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CORK Bibliography: Hallucinogens

81 citations. January 2010 to present

Prepared: September 2012

Ahern NR; Greenberg CS. Psychoactive herb use and youth: A closer look at salvia divinorum. Journal of Psychosocial Nursing and Mental Health Services 49(8): 16-19, 2011. (21 refs.)

Salvia divinorum is a psychoactive herb and an increasingly popular recreational drug used by young people in our country and abroad. Much of its increased popularity stems from its easy accessibility and affordability; its effects produce an intense and potent "high" and concomitant disorientation and hallucinations. The risks associated with Salvia are poorly defined due to a lack of scientific evidence, leaving Salvia users with false assurances about its safety. Although its safety profile is ill defined, its intense effects are well known and can put young people at risk for injuries and serious errors in judgment. Psychiatric nurses and health care practitioners are in key positions to influence practice, education, and policy regarding the use and abuse of this drug by youth.

Copyright 2011, Slack

[Anon]. Cancer and hallucinogens: A long, strange trip. (editorial). Lancet Oncology 11(7): 603-603, 2010. (0 refs.)

Baggott MJ; Coyle JR; Erowid E; Erowid F; Robertson LC. Abnormal visual experiences in individuals with histories of hallucinogen use: A web-based questionnaire. Drug and Alcohol Dependence 114(1): 61-67, 2011. (43 refs.)

Despite longstanding reports of prolonged or reoccurring perceptual changes in a subset of hallucinogen users, very little is known about Hallucinogen Persisting Perception Disorder and related visual abnormalities in hallucinogen users. We used an online questionnaire to document the symptoms and relationship to drug use of unusual visual phenomena in hallucinogen users. 16,192 individuals viewed the information sheet and 2679 were included in the study. Of these, 224 reported having unrelated diagnoses associated with unusual visual experiences and were excluded from main analyses. Most (60.6%) of the remaining 2455 participants reported having experienced drug-free visual experiences that resembled hallucinogen effects. Probability of experiencing constant or near-constant symptoms was predicted by greater past exposure to specific hallucinogens, including lysergic acid diethylamide (LSD). Although symptoms were common, few (104, or 4.2% of the sample) found them distressing or impairing enough to consider seeking treatment. Visual changes in hallucinogen users may be more common than previously suspected and are worthy of further study.

Copyright 2011, Elsevier Science

Baggott MJ; Erowid E; Erowid F; Galloway GP; Mendelson J. Use patterns and self-reported effects of Salvia divinorum: An internet-based survey. Drug and Alcohol Dependence 111(3): 250-256, 2010. (67 refs.)

Background: There is growing use of Salvia divinorum (SD) a psychoactive plant that produces hallucinogen-like effects through a kappa opioid receptor (KOR) mechanism. Little is known about KOR agonist effects in humans and about users of SD Objectives To characterize the reasons methods and reported consequences of SD use. Methods: Individuals reading SD-related pages of a drug-information website were invited to anonymously complete an online questionnaire if they had used SD. Results: Participants (N=500) were 92 6% male and 23 4 +/- 8 7 (mean +/- s d) years old They had used a median of six times (range 1-250) 80 6% probably or definitely would use SD again Most participants (92 6%) typically smoked or vaporized SD product When smoked the drug s main effects were estimated to last 14 1 +/- 12 8 (range 0 5-120) minutes When asked to compare SD effects to other methods of altering consciousness the most common answer was that SD was unique (38 4%) 25 8% reported persisting (>= 24 h) positive effects (often described as increased sense of well-being) on at least one occasion 4 4% reported persisting negative effects (most often anxiety). Conclusions: SD is typically smoked, acute effects are brief, and persistent adverse effects are uncommon. In addition to acute hallucinogenic effects SD may produce subacute increases in subjective well-being. Such a subacute effect would be unusual for a drug that is used non-medically as withdrawal from other drugs typically either does not affect mood or causes dysphoria. Findings from this convenience sample should be confirmed and extended using surveys of random samples and controlled clinical studies.

Copyright 2010, Elsevier Science

Baggott MJ; Siegrist JD; Galloway GP; Robertson LC; Coyle JR; Mendelson JE. Investigating the mechanisms of hallucinogen-induced visions using 3,4-methylenedioxyamphetamine (MDA): A randomized controlled trial in humans. PLoS ONE 5(11): e-article 14074, 2010. (122 refs.)

Background: The mechanisms of drug-induced visions are poorly understood. Very few serotonergic hallucinogens have been studied in humans in decades, despite widespread use of these drugs and potential relevance of their mechanisms to hallucinations occurring in psychiatric and neurological disorders. Methodology/Principal Findings: We investigated the mechanisms of hallucinogen-induced visions by measuring the visual and perceptual effects of the hallucinogenic serotonin 5-HT2AR receptor agonist and monoamine releaser, 3,4-methylenedioxyamphetamine (MDA), in a double-blind placebo-controlled study. We found that MDA increased self-report measures of mystical-type experience and other hallucinogen-like effects, including reported visual alterations. MDA produced a significant increase in closed-eye visions (CEVs), with considerable individual variation. Magnitude of CEVs after MDA was associated with lower performance on measures of contour integration and object recognition. Conclusions/Significance: Drug-induced visions may have greater intensity in people with poor sensory or perceptual processing, suggesting common mechanisms with other hallucinatory syndromes. MDA is a potential tool to investigate mystical experiences and visual perception.

Copyright 2010, Public Library of Science

Berchtold A; Jeannin A; Akre C; Michaud PA; Suris JC. First use of multiple substances: Identification of meaningful patterns. Journal of Substance Use 15(2): 118-130, 2010. (57 refs.)

Context: Understanding the process through which adolescents and young adults are trying legal and illegal substances is a crucial point for the development of tailored prevention and treatment programs. However, patterns of substance first use can be very complex when multiple substances are considered, requiring reduction into a few meaningful number of categories. Data: We used data from a survey on adolescent and young adult health conducted in 2002 in Switzerland. Answers from 2212 subjects aged 19 and 20 were included. The first consumption ever of 10 substances (tobacco, cannabis, medicine to get high, sniff (volatile substances, and inhalants), ecstasy, GHB, LSD, cocaine, methadone, and heroin) was considered for a grand total of 516 different patterns. Methods: In a first step, automatic clustering was used to decrease the number of patterns to 50. Then, two groups of substance use experts, three social field workers, and three toxicologists and health professionals, were asked to reduce them into a maximum of 10 meaningful categories. Results: Classifications obtained through our methodology are of practical interest by revealing associations invisible to purely automatic algorithms. The article includes a detailed analysis of both final classifications, and a discussion on the advantages and limitations of our approach.

Copyright 2010, Informa Healthcare

Berrens Z; Lammers J; White C. Rhabdomyolysis after LSD ingestion. Psychosomatics 51(4): 356-U130, 2010. (20 refs.)

Background: Rhabdomyolysis involves the release of intracellular contents secondary to muscle cell injury; it generally presents with muscle pain and weakness. Illicit drugs, including phencyclidine, MDMA ("ecstasy"), and cocaine, are frequently documented as a cause of rhabdomyolysis. Objective: The authors review the literature on LSD-associated rhabdomyolysis. Method: The authors provide a new case report of a previously health patient who suffered rhabdomyolysis after LSD ingestion. Results: Although frequently listed as a cause of rhabdomyolysis, there are only limited reports of rhabdomyolysis in patients who have ingested LSD. Discussion: The discussion outlines potential mechanisms and management of LSD-associated rhabdomyolysis. Consultation psychiatrists may be called to assist in management of acute mental-status changes or agitation associated with LSD intoxication in addition to facilitating subsequent chemical-dependency treatment.

Copyright 2010, American Psychiatric Association

Blackford MG; Fitzgibbon JJ; Reed MD. Assessment of serum creatine kinase among adolescent patients following jimsonweed (Datura stramonium) and moonflower (Datura inoxia) ingestions: A review of 11 cases. (review). Clinical Toxicology 48(5): 431-434, 2010. (10 refs.)

Introduction. Datura stramonium (DS) (jimsonweed) is well known for its abuse potential for hallucinogenic effects and Datura inoxia (DI) (moonflower) has been abused for similar effects. To our knowledge, only one case report describes rhabdomyolysis in association with DS or DI ingestion. Case identification and details. Patient hospital charts were retrospectively screened from January 1, 2002 to December 31, 2007 to identify patients with qualifying ICD-9 codes for toxic plant ingestions. We report on 11 patient cases of DS/DI ingestions in which serum creatine kinase (CK) concentrations were monitored. These admissions occurred at our hospital over a 6-year period. Serum CK concentrations ranged from 72 to 70,230 U/L. Only three patients had serum CK concentrations greater than 1,000 U/L. One patient with a peak concentration of 70,230 U/L and a positive myoglobinuria was diagnosed with rhabdomyolysis. Discussion. Based on our review of the literature and these cases, it is possible that serum CK concentrations may be elevated more frequently than previously realized. The clinical significance of this abnormal laboratory value is uncertain with the majority of patients remaining asymptomatic without any clinical evidence of rhabdomyolysis.

Copyright 2010, Informa Healthcare

Boleda MR; Huerta-Fontela M; Ventura F; Galceran MT. Evaluation of the presence of drugs of abuse in tap waters. Chemosphere 84(11): 1601-1607, 2011. (44 refs.)

A total of seventy samples of drinking water were tested for non-controlled and illicit drugs. Of these, 43 were from Spanish cities, 15 from seven other European countries, three from Japan and nine from seven different Latin American countries. The most frequently detected compounds were caffeine, nicotine, cotinine, cocaine and its metabolite benzoylecgonine, methadone and its metabolite EDDP. The mean concentrations of non-controlled drugs were: for caffeine 50 and 19 ng L(-1), in Spanish and worldwide drinking water respectively and for nicotine 13 and 19 ng L. Illicit drugs were sparsely present and usually at ultratrace level (<1 ng L(-1)). For example, cocaine has mean values of 0.4 (Spain) and 0.3 ng L(-1) (worldwide), whereas for benzoylecgonine, these mean values were 0.4 and 1.8 ng L(-1), respectively. Higher concentrations of benzoylecgonine were found in Latin American samples (up to 15 ng L(-1)). No opiates were identified in any sample but the presence of methadone and EDDP was frequently detected. Total mean values for EDDP were 0.4 ng L(-1) (Spain) and 0.3 ng L(-1) (worldwide). Very few samples tested positive for amphetamines, in line with the reactivity of chlorine with these compounds. No cannabinoids, LSD, ketamine, fentanyl and PCP were detected.

Copyright 2011, Elsevier Science

Breton JJ; Huynh C; Raymond S; Labelle R; Bonnet N; Cohen D et al. Prolonged hallucinations and dissociative self mutilation following use of Salvia divinorum in a bipolar adolescent girl. Journal of Substance Use 15(2): 113-117, 2010. (12 refs.)

The case of a bipolar 17-year-old girl who developed prolonged vivid hallucinations and a dissociative state involving self-destructive behaviour following the use of Salvia divinorum is presented. The herb has mostly short-term (10-15 min) hallucinogenic properties. Salvatorin A, the main active compound, is a highly selective agonist of the kappa-opioid receptor. The plant is available at tobacco or other specialized stores in many countries such as France, UK, Canada, and USA, where it is legal. The clinical case reported in this article suggests that the recreational use of Salvia divinorum may result in serious psychiatric consequences in vulnerable individuals.

Copyright 2010, Informa Healthcare

Bruno R; Matthews AJ; Dunn M; Alati R; Mcllwraith F; Hickey S et al. Emerging psychoactive substance use among regular ecstasy users in Australia. Drug and Alcohol Dependence 124(1-2): 19-25, 2012. (42 refs.)

Background: The past decade has seen the development of an array of emerging psychoactive substances (EPS), however, there is minimal information on the extent of their use outside Europe. This study aimed to determine the extent of use of EPS from stimulant (such as mephedrone) and psychedelic classes (such as 5-methoxy-dimethyltryptamine [5-MeO-DMT]) among an Australian sample of regular ecstasy users (REU). Further, to determine if consumers of these drugs represent a distinct subgroup of REU. Methods: Australian national cross-sectional surveys of 693 regular (at least monthly) ecstasy users conducted during 2010. Results: More than one quarter (28%) of REU had used an EPS in the past six months, most commonly from the stimulant class (20%, typically mephedrone, 17%) rather than the psychedelic class (13%). Demographics and risk behaviours of REU that used stimulant EPS were largely no different from non-EPS consuming REU. Those using psychedelic EPS were distinct, initiating ecstasy use earlier, more frequently using multiple substances (cannabis, inhalants, GHB, ketamine) and more commonly experiencing legal, psychological and social problems. Conclusions: Psychedelic EPS use appears largely restricted to a distinct subset of REU with high-level non-injecting polydrug use, but use appears generally limited. The demographic similarity of stimulant EPS consumers with 'mainstream' REU, in conjunction with positive responses to the psychoactive effects of these drugs and declining ecstasy purity, suggests strong potential for stimulant EPS to expand further into ecstasy markets. Such drugs may have a greater public health impact than ecstasy, and merit careful monitoring into the future.

Copyright 2012, Elsevier Science

Butelman ER; Caspers M; Lovell KM; Kreek MJ; Prisinzano TE. Behavioral effects and central nervous system levels of the broadly available kappa-agonist hallucinogen Salvinorin A Are Affected by P-Glycoprotein Modulation In Vivo. Journal of Pharmacology and Experimental Therapeutics 341(3): 802-808, 2012. (39 refs.)

Active blood-brain barrier mechanisms, such as the major efflux transporter P-glycoprotein (mdr1), modulate the in vivo/central nervous system (CNS) effects of many pharmacological agents, whether they are used for nonmedical reasons or in pharmacotherapy. The powerful, widely available hallucinogen salvinorin A (from the plant Salvia divinorum) is a high-efficacy, selective kappa-opioid agonist and displays fast-onset behavioral effects (e. g., within 1 min of administration) and relatively short duration of action. In vitro studies suggest that salvinorin A may be a P-glycoprotein substrate; thus, the functional status of P-glycoprotein may influence the behavioral effects of salvinorin A or its residence in CNS after parenteral administration. We therefore studied whether a competing P-glycoprotein substrate (the clinically available agent loperamide; 0.032-0.32 mg/kg) or a selective P-glycoprotein blocker, tariquidar (0.32-3.2 mg/kg) could enhance unconditioned behavioral effects (ptosis and facial relaxation, known to be caused by kappa-agonists in nonhuman primates) of salvinorin A, as well as its entry and residence in the CNS, as measured by cerebrospinal fluid sampling. Pretreatment with either loperamide or tariquidar dose-dependently enhanced salvinorin A-induced ptosis, but not facial relaxation. In a control study, loperamide and tariquidar were inactive when given as a pretreatment to ((+)-(5 alpha,7 alpha,8 beta)-N-methyl-N-[7-(1-pyrrolidinyl)-1-oxaspiro[4.5]dec-8-yl]-benzeneacetamide (U69,593), a kappa-agonist known to be a very poor P-glycoprotein substrate. Furthermore, pretreatment with tariquidar (3.2 mg/kg) also enhanced peak levels of salvinorin A in cerebrospinal fluid after intravenous administration. These are the first studies in vivo showing the sensitivity of salvinorin A effects to modulation by the P-glycoprotein transporter, a major functional component of the blood-brain barrier.

Copyright 2012, American Society of Pharmacology and Experimental Therapeutics

Cakic V; Potkonyak J; Marshall A. Dimethyltryptamine (DMT): Subjective effects and patterns of use among Australian recreational users. Drug and Alcohol Dependence 111(1-2): 30-37, 2010. (58 refs.)

Dimethyltryptamine (DMT) is an endogenous hallucinogen with traditional use as a sacrament in the orally active preparation of ayahuasca. Although the religious use of ayahuasca has been examined extensively, very little is known about the recreational use of DMT. In this study, Australian participants (n = 121) reporting at least one lifetime use of DMT completed an online questionnaire recording patterns of use, subjective effects and attitudes towards their DMT use. Smoking DMT was by far the most common route of administration (98.3%) with a comparatively smaller proportion reporting use of ayahuasca (30.6%). The reasons for first trying DMT were out of a general interest in hallucinogenic drugs (46.6%) or curiosity about DMT's effects (41.7%), while almost one-third (31.1%) cited possible psychotherapeutic benefits of the drug. An increase in psychospiritual insight was the most commonly reported positive effect of both smoked DMT (75.5%) and ayahuasca (46.7%), a finding that is consistent with other studies examining the ritualised use of ayahuasca in a religious context. Although previous studies of DMT use have examined ayahuasca use exclusively, the present study demonstrates the ubiquity of smoking as the most prevalent route of administration among recreational DMT users.

Copyright 2010, Elsevier Sciences

Carhart-Harris RL; Nutt DJ. User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study. Journal of Substance Use 15(4): 283-300, 2010. (32 refs.)

This study used a web-based questionnaire to investigate user perceptions of the benefits and harms of hallucinogenic drug use. Over 600 forms were submitted. Users were asked to comment on the acute and prolonged effects of different drugs and to provide more specific information on how particular drugs have harmed and/or helped them. Subjects reported relatively less harm associated with the classic hallucinogens, LSD and psilocybin, than other drugs specifically focused on in the questionnaire (MDMA, cannabis, ketamine and alcohol). A wide-range of benefits was reported, including: help with mood disorders, addictions and migraine as well as more general long-term improvements in wellbeing. Symptoms of hallucinogen persisting perceptual disorder were reported by a number of subjects and these were most closely associated with use of LSD; however, few users regarded these effects as troubling. Eighty-one per cent of users reported having had a 'spiritual experience' on a hallucinogenic drug and over 90% considered 'access to the unconscious mind' to be a specific property of the classic hallucinogens. With caution, these findings support recent calls for a systematic investigation of the therapeutic potential of the classic hallucinogens and highlight the scope for empirical investigations of spiritual and psychodynamic phenomena.

Copyright 2010, Informa Healthcare

Caudevilla-Galligo F; Riba J; Ventura M; Gonzalez D; Farre M; Barbanoj MJ; Bouso JC. 4-Bromo-2, 5-dimethoxyphenethylamine (2C-B): Presence in the recreational drug market in Spain, pattern of use and subjective effects. Journal of Psychopharmacology 26(7): 1026-1035, 2012. (63 refs.)

4-Bromo-2, 5-dimethoxyphenethylamine (2C-B) is a psychoactive analogue of mescaline that is becoming increasingly popular as a rave and club drug. We investigated its presence in the illicit drug market in Spain, its pattern of use and profile of subjective effects. Drug material was analysed for 2C-B and information on pattern of use and subjective effects was obtained from recreational users. Scores were statistically compared with previously collected data on psychostimulants (d-amphetamine), entactogens (MDMA) and psychedelics (ayahuasca and Salvia divinorum). The percentage of samples containing 2C-B doubled between 2006 and 2009, evolved from powder to tablet form and showed low falsification rates. Respondents reported taking 2C-B orally in doses of about 20 mg. Subjective effects involved perceptual modifications analogous to those observed after ayahuasca and salvia but absent after amphetamine and MDMA. Pleasure and sociability effects did not differ from those after MDMA and incapacitation was lower than for the psychedelics used as comparators. In conclusion, we found 2C-B is consistently present in the illicit drug market in Spain. While it elicits perceptual modifications that are analogous to other psychedelics, the lower impairment and higher pleasurable effects make it comparable with entactogens.

Copyright 2012, Sage Publications

Cruz SL; Dominguez M. Misusing volatile substances for their hallucinatory effects: A qualitative pilot study with Mexican teenagers and a pharmacological discussion of their hallucinations. Substance Use & Misuse 46(Supplement 1): 84-94, 2011. (41 refs.)

This work describes the solvent-induced hallucinatory experiences of 10 male and seven female teenagers in Mexico City from 1998 to 2000. The youth were recruited from public schools through a combined snowball and convenience sampling procedure. Inclusion criteria were: 13-18 years of age, school attendance, living with family, and weekly toluene-based solvent misuse. Interested students were interviewed and transcripts were analyzed. Hallucinations and illusions were common, including changes in color perception, visual, somatic, auditory, and tactile hallucinations. Some users described their hallucinatory experience as being able to be shared by a group and modulated by their environment. The pharmacological linkages with hallucinations are discussed. The study's limitations are noted.

Copyright 2011, Informa Healthcare

Davstad I; Allebeck P; Leifman A; Stenbacka M; Romelsjo A. Self-reported drug use and mortality among a nationwide sample of Swedish conscripts: A 35-year follow-up. Drug and Alcohol Dependence 118(2-3): 383-390, 2011. (59 refs.)

Background: Drug users in clinical samples have elevated mortality compared with the general population, but little is known about mortality among users of drugs within the general population. Aim: To determine whether self-reported use of illicit drugs and non-prescribed sedatives/hypnotics among young men in the general population is related to mortality. Methods: A 35-year follow-up of 48 024 Swedish men, born 1949-1951 and conscripted in 1969/1970, among whom drug use was reported by 8767 subjects. Cross-record linkage was effected between individual data from the Swedish conscription and other national registers. Deaths and causes of death/1000 person-years were calculated. Cox PH regression was used to estimate hazard ratios (HRs) for death with 95% confidence intervals (95% CIs). An HR was calculated for users of different dominant drugs at conscription compared with non-users by age interval, after adjusting for confounders and hospitalisation with a drug-related diagnosis. Results: Drug users showed elevated mortality (HR 1.61, p < 0.05) compared with non-users. After adjusting for risk factors, users of stimulants (HR 4.41, p < 0.05), cannabis (HR 4.27, p < 0.05), opioids (HR 2.83, p > 0.05), hallucinogens (HR 3.88, p < 0.05) and unspecified drugs (HR 4.62, p < 0.05) at conscription with a drug-related diagnosis during follow-up showed an HR approaching the standard mortality ratios in clinical samples. Among other drug users (95.5%), only stimulant users showed statistically significantly increased mortality (HR 1.96, p < 0.05). Conclusions: In a life-time perspective, drug use among young men in the general population was a marker of premature death, even a long time after exposure.

Copyright 2011, Elsevier Science

Diaz JL. Sacred plants and visionary consciousness. Phenomenology and the Cognitive Sciences 9(2): 159-170, 2010. (25 refs.)

Botanical preparations used by shamans in rituals for divination, prophecy, and ecstasy contain widely different psychoactive compounds, which are incorrectly classified under a single denomination such as "hallucinogens," "psychedelics," or "entheogens." Based on extensive ethnopharmacological search, I proposed a psychopharmacological classification of magic plants in 1979. This paper re-evaluates this taxonomy in the context of consciousness research. Several groups of psychodysleptic magic plants are proposed: (1) hallucinogens-psilocybin mushrooms, mescaline cacti, dimethyltryptamine snuffs, and the synthetic ergoline lysergic acid diethylamide induce strong perceptual changes, affective intensification, and cognitive enhancement. Their ethnobotanical uses include long lasting divination rituals, prophecy, and sacramental practice. (2) Trance-inducers-ergoline Convolvulaceae and South American Banisteriopsis produce quietness, abstraction, lethargy, mild sensorial and cognitive changes, and salient visual imagery changes used in trance rituals and specific divination practices. (3) Cognodysleptics-marijuana (tetrahydrocannabinol) and other terpene-containing plants induce changes in thought, imagination, and affective functions and are used in short-term divination or oneiromancy. (4) Deliriants-tropane-containing Solanaceae, wild tobacco, and Amanita muscaria (muscimol) induce a delirium characterized by dim and clouded consciousness, stupor, confusion, disorientation, perception distortion, difficulties in recollection, anxiety, irritability, excitation, and behavioral disorganization employed in sorcery, purification, or exorcism rituals. The core mental effects required for a drug to be used in shamanistic rituals include light-headedness, enhanced imagery, and experience intensification. This constellation was the reason why, in his classification of psychoactive compounds, the pioneer German psychopharmacologist Louis Lewin established in 1924 a group of drugs under the appropriate name of Phantastica.

Copyright 2010, Springer

Dowse MS; Shaw S; Cridge C; Smerdon G. The use of drugs by UK recreational divers: Illicit drugs. Diving and Hyperbaric Medicine 41(1): 9-15, 2011. (24 refs.)

Aims: Anecdotal observations suggest the use of illicit drugs takes place amongst recreational divers but, to date, there has been little open debate within the diving community concerning possible prevalence. This study investigated the prevalence and type of illicit drugs used by recreational divers in the United Kingdom (UK). Methods: Anonymous questionnaires were circulated via UK dive clubs, dive schools, dive shows and conferences. Questions incorporated diver and diving demographics and general health, which included anxiety, depression and panic attacks, alcohol use, smoking and illicit drug use since learning to dive and closest time to a dive. Questions pertaining to over-the-counter and prescription drug use were also asked. Results: 479 divers responded (66% males and 34% females) in the age range 16 to 59 years. Of the respondents, 22% had used one or more illicit drug since learning to dive, reporting benzodiazepines, amphetamines, cocaine, ecstasy, LSD, cannabis, heroin, and 'magic mushrooms'. Illicit drugs had been used by 3.5% of respondents in the last 12 months, and 3% in the last month. Cannabis, cocaine and ecstasy use was reported within 6 hours of a dive. Logistic regression confirmed a relationship between illicit drug use and depression (P = 0.014), and also between illicit drug use and anxiety (P = 0.024). Conclusion: These data support anecdotal reports that recreational divers use a range of illicit drugs. The significant relationship between illicit drug use and depression and anxiety supports the literature in non-diving populations.

Copyright 2011, South Pacific Underwater Medical Society

Ettner SL; French MT; Popovici I. Heavy drinking and health promotion activities. Social Science & Medicine 71(1): 134-142, 2010. (54 refs.)

Empirical evidence suggests that individuals who consume relatively large amounts of alcohol are more likely to use expensive acute medical care and less likely to use preventive or ambulatory services than other individuals. The few studies that investigated the associations between heavy drinking and health promotion activities did not try to address omitted-variable biases that may confound the relationships. To fill this void in the literature, we examined the effects of heavy alcohol use on three health promotion activities (routine physical exam, flu shot, regular seatbelt use) using the US 2006 Behavioral Risk Factor Surveillance Survey. Although specification tests indicated that omitted variable bias was not present in the majority of the single-equation probit models, we cautiously interpret our findings as evidence of strong associations rather than causal effects. Among both men and women, heavy alcohol use is negatively and significantly associated with each of our three outcomes. These findings suggest that heavy drinkers may be investing less in health promotion activities relative to abstainers and other drinkers. Policy options to address the associated externalities may be warranted.

Copyright 2010, Elsevier Science

Fabregas JM; Gonzalez D; Fondevila S; Cutchet M; Fernandez X; Barbosa PCR et al. Assessment of addiction severity among ritual users of ayahuasca. Drug and Alcohol Dependence 111(3): 257-261, 2010. (25 refs.)

Ayahuasca is a psychoactive beverage used for magico-religious purposes in the Amazon. Recently, Brazilian syncretic churches have helped spread the ritual use of ayahuasca abroad. This trend has raised concerns that regular use of this N N-dimethyltryptamine-containing tea may lead to the medical and psychosocial problems typically associated with drugs of abuse Here we assess potential drug abuse-related problems in regular ayahuasca users Addiction severity was assessed using the Addiction Severity Index (ASI) and history of alcohol and illicit drug use was recorded In Study 1 Jungle-based ayahuasca users (n = 56) were compared vs rural controls (n = 56) In Study 2 urban-based ayahuasca users (n = 71) were compared vs urban controls (n = 59). Follow-up studies were conducted 1 year later In both studies ayahuasca users showed significantly lower scores than controls on the ASI Alcohol Use and Psychiatric Status subscales. The Jungle-based ayahuasca users showed a significantly higher frequency of previous illicit drug use but this had ceased at the time of examination except for cannabis At follow-up abstinence from illicit drug use was maintained in both groups except for cannabis in Study 1. However differences on ASI scores were still significant in the Jungle-based group but not in the urban group. Despite continuing ayahuasca use a time-dependent worsening was only observed in one subscale (Family/Social relationships) in Study 2 vet all the ritual use of ayahuasca as assessed with the ASI in currently active users does not appear to be associated with the deleterious psychosocial effects typically caused by other drugs of abuse.

Copyright 2010, Elsevier Science

Fahmy V; Hatch SL; Hotopf M; Stewart R. Prevalences of illicit drug use in people aged 50 years and over from two surveys. Age and Ageing 41(4): 553-556, 2012. (15 refs.)

Objectives: to quantify illicit drug use in people aged 50 years and over in England and inner London and to compare this between 50 and 64 and 65+ age groups. Methods: primary analyses used data from the 2007 Adult Psychiatric Morbidity Survey (APMS) and the 2008-10 South East London Community Health (SELCoH) Survey. Secondary analyses included additional data on 50-64 year olds from the 1993, 2000 and 2007 APMS, and on 65-74 year olds from the 2000 and 2007 APMS. Results: cannabis was the drug most commonly used in all samples. Prevalences of use within the last 12 months in 50-64 and 65+ age groups were 1.8 and 0.4%, respectively, in England and 9.0 and 1.1%, respectively, in inner London. Prevalences of use at any time previously were 11.4, 1.7, 42.8 and 9.4%, respectively. Lifetime cannabis, amphetamine, cocaine and LSD use in 50-64 year olds had increased approximately tenfold in England from 1993. Lifetime and 12-month trends in tranquilisers were relatively stable. Conclusions: use of some illicit drugs, particularly cannabis, has increased rapidly in mid- and late-life.

Copyright 2012, Oxford University Press

Falck RS; Nahhas RW; Li LN; Carlson RG. Surveying teens in school to assess the prevalence of problematic drug use. Journal of School Health 82(5): 217-224, 2012. (34 refs.)

Background: Illicit drug use by school-aged teens can adversely affect their health and academic achievement. This study used a survey administered in schools to assess the prevalence of problematic drug use among teenagers in a Midwestern community. Methods: Self-report data were collected from 11th- and 12th-grade students (N = 3974) in 16 school districts in the Dayton, Ohio, area. Students responded to a drug use survey that also included CRAFFT, a brief substance abuse screening instrument. Binomial and zero-inflated Poisson regressions were used to examine the association between CRAFFT scores and drug use practices, including abstinence. RESULTS: More than one third of students had CRAFFT scores suggestive of problematic use. Of these, 14.1% had scores suggesting drug dependence. Although alcohol, marijuana, and tobacco were the drugs most commonly used, an array of other drugs including opioids, benzodiazepines, stimulants, hallucinogens, and dextromethorphan were also commonly used. Higher CRAFFT scores were associated with a greater number of drugs used (p < .0001). Proportionately more 12th graders than 11th graders had CRAFFT scores indicating problems (p < .0001). Among 12th graders, boys were more likely than girls to have CRAFFT scores indicating dependence (p = .01). Conclusions: The results suggest that problematic drug use among high school students is more prevalent than has been recognized previously. CRAFFT can be used easily to assess the prevalence of problematic drug use among teenagers in school settings. CRAFFT results can also inform prevention and intervention activities, particularly if the CRAFFT instrument is paired with a drug use survey.

Copyright 2012, Wiley-Blackwell

Feeney K. Revisiting Wasson's Soma: Exploring the effects of preparation on the chemistry of amanita muscaria. Journal of Psychoactive Drugs 42(4): 499-506, 2010. (39 refs.)

In 1968 R. Gordon Wasson first proposed his groundbreaking theory identifying Soma, the hallucinogenic sacrament of the Vedas, as the Amanita muscaria mushroom. While Wasson's theory has garnered acclaim, it is not without its faults. One omission in Wasson's theory is his failure to explain how pressing and filtering Soma, as described in the Rig Veda, supports his theory of Soma's identity. Several critics have reasoned that such preparation should be unnecessary if equivalent results can be obtained by consuming the raw plant, as is done with other psychoactive mushrooms. In order to address these specific criticisms over 600 anecdotal accounts of Amanita muscaria inebriation were collected and analyzed to determine the impact of preparation on Amanita muscaria's effects. The findings of this study demonstrated that the effects of Amanita muscaria were related to the type of preparation employed, and that its toxic effects were considerably reduced by preparations that paralleled those described for Soma in the Rig Veda. While unlikely to end debate over the identity of Soma, this study's findings help to solidify the foundation of Wasson's theory, and also to demonstrate the importance of preparation in understanding and uncovering the true identity of Soma.

Copyright 2010, Haight-Ashbury

Floyd LJ; Alexandre PK; Hedden SL; Lawson AL; Latimer WW; Giles N. Adolescent drug dealing and race/ethnicity: A population-based study of the differential impact of substance use on involvement in drug trade. American Journal of Drug and Alcohol Abuse 36(2): 87-91, 2010. (26 refs.)

Background: Among adolescents, peers are an important source of drug procurement. However, little is known about factors associated with youths' involvement in drug trade. Objectives: The aim of the study is to identify substance use behaviors and contextual factors related to drug dealing among Black and White adolescents. Methods: The sample consisted of 13,706 White and Black youths who completed the National Survey on Drug Use and Health. Separate backward logistic regression was used to identify substance use behaviors and contextual factors associated with drug dealing among Black and White youths. Results: Among White youths, drug dealing was associated with use of marijuana, hallucinogens, cocaine, prescription drug misuse, availability of cocaine, and socioeconomic status (SES). Among Black youths, marijuana use and availability of crack and marijuana were associated with drug dealing. Conclusions and Scientific Significance: For White youths, substance use seems to be more relevant to drug dealing. Consequently, preventing and treating substance abuse may reduce involvement in the illegal distribution of drugs among White youths. More research is needed to identify risk and protective factors for drug dealing among Black adolescents.

Copyright 2010, Taylor & Francis

Fort E; Massardier-Pilonchery A; Facy F; Bergeret A. Prevalence of drug use in French seamen. Addictive Behaviors 37(3): 335-338, 2012. (22 refs.)

The main objective of the present study is to determine the prevalence of lifetime use and use in the past 30 days of narcotics in French seamen and to assess factors correlated with positive urine test in seamen as a whole. A stratified survey conducted in 19 French ports collected 1, 928 self-administered questionnaires on cigarette, alcohol and narcotics consumption. Seafarers were randomly selected and interviewed during their annual seafaring aptitude consultation. Only the 1847 male respondents were included in analysis. Nearly half of the seamen had tried cannabis at some point in their life, and 16% were users in the past 30 days. Lifetime use of certain other illegal drugs (cocaine, heroin, hallucinogenic mushrooms, poppers and ecstasy) was non-negligible, but cocaine and heroin were the only ones showing exceptional prevalence of consumption over the previous 30 days. Lifetime use of drugs was non-negligible among seamen. Prevalence of recent cannabis use was elevated. Recent consumption as indicated by positive urine test correlated with age group, family situation, occupational category, geographical area, young age of first alcohol consumption and experimentation with other drugs.

Copyright 2012, Elsevier Science

Glausser W. Cultural Encyclopedia of LSD. New York: McFarland, 2011

This is an encyclopedia with over 400 entries. It covers the discovery of LSD by Albert Hoffman, when he accidentally absorbed a small quantity through his fingertips. It covers early the early scientific studies and its emergence into the popular culture in the 1960s. The entries document the influence of LSD on diverse aspects of culture, from psychiatry, to religion, philosophy, arts, entertainment and sports, to commerce, science, politics and espionage. Coverage concentrates on the peak period of 1965 to 1969, but in addition to LSD's early years also discusses later influences.

Copyright 2012, Project Cork

Gomes MM; Dorr FA; Catalani LH; Campa A. Oxidation of lysergic acid diethylamide (LSD) by peroxidases: A new metabolic pathway. Forensic Toxicology 30(2): 87-97, 2012. (41 refs.)

Lysergic acid diethylamide (LSD) is a potent hallucinogen that is primarily metabolized to 2-oxo-3-hydroxy-LSD (O-H-LSD) and N-desmethyl-LSD (nor-LSD) by cytochrome P450 complex liver enzymes. Due to its extensive metabolism, there still is an interest in the identification of new metabolites and new routes of its metabolism in humans. In the present study, we investigated whether LSD could be a substrate for horseradish peroxidase or myeloperoxidase (MPO). Using liquid chromatography coupled to UV detection and electrospray ionization mass spectrometry (LC-UV-ESI-MS), we found that both peroxidases were capable of metabolizing LSD to the same compounds that have been observed in vivo (i.e., O-H-LSD and nor-LSD). In addition, we found another major metabolite, N,N-diethyl-7-formamido-4-methyl-6-oxo-2,3,4,4a,5,6-hexahydrobenzo[f]quinoline-2-carboxamide (FOMBK), which is an opened indolic ring compound. Hydrolysis of FOMBK led to the deformylated compound 7-amino-N,N-diethyl-4-methyl-6-oxo-2,3,4,4a,5,6-hexahydrobenzo[f]quinoline-2-carboxamide. The reactions of LSD with the peroxidases were chemiluminescent and sensitive to inhibition by reactive oxygen scavengers, which indicated that the classic peroxidase cycle is involved in this new alternative metabolic pathway. Considering that MPO is abundant in immune cells and also present in the central nervous system, the degradation pathway described in this study suggests a possible route of LSD metabolism that may occur concurrently with the in vivo reaction catalyzed by the cytochrome P450 system.

Copyright 2012, Springer

Gray C. The Acid Diaries: A Psychonaut's Guide to the History and Use of LSD. South Paris, ME: Park Street Press, 2010

This is a memoir of someone who late in life, when he was in his late 50s, began to experiment with LSD, using it once every two to three weeks. This is a recounting of those experiences. The author reports that his visions were weaving an ongoing story from trip to trip, revealing an underlying reality of personal and spiritual truths. Following the theories of Stanislav Grof and offering quotes from others' experiences that parallel his own--including those of Aldous Huxley, Albert Hofmann, and Gordon Wasson--he shows that trips progress through three stages: the first dealing with personal issues and pre-birth consciousness; the second with ego-loss, often with supernatural overtones; and the third with sacred, spiritual, and even apocalyptic themes. This personal experience is complemented by discussion of psychedelic use throughout history, including the ergot-spawned mass hallucinations that were common through the Middle Ages and the early use of LSD for therapeutic purposes.

Copyright 2010, Project Cork

Griffiths RR; Grob CS. Hallucinogens as medicine. Scientific American 303(6): 76-79, 2010. (4 refs.)

Hundreds of research reports on hallucinogens appeared during the 1950s and 1960s. Illicit use resulted in outlawing of the drugs. Restrictions on research, moreover, brought studies to a halt. Hints from the early set of studies suggesting that these chemicals might help treat patients with various psychiatric disorders were not pursued because of strictures on research. A new wave of studies on hallucinogens, primarily psilocybin, has begun to address whether the drugs can effectively treat the anxiety of cancer patients or help addicts kick their habits. Early results from new trials point to the promise of these therapies, with some patients reporting profound spiritual experiences and, hence, the ability to make important life changes.

Copyright 2010, Nature Publishing

Grob CS; Danforth AL; Chopra GS; Hagerty M; McKay CR; Halberstadt AL et al. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of General Psychiatry 68(1): 71-78, 2011. (37 refs.)

Context: Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer. Objective: To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety. Design: A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin. Setting: A clinical research unit within a large public sector academic medical center. Participants: Twelve adults with advanced-stage cancer and anxiety. Main Outcome Measures: In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment. Results: Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance. Conclusions: This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field.

Copyright 2011, American Medical Association

Halberstadt AL; Geyer MA. Multiple receptors contribute to the behavioral effects of indoleamine hallucinogens. (review). Neuropharmacology 61(3, special issue): 364-381, 2011. (303 refs.)

Serotonergic hallucinogens produce profound changes in perception, mood, and cognition. These drugs include phenylalkylamines such as mescaline and 2,5-dimethoxy-4-methylamphetamine (DOM), and indoleamines such as (+)-lysergic acid diethylamide (LSD) and psilocybin. Despite their differences in chemical structure, the two classes of hallucinogens produce remarkably similar subjective effects in humans, and induce cross-tolerance. The phenylalkylamine hallucinogens are selective 5-HT2 receptor agonists, whereas the indoleamines are relatively non-selective for serotonin (5-HT) receptors. There is extensive evidence, from both animal and human studies, that the characteristic effects of hallucinogens are mediated by interactions with the 5-HT2A receptor. Nevertheless, there is also evidence that interactions with other receptor sites contribute to the psychopharmacological and behavioral effects of the indoleamine hallucinogens. This article reviews the evidence demonstrating that the effects of indoleamine hallucinogens in a variety of animal behavioral paradigms are mediated by both 5-HT2 and non-5HT(2) receptors. This article is part of a Special Issue entitled 'Serotonin: The New Wave'.

Copyright 2011, Elsevier Science

Halkitis PN; Manasse AN; McCready KC. Illicit drug use in a community-based sample of heterosexually identified emerging adults. Journal of Child & Adolescent Substance Abuse 19(4): 300-308, 2010. (10 refs.)

In this study we assess lifetime and recent drug use patterns among 261 heterosexually identified 18- to 25-year-olds through brief street intercept surveys conducted in New York City. Marijuana, hallucinogens, powder cocaine, and ecstasy were the most frequently reported drugs for both lifetime and recent use. Findings further suggest significant differences in lifetime use along the lines of gender, race/ethnicity, and school enrollment for various drugs. Males reported using significantly greater numbers of different drugs compared to females, as did those not enrolled in school compared to school enrollees. These data suggest that illicit drug use in emergent adulthood does not develop in a monolithic manner and synergies must be considered in relation to gender, school enrollment, and employment that first surface in the child and adolescent developmental stages. In addition, primary prevention efforts targeting child and adolescent drug use may mitigate the emerging adult and lifetime substance use.

Copyright 2010, Haworth Press

Han B; Gfroerer JC; Colliver JD. Associations between duration of illicit drug use and health conditions: Results from the 2005-2007 National Surveys on Drug Use and Health. Annals of Epidemiology 20(4): 289-297, 2010. (60 refs.)

PURPOSE: To estimate and compare prevalence rates of lifetime health conditions by inferred duration of illicit drug use among the general U.S. adult population and to investigate associations between duration of use of each specific illicit drug (marijuana, cocaine, heroin, hallucinogens, or inhalant) and each lifetime health condition after controlling for potential confounding factors. METHODS: Data from respondents aged 35 to 49 (N = 29,195) from the 2005-2007 National Surveys on Drug Use and Health (NSDUH) were analyzed. RESULTS: The prevalence rates of a broad range of health conditions by duration of use of specific illicit drug among persons 35 to 49 years of age in the United States were estimated and compared. After adjustment for potential confounding factors, the results of 20 multivariate logistic regression models indicated positive associations between duration of marijuana use and anxiety, depression, sexually transmitted disease (STD), bronchitis, and lung cancer; between duration of cocaine use and anxiety and pancreatitis; between duration of heroin use and anxiety, hepatitis, and tuberculosis; between duration of hallucinogen use and tinnitus and STD; and between duration of inhalant use and anxiety, depression, HIV/AIDS, STD, tuberculosis, bronchitis, asthma, sinusitis, and tinnitus. CONCLUSIONS: This study provides initial analyses on the relationships between illicit drug use and health conditions based on a large nationally representative sample. These results can help prepare for treating health problems among former and continuing illicit drug users.

Copyright 2010, Elsevior Science

Hewitt K. The "Feeling of Knowing," the psychedelic sensorium, and contemporary neuroscience shifting contexts for noetic insight. Senses & Society 6(2): 177-202, 2011. (66 refs.)

Noetic insight involves direct access to knowledge beyond that which is available through the five senses or through reason. It typically has to do with sensing the interconnectedness of all things, and is informed by a feeling that one knows but without knowing how. Psychedelic substances constitute one vehicle for the production of noetic experiences. Using a biopsychosocial approach, this article explores the shifting contexts for the enjoyment and analysis of noetic experience in twentieth-century American popular and scientific culture, beginning with the psychedelic revolution and culminating in the "quantum computer" turn of brain (and mind). It emerges that the 'feeling of knowing' may be a sensory ability after all, and a key to understanding many other forms of anomalous cognition.

Copyright 2011, Berg Publishing

Hintzen A; Passie T. The Pharmacology of LSD: A Critical Review. London: Oxford University Press and The Beckley Foundation Press, 2011. (1,245 refs.)

The book represents the first comprehensive review of the psychological and pharmacological effects of LSD. It draws on data from more than 3000 experimental and clinical studies, and has more than 1000 referenced. After its discovery in 1943 LSD (lysergic acid diethylamide) became the most extensively studied psycho pharmacological agent ever and had a significant impact on neurotransmitter research. LSD has a controversial and extraordinary reputation due to the special effects it can induce on human consciousness. Its experimental use led to some ground breaking discoveries about the brain and the deeper layers of the human psyche. After its application in neuroscience, and as a tool within psychotherapy, it then increasingly was used by those outside of the laboratory setting to produce euphoria, altered perception and evoke religious experiences ("consciousness expansion"). Its complex effects on sensory, emotional and cognitive functions made LSD a probe into the human psyche, a research tool, a therapeutic agent and a controversial catalyst of individual and social change. Not widely known, but during the 1980s some important new neuroleptic drugs for treating schizophrenia were developed by testing the drug on LSD-trained animals (e.g. risperidone). Today there is a resurgence of interest in LSD, including its possible uses in psychotherapy and in some headache disorders. The pharmacology of LSD is complex and its mechanisms of action are still not completely understood. During the active phase of research with LSD during the 1950s and 1960s more than 5000 scientific publications appeared. Due to the lack of any comprehensive review about this widely dispersed experimental literature, the present book focuses on a careful and systematic review of the data about all aspects of the pharmacology and psychopharmacology of LSD, including most of the animal research and virtually all human clinical studies relevant to its pharmacology and mechanisms of action. The introduction gives a concise overview of the history of the drug, its potentials and the turmoil which surrounded it.

Copyright 2012, Project Cork

Jenks AA; Walker JB; Kim SC. Evolution and origins of the Mazatec hallucinogenic sage, Salvia divinorum (Lamiaceae): A molecular phylogenetic approach. Journal of Plant Research 124(5): 593-600, 2011. (39 refs.)

Salvia divinorum Epl. & Jativa-M. (Lamiaceae) is a potent hallucinogenic plant that is classified within Salvia subgenus Calosphace, section Dusenostachys, and hypothesized to be an interspecific hybrid. It is of ethnobotanical significance due to its employment in traditional healing ceremonies by the Mazatecs of Oaxaca, Mexico, and due to its unique pharmacology-a highly selective, non-nitrogenous, kappa-opioid receptor agonist. In order to test its phylogenetic position and putative hybridity, we sequenced multiple DNA regions (ITS, trnL-trnF, and psbA-trnH) of 52 species-representing the major lineages of subgenus Calosphace-and six accessions of S. divinorum. Our molecular phylogenetic results suggest that S. divinorum should not be classified within Dusenostachys and that it is not a hybrid. Additionally, we determine that the closest known relative of this psychoactive Mexican sage is S. venulosa, a rare endemic of Colombia.

Copyright 2011, Springer

Johnson MW; MacLean KA; Reissig CJ; Prisinzano TE; Griffiths RR. Human psychopharmacology and dose-effects of salvinorin A, a kappa opioid agonist hallucinogen present in the plant Salvia divinorum. Drug and Alcohol Dependence 115(1-2): 150- 155, 2011. (31 refs.)

Salvinorin A is a potent, selective nonnitrogenous kappa opioid agonist and the known psychoactive constituent of Salvia divinorum, a member of the mint family that has been used for centuries by Mazatec shamans of Mexico for divination and spiritual healing. S. divinorum has over the last several years gained increased popularity as a recreational drug. This is a double-blind, placebo controlled study of salvinorin A in 4 psychologically and physically healthy hallucinogen-using adults. Across sessions, participants inhaled 16 ascending doses of salvinorin A and 4 intermixed placebo doses under comfortable and supportive conditions. Doses ranged from 0.375 mu g/kg to 21 mu g/kg. Subject-rated drug strength was assessed every 2 min for 60 min after inhalation. Orderly time- and dose-related effects were observed. Drug strength ratings peaked at 2 min (first time point) and definite subjective effects were no longer present at approximately 20 min after inhalation. Dose-related increases were observed on questionnaire measures of mystical-type experience (Mysticism Scale) and subjective effects associated with classic serotonergic (5-HT2(A)) hallucinogens (Hallucinogen Rating Scale). Salvinorin A did not significantly increase, heart rate or blood pressure. Participant narratives indicated intense experiences characterized by disruptions in vestibular and interoceptive signals (e.g., change in spatial orientation, pressure on the body) and unusual and sometimes recurring themes across sessions such as revisiting childhood memories, cartoon-like imagery, and contact with entities. Under these prepared and supportive conditions, salvinorin A occasioned a unique profile of subjective effects having similarities to classic hallucinogens, including mystical-type effects.

Copyright 2011, Elsevier Science

Kerridge BT; Saha TD; Smith S; Chou PS; Pickering RP; Huang B et al. Dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria: Implications for the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition. Addictive Behaviors 36(9): 912-918, 2011. (34 refs.)

Background: Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM-IV currently lacking empirical justification. Methods: Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. Results: Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. Conclusion: Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse criterion.

Copyright 2011, Elsevier Science

Kjellgren A; Soussan C. Heaven and Hell: A phenomenological study of recreational use of 4-HO-MET in Sweden. Journal of Psychoactive Drugs 43(3): 211-219, 2011. (30 refs.)

The psychoactive substance 4-HO-MET (4-hydroxy-N-methyl-N-ethyltryptamine) with psychedelic qualities is one of many legal so-called Internet drugs. The aim of this qualitative study was to establish an understanding of what characterizes its recreational use. Very little is known about the effects of this substance. Twenty-five anonymous Swedish experience reports (from persons aged 18-30 years) from public Internet forums were analyzed using the Empirical Phenomenological Psychological Method. The analysis produced 37 categories that were compiled into nine general themes: (I) motivation, preparation and expectation; (2) initial effects; (3) change of perception; (4) unfiltered awareness and intensified flow of information; (5) lateral cognition; (6) border between subject and object is erased; (7) heaven; (8) hell; and (9) subsiding effects. An understanding of the chronological happenings, called The Process, appeared out of the general structure. Drastic changes in cognitive, emotional and bodily functions were described. The motivation for use seemed to be driven by a strong curiosity. The experiences shifted between "heaven" and "hell," but participants appeared satisfied and ready to repeat the experience. The experiences described show great similarity with classic psychedelic substances as LSD or psilocybin. More research is needed about health hazards or possible therapeutic potentials.

Copyright 2011, Haight-Asbury Publishing

Krebs TS; Johansen PO. Lysergic acid diethylamide (LSD) for alcoholism: Meta-analysis of randomized controlled trials. Journal of Psychopharmacology 26(7): 994-1002, 2012. (39 refs.)

Assessments of lysergic acid diethylamide (LSD) in the treatment of alcoholism have not been based on quantitative meta-analysis. Hence, we performed a meta-analysis of randomized controlled trials in order to evaluate the clinical efficacy of LSD in the treatment of alcoholism. Two reviewers independently extracted the data, pooling the effects using odds ratios (ORs) by a generic inverse variance, random effects model. We identified six eligible trials, including 536 participants. There was evidence for a beneficial effect of LSD on alcohol misuse (OR, 1.96; 95% CI, 1.36-2.84; p = 0.0003). Between-trial heterogeneity for the treatment effects was negligible (I-2 = 0%). Secondary outcomes, risk of bias and limitations are discussed. A single dose of LSD, in the context of various alcoholism treatment programs, is associated with a decrease in alcohol misuse.

Copyright 2012, Sage Publications

Kuzenko N; Sareen J; Beesdo-Baum K; Perkonigg A; Hofler M; Simm J et al. Associations between use of cocaine, amphetamines, or psychedelics and psychotic symptoms in a community sample. Acta Psychiatrica Scandinavica 123(6): 466- 474, 2011. (58 refs.)

Objective: To investigate the association between use of cocaine, amphetamines, or psychedelics and psychotic symptoms. Method: Cumulated lifetime data from a prospective, longitudinal community study of 2588 adolescents and young adults in Munich, Germany, were used. Substance use at baseline, 4-year and 10-year follow-up and psychotic symptoms at 4-year and 10-year follow-up were assessed using the Munich-Composite International Diagnostic Interview. Data from all assessment waves were aggregated, and multinomial logistic regression analyses were performed. Additional analyses adjusted for sociodemographics, common mental disorders, other substance use, and childhood adversity (adjusted odds ratios, AOR). Results: After adjusting for potential confounders, lifetime experience of two or more psychotic symptoms was associated with lifetime use of cocaine (AOR 1.94; 95% CI 1.10-3.45) and psychedelics (AOR 2.37; 95% CI 1.20-4.66). Additionally, when mood or anxiety disorders were excluded, lifetime experience of two or more psychotic symptoms was associated with use of psychedelics (AOR 3.56; 95% CI 1.20-10.61). Conclusion: Associations between psychotic symptoms and use of cocaine, and/or psychedelics in adolescents and young adults call for further studies to elucidate risk factors and developmental pathways.

Copyright 2011, Wiley-Blackwell

Labate B; MacRae E, eds. Ayahuasca, Ritual and Religion in Brazil. London: Equinox Publishing, 2010. (Chapter refs.)

This book examines the emergence of religious groups in the Brazilian Amazon who organize their systems of ritual, myth and beliefs around the use of a psychoactive brew known by diverse names, one of which is the Quechua term 'ayahuasca'. Although the study of these religious groups has seen much development in recent decades there are still few publications in English, especially in the area of anthropology. This book with 8 articles, presents material previously published only in Portuguese. The collection includes samples of the main types of research conducted, thus providing an overview of the current research activities. The ethnographic pieces included provide an introduction of the mapping of this phenomenon, and the nature of its historical and cultural origins. The book speaks to the history, theology, cosmology, rituals, liturgical practices, and social organization of these three religious groups, located in the forests of Brazil. Among the dilemmas facing those in policy positions in Brazil is how to distinguish between .ayahuasca and common street drugs, and how to discuss these distinctions with the general population. A central complication stems from the fact that indigenous conceptions of ayahuasca are based on different premises from the usual notions about drugs. it is suggested that the general views of drugs rely on a version of Christian cosmology that posits a transcendent spiritual realm radically divorