (p <.01, r=-.13) than females. Slovak users of hallucinogens in our sample showed similar usage trends as users abroad. Even though both males and females perceive and evaluate hallucinogens very similarly, females are significantly more careful in using these substances.

Psychedelics alter metaphysical beliefs

Can the use of psychedelic drugs induce lasting changes in metaphysical beliefs? While it is popularly believed that they can, this question has never been formally tested. Here we exploited a large sample derived from prospective online surveying to determine whether and how beliefs concerning the nature of reality, consciousness, and free-will, change after psychedelic use. Results revealed significant shifts away from ‘physicalist’ or ‘materialist’ views, and towards panpsychism and fatalism, post use. With the exception of fatalism, these changes endured for at least 6 months, and were positively correlated with the extent of past psychedelic-use and improved mental-health outcomes. Path modelling suggested that the belief-shifts were moderated by impressionability at baseline and mediated by perceived emotional synchrony with others during the psychedelic experience. The observed belief-shifts post-psychedelic-use were consolidated by data from an independent controlled clinical trial. Together, these findings imply that psychedelic-use may causally influence metaphysical beliefs—shifting them away from ‘hard materialism’. We discuss whether these apparent effects are contextually independent.

Psychedelics as Tools for Belief Transmission. Set, Setting, Suggestibility, and Persuasion in the Ritual Use of Hallucinogens.

The use of psychedelics in the collective rituals of numerous indigenous groups suggests that these substances are powerful catalysts of social affiliation, enculturation, and belief transmission. This feature has recently been highlighted as part of the renewed interest in psychedelics in Euro-American societies, and seen as a previously underestimated vector of their therapeutic properties. The property of psychedelics to increase feelings of collective belonging and transmission of specific cultural values or beliefs raise, however, complex ethical questions in the context of the globalization of these substances. In the past decades, this property has been perceived as problematic by anticult movements and public authorities of some European countries, claiming that these substances could be used for “mental manipulation.” Despite the fact that this notion has been widely criticized by the scientific community, alternative perspectives on how psychedelic experience supports enculturation and social affiliation have been yet little explored. Beyond the political issues that underlie it, the re-emergence of the concept of “psychedelic brainwashing” can then be read as the consequence of the fact that the dynamic through which psychedelic experience supports persuasion is still poorly understood. Beyond the unscientific and politically controversed notion of brainwashing, how to think the role of psychedelics in the dynamics of transmission of belief and its ethical stakes? Drawing on data collected in a shamanic center in the Peruvian Amazon, this article addresses this question through an ethnographic case-study. Proposing the state of hypersuggestibility induced by psychedelics as the main factor making the substances powerful tools for belief transmission, I show that it is also paradoxically in its capacity to produce doubt, ambivalence, and reflexivity that psychedelics support enculturation. I argue that, far from the brainwashing model, this dynamic is giving a central place to the agency of the recipient, showing that it is ultimately on the recipient’s efforts to test the object of belief through an experiential verification process that the dynamic of psychedelic enculturation relies on. Finally, I explore the permanence and the conditions of sustainability of the social affiliation emerging from these practices and outline the ethical stakes of these observations.

Toward a typology of hallucinogen users in the United States

BackgroundRoughly one in ten American adults have used hallucinogens, and emerging evidence suggests that the prevalence of use is increasing. However, our understanding of the degree to which individuals “specialize” in the use of a particular hallucinogen or are poly-hallucinogen users remains incomplete. MethodsThis study examined data from 6381 individuals reporting past-year hallucinogen use in the 2016–2018 National Survey on Drug Use and Health. Logistic regression examined the association between the number of distinct hallucinogens used and psychosocial/behavioral risks, and latent class analysis (LCA) characterized subgroups of hallucinogen users. ResultsThe vast majority of hallucinogen users, roughly 70%, are not “specialists” who use only one hallucinogen type; rather, lifetime poly-hallucinogen use is the norm. Critically, however, we also see that important differences exist within the population of hallucinogen users—half (51%) could be classified as LSD-Mushroom-Ecstasy users only (this group was disproportionally comprised of youth), nearly one third (30%) were Poly-Hallucinogen users (this group was disproportionately male and non-Hispanic White), and smaller proportions were limited primarily to use of LSD-Mushrooms (6%; these individuals were almost exclusively ages 35 and older) or Ecstasy Only (12%; these individuals were mostly younger adults ages 18–34). ConclusionsFindings provide a fresh contribution to our understanding of poly-hallucinogen use in a time in which local and state governmental leaders, and people across the country, weigh the benefits and drawbacks of legalizing specific hallucinogenic drugs.

Why was early therapeutic research on psychedelic drugs abandoned?

Advocates of the therapeutic use of psychedelic drugs have argued that a promising approach to treatment was prematurely abandoned in the 1960s primarily because of Richard Nixon's 'War on Drugs'.This paper (1) briefly describes research in the 1950s and 1960s in North America on the use of LSD to treat alcohol dependence, anxiety in terminal illness, and anxiety and depression; and (2) discusses the factors that led to its abandonment. An analysis of historical scholarship on psychedelic research in the 1950s, 1960s and 1970s in North America. Research on psychedelic drugs in psychiatry was abandoned for a number of reasons that acted in concert. A major factor was that clinical research on psychedelic drugs was caught up in the tighter regulation of pharmaceutical research after the Thalidomide disaster in 1963. Psychedelic drugs also presented special challenges for randomised, placebo-controlled clinical trials in the 1970s that were not as positive as the claims made by their advocates in the 1950s and 1960s. Clinical research became more difficult after 1965 when Sandoz ceased providing psychedelic drugs for research and their nonmedical use was prohibited in 1970. The demise of psychedelic drug research was not solely due to the 'War on Drugs'. It was hastened by tighter regulation of pharmaceutical research, the failure of controlled clinical trials to live up to the claims of psychedelic advocates, and the pharmaceutical industry's lack of interest in funding clinical trials.

Racial/ethnic differences in prevalence of hallucinogen use by age cohort: Findings from the 2018 National Survey on Drug Use and Health

AbstractBackgroundFew studies have assessed the epidemiology of hallucinogenic substance use among racial and ethnic groups of varying age cohorts. Use of psychedelic substances may differ among people of color (POC), due to factors such as stigma and discriminatory drug enforcement practices against POC. The lack of inclusion of POC in psychedelic research further underscores the importance of identifying differences in use among racial/ethnic groups and age cohorts.MethodsData from the 2018 National Survey on Drug Use and Health (NSDUH) was used for this analysis (N= 56,313, unweighted), representative of the non-institutionalized U.S. population. Proportions of lifetime hallucinogen use by race/ethnicity were compared. Proportions of past year rates of use were compared to examine differences by race/ethnicity and age cohort.ResultsApproximately 15.9% of the U.S. population over 12 had used a hallucinogen at some point in their lifetime and 2.0% had used in the past year. Lifetime hallucinogen use was most prevalent among non-Hispanic White and multi-racial individuals, while Black/African Americans reported the lowest rates of use. White and multi-racial groups also reported the highest proportions of past year use among 12–34 year olds, and White individuals reported the highest proportions among 35–49 year olds. Hispanic individuals reported higher proportions of use among the 12–17 cohort, but lower proportions among the 26–49 year old cohorts. Black/African Americans reported the lowest rates of past year use among the 12–25 year old cohorts. 50+ and older cohorts reported the lowest rates of hallucinogen use in the past year.LimitationsData is cross-sectional and self-reported. “Race” is a social construction is subject to change over time, and NSDUH ethnoracial categories are limited. Institutionalized populations are not included in the study.ConclusionsSignificant differences in hallucinogen use among ethnoracial groups by substance and age cohorts were observed. Findings from this work may inform education, interventions, and therapeutic psychedelic research.

Visual Phenomena Associated With Migraine and Their Differential Diagnosis.

Visual phenomena are of many different kinds; their differential diagnosis is usually possible with directed history-taking. In this review, we describe common visual phenomena that must be distinguished from a migraine aura. This review is based on publications retrieved by a selective search in PubMed and the Web of Knowledge/Science, with special attention to the current classification of the International Headache Society and the recommendations of the German Migraine and Headache Society. The following search terms were used: "visual phenomena/phenomenon," "migraine aura," and "persistent/complication/ long-lasting/ongoing." The most helpful questions for differential diagnosis are whether the symptoms are present in one eye only or in both, whether their onset was sudden or over minutes or days, and whether the phenomenon has occurred only once or repeatedly, or is persistently present. A visual aura associated with migraine must be distinguished, in rare cases, from an isolated epileptic aura, from cerebral/retinal ischemia, or from visual snow. Further differential diagnoses include a persisting perceptual disturbance after hallucinogen use (HPPD, "hallucinogen persisting perception disorder") and the Charles Bonnet syndrome (CBS); the latter arises as a consequence of severely impaired vision. Posterior reversible encephalopathy syndrome (PRES) is rare and generally reveals itself over its further course through the appearance of additional clinical manifestations. Primary ophthalmological causes can usually be readily identified and classified by ophthalmological examination. Patients with visual phenomena typically consult physicians from various medical specialties. A correct differential diagnosis can be made based on the history if the physician views the symptoms in their overall context to determine the particular disease entity that is responsible.

Population Size Estimation of Drug Users in Isfahan City (Iran) Using Network Scale-up Method in 2018.

BackgroundTo provide prevention programs and educate drug users (DUs), the estimation of their population is necessary. This study aimed to estimate the population size of this hidden group in Isfahan city as a metropolitan in Iran using the network scale-up ýmethod (NSUM).MethodsThis cross-sectional study was performed in summer 2018 on 1000 people selected through a multistage sampling method based on 14 region of the municipality of Isfahan. The data collection tool was a questionnaire that was previously used in Dr. Banshi's national plan without any changes. The Cronbach's alpha value of the questionnaire was 0.826. Using correction factors such as transparency of response and the ratio of social network size used in previous national studies, the number of people with high-risk behaviors was estimated. The results were analyzed through NSUM based on survey analysis.FindingsAmong all kinds of DUs, men were the largest consumers. The prevalence of use of opium, cannabis, heroin/crack, stimulants, ecstasy, hallucinogens, tramadol, zolpidem, tobacco, and drug injection was 2983, 2342, 613, 766, 86, 268, 1185, 213, 5869, 135 in 100000 people, among individuals of over 18 years of age. In both sexes, the prevalence of using opium and its nectar and illegal treatment with methadone and buprenorphine was higher in people of over 30 years of age, while the prevalence of consuming cannabis, ecstasy, tramadol, tobacco products, and stimulants was higher in the age group of 18 to 30 years.ConclusionThe results indicated that the prevalence of different DUs in Isfahan city, especially among men was higher than the reported average (especially in young men of 18-30 years of age). Since the prevalence of drug use varies based on the type of substance used among age groups, targeted preventive planning based on the type of drug used and age group is recommended.

Attitudes and Beliefs about the Therapeutic Use of Psychedelic Drugs among Psychologists in the United States

ABSTRACT Psychologists are a vital component of mental health treatment and their perceptions of psychedelic-assisted therapy are critical for future implementation. This cross-sectional quasi-experimental electronic survey study explored the attitudes about psychedelics used in treatment among 366 clinical psychologists in the United States. Participants expressed cautiously favorable attitudes toward therapeutic psychedelic experiences but indicated concern about possible psychiatric and neurocognitive risks. Most participants indicated that they lack an understanding of the full range of effects of psychedelics, would need to seek out additional consultation, and endorsed positive beliefs in the potential of psychedelic treatment and the need for further research. Overall, this research identified the need to increase education and training about psychedelics for psychologists in order to help increase knowledge and reduce stigma about psychedelic therapies.

Driving while under the influence of hallucinogens: Prevalence, correlates, and risk profiles

BackgroundHallucinogen use is rising in the US, yet little is known regarding the prevalence and psychosocial/behavioral correlates of driving under the influence of these drugs. MethodsThis study examined data from 4447 individuals ages 16–64 who reported past-year hallucinogen use in the 2016–2018 National Survey on Drug Use and Health. Prevalence estimates (with 95% confidence intervals [CIs]) were calculated for driving under the influence of hallucinogens (DUIH). Logistic regression examined psychosocial/behavioral correlates of DUIH, and latent class analysis (LCA) characterized subgroups of individuals reporting DUIH. ResultsThe prevalence of past-year hallucinogen use was 2.42% (CI = 2.30–2.54) and, in the general population, the prevalence of DUIH was 0.21%. Among past-year hallucinogen users, 8.94% (CI = 7.74–10.31) reported DUIH on at least one occasion over the previous 12 months. The probability of DUIH increased significantly with more frequent use. Compared to individuals who used hallucinogens and did not report DUIH, individuals reporting DUIH were significantly more likely to report mental health problems; use of other illicit drugs; selling drugs; a past-year arrest; or driving under the influence of alcohol, cannabis, or other illicit drugs. LCA identified three classes of individuals reporting DUIH, characterized by: use of and driving under the influence of cannabis; use of and driving under the influence of cannabis and other illicit drugs; and mental health concerns. ConclusionsNearly one in ten individuals who report using hallucinogens also report driving under the influence of hallucinogens—drugs that affect perception and risk-taking, with alarming implications for driving safety.

Psychedelic drug use and schizotypy in young adults

Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.

Increased Entropic Brain Dynamics during DeepDream-Induced Altered Perceptual Phenomenology.

In recent years, the use of psychedelic drugs to study brain dynamics has flourished due to the unique opportunity they offer to investigate the neural mechanisms of conscious perception. Unfortunately, there are many difficulties to conduct experiments on pharmacologically-induced hallucinations, especially regarding ethical and legal issues. In addition, it is difficult to isolate the neural effects of psychedelic states from other physiological effects elicited by the drug ingestion. Here, we used the DeepDream algorithm to create visual stimuli that mimic the perception of hallucinatory states. Participants were first exposed to a regular video, followed by its modified version, while recording electroencephalography (EEG). Results showed that the frontal region’s activity was characterized by a higher entropy and lower complexity during the modified video, with respect to the regular one, at different time scales. Moreover, we found an increased undirected connectivity and a greater level of entropy in functional connectivity networks elicited by the modified video. These findings suggest that DeepDream and psychedelic drugs induced similar altered brain patterns and demonstrate the potential of adopting this method to study altered perceptual phenomenology in neuroimaging research.

Cross-Sectional Associations Between Lifetime Use of Psychedelic Drugs and Psychometric Measures During the COVID-19 Confinement: A Transcultural Study.

Background: One of the main public health strategies adopted at the beginning of the COVID-19 pandemic consisted of implementing strict lockdowns to stop the transmission of the virus. Despite being an effective measure, the confinement and the associated social isolation create a stressful, potentially lengthy situations that has been proven to have several psychological consequences. Given the potential benefits that certain psychedelic drugs have shown for the treatment of psychological disorders, this study aimed to assess the impact of lifetime psychedelic drug use on mental health in relation to the first strict lockdown adopted by various countries (April-July 2020).Methods: Subjects completed an online survey that inquired about sociodemographic factors, activities, and lifestyle factors during confinement, as well as health and mental health related factors. Subjects were asked about their lifetime use of psychedelic drugs (MDMA, ayahuasca, psilocybin-containing mushrooms, LSD, peyote, San Pedro, Bufo alvarius or 5-MeO-DMT, and others), being classified as regular users (more than once per 6 months), occasional users, or non-users. The survey included psychometric tests used to assess psychological distress, peritraumatic stress, social support, psychopathological symptoms, and personality. Linear regressions were performed with psychedelic drug users as the independent variable and psychometric factors as the outcomes, while correcting for age, gender, language, religion, spirituality, and use of non-psychedelic drugs.Results: The study included 2,974 English, Portuguese, and Spanish speakers (497 regular users of psychedelic drugs, 606 occasional users, and 1,968 non-users). On average, respondents were 36 years old and 70% were female. Psychedelic drug users, especially regular ones, reported less psychological distress, less peritraumatic stress, and more social support. Regarding personality measures, psychedelic drug users scored higher on the novelty-seeking and self-transcendence scales, and lower on cooperativeness.Conclusion: Our findings showed that regular users of psychedelic drugs had less psychological stress and some personality differences when compared to occasional users and non-users. This suggests that either the use of psychedelics might be a protective factor itself or people with certain previous traits are more prone to frequently using psychedelic drugs. Future prospective longitudinal research should investigate the underlying processes observed in this study to develop consistent hypotheses.

Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

IntroductionDespite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes.ObjectivesTo explore mental health service user attitudes to psychedelics and psilocybin therapy.MethodsA questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users.ResultsNinety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued.ConclusionsThe majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy.

The need for publicly funded research on therapeutic use of psychedelic drugs.

The need for publicly funded research on therapeutic use of psychedelic drugs.

Epidemiology of hospitalizations with hallucinogen use disorder: a 17-year U.S. National study

Objective To assess time-trends and outcomes of hallucinogen use disorder hospitalizations. Methods The U.S. National Inpatient Sample (NIS) data from 1998 to 2014 were used. People hospitalized with hallucinogen use disorder as primary or secondary diagnosis were assessed. Rates were calculated per 100,000 NIS claims. Multivariable-adjusted logistic regression analyses assessed the association of patient and hospital characteristics with outcomes. Results The national U.S. rates per 100,000 total NIS claims for hallucinogen use disorder hospitalizations increased from 1998–2000 to 2013–2014 and outcomes worsened over time: 1 hospitalizations, from 22.8 to 40.4 (1.8-fold); 2 in-hospital mortality rate, from 0.3 to 0.6 (2.3-fold); and 3 non-home discharge, from 4.2 to 6.3 (1.5-fold), respectively. Various patient and hospital characteristics were associated with worse healthcare utilization outcomes and in-hospital mortality. Conclusions Hallucinogen use disorder hospitalizations were common and increased from 1998 to 2014 in the U.S. interventions targeting modifiable patient and hospital factors can potentially reduce this burden.

Therapeutic use of psychedelic drugs in depression disorders

IntroductionDepression is one of the most prevalent mental illnesses, leading to important personal distress and economic consequences. Treatment is long, often involving psychotherapy and pharmacological treatment, and relapses are frequent. Used mostly for treatment of mood disorders and alcohol dependence, drugs such as lysergic acid diethylamide (LSD) were studied in the 1950’s and showed therapeutic promise in attenuating depressive symptoms. However, in the 1960s all major psychedelic research programs were ended. Recently, there is a renewed research interest in these drugs, considering its antidepressant potential.ObjectivesTo review current knowledge on the therapeutic uses of psychedelic drugs such as LSD in depression disorders.MethodsReview of the most recent literature regarding the therapeutical potential of psychedelic drugs such as LSD in depression disorders. The research was carried out through the UptoDate, PubMed, MedLine, ScienceDirect and SpringerLink databases, using the terms “LSD”, “psychedelic drugs” and “depression disorders”, until December 2020.ResultsAs in past scientific studies, data of recent clinical research shows that the use of LSD relieves distress concerning death, particularly in terminally ill oncologic patients, and addictions including alcoholism and nicotine. There is more limited data concerning the use of classic hallucinogens to treat depression and anxiety disorders.ConclusionsAlthough research has shown many of the neurobiological and psychological effects of classic hallucinogens on humans, the studies that have been completed to date are not sufficient to establish clinically relevant effects. Despite further research is needed, the outcomes are encouraging, and larger, well-designed, placebo-controlled trials are now underway or being planned.DisclosureNo significant relationships.

Substance Use Trajectories: Nonmedical Use (NMU) of Prescription Stimulants via Non-Oral Routes of Administration Among Adults Recruited from Reddit

NMU of prescription stimulant medications (RxStim) intended for treatment of attention deficit/hyperactivity disorder (ADHD) is a growing public health concern, particularly when used via non-oral routes of administration. However, the role of non-oral routes of administration for RxStim NMU in the larger substance abuse pathway is less well studied. The purpose of this study was to characterize RxStim NMU and investigate substance use trajectories among adults who reported non-oral RxStim NMU recruited from Reddit.Eligible participants must have been located in the US, English speaking, age 18 y, and have reported RxStim NMU via a non-oral route (any route other than ingestion) within the past 5 y. Participants were recruited from Feb-Sep 2019 using banner ads on Reddit, the 5th most visited website in the US. Participants completed an online survey which captured demographics, lifetime RxStim NMU and illicit substance use; they were compensated for their time. For purposes of this study, NMU included ANY of the following: (1) use for any reason, even once, without their own prescription, (2) use in ways other than prescribed, and (3) use for the feeling or experience the medication caused.Respondents (n=225) were primarily male (86.2%), 18-24 (48.0%) or 25-34 (43.1%) years of age, and Caucasian (78.2%), Black (7.1%) or Hispanic (5.3%). Lifetime diagnosis of ADHD was reported by 27.6%, with 53.2% diagnosed at age 11-19 and 35.5% at age 20+ years. RxStim NMU via snorting was reported by 99.1%, smoking 3.6% and injecting 6.2% (multiple routes could be reported). Almost all (n=222; 98.7%) also reported lifetime illicit drug use, among whom 182 (82.0%) initiated substance use by using an illicit drug (77.9% marijuana, 1.8% cocaine/crack, 0.9% inhalants, 0.9% hallucinogens, 0.5% methamphetamine/amphetamines) prior to RxStim NMU. Forty (18.0%) respondents initiated with RxStim NMU; 14.4% then initiated marijuana use, 0.9% initiated cocaine/crack use, 0.9% initiated barbiturate use, and 0.5% initiated heroin, inhalant, methamphetamine/amphetamine, and hallucinogen use. Average age of initial RxStim NMU was 18.7 (SD 3.7) years and most often was via swallowing (89.1%) followed by snorting (10.9%). Respondents began using marijuana at age 15.9 (SD 2.5), cocaine or crack at 19.7 (SD 3.3), and heroin at 20.9 (SD 5.5).Engagement in RxStim NMU via a non-oral route of administration is most often preceded by marijuana use. Among this Reddit-recruited population of non-oral RxStim nonmedical users, only 1 in 4 reported an ADHD diagnosis and <1 in 5 reported RxStim NMU as their first substance use experience; most of these then added marijuana and few moved toward cocaine/crack or methamphetamine. RxStim NMU via non-oral routes is associated with a larger pattern of risky substance use behaviors. Nearly all non-oral RxStim NMU is associated with concomitant drug use, especially marijuana.Funding. Arbor Pharmaceuticals, LLC.

Do Hallucinogens Have a Role in the Treatment of Addictions? A Review of the Current Literature

The utility of hallucinogenic drugs within psychiatry is an emerging topic, although not entirely a novel idea. After their introduction to western society in the mid-twentieth century, psychologists and psychiatrists studied their properties for use as adjunctive therapy in the treatment of psychiatric illness. Unfortunately, their classification as Schedule 1 drugs by the Drug Enforcement Administration in the 1970s put an end to this research. In the past decade, however, interest in hallucinogens has been reignited. The psychiatric community has begun to reinvestigate their role in mental health treatment, with addiction being one focus. Though there is a growing pool of research surrounding the use of hallucinogens in addiction treatment, there have been few reviews focusing on this topic. This paper will serve to summarize this data, focusing specifically on the following hallucinogenic agents: lysergic acid diethylamide, psilocybin, ketamine, ibogaine, and ayahuasca. It will review both the basic pharmacology of each of these chemicals and studies assessing their use in treating various addictions including alcoholism, nicotine addiction, opioid use disorder, and cocaine use disorder. Though more robust research is needed before use of these drugs can be effectively adopted into clinical practice, the current data is promising and suggests the potential for a new and unique avenue for the treatment of addiction.

Time-trends in cocaine, hallucinogen, amphetamine, and sedative/anxiolytic/hypnotic use disorder hospitalizations in rheumatic diseases: a national time-trends study.

Musculoskeletal diseases (MSDs) are common in the general population, frequently associated with pain, functional limitation, and reduction in quality of life. Similarly, drug/substance use disorders are common in the general population. Recently, opioid drug use disorder has gained a lot of attention as a public health problem. To our knowledge, limited data exist regarding the non-opioid drug/substance use disorders in musculoskeletal diseases. This study's objective was to examine the frequency and rates of common drug/substance use disorder hospitalizations in five MSDs, namely gout, osteoarthritis, fibromyalgia, rheumatoid arthritis, and low back pain. This was achieved by using the diagnostic codes for cocaine, hallucinogen, amphetamine, or ASH use disorder hospitalization in five MSDs in the US National Inpatient Sample from 1998 to 2014. Cocaine, hallucinogen, amphetamine, or ASH use disorder hospitalizations per 1 million NIS total hospitalizations for five MSDs in 2013-2014 were as follows, respectively: gout, 10.2, 0.1, 2.8, and 1.5; osteoarthritis, 21.4, 0.4, 5.9, and 7.7; fibromyalgia, 5.5, 0.1, 2.0, and 2.3; rheumatoid arthritis, 8.7, 0.4, 4.5, and 7.7, and low back pain, 16.2, 0.5, 7.3, and 7.5. The frequency and the rate of each drug use disorder hospitalization increased in each of the five MSDs from 1998 to 2014. Key Points • Cocaine or hallucinogen use disorder hospitalization rates increased several-fold in people with MSDs from 1998 to 2014. • Amphetamine and anxiolytic, sedative, or hypnotic (ASH) use disorder hospitalization rates increased 9- to 23-fold vs. 4- to 7-fold, respectively, in people with common MSDs in the USA from 1998 to 2014.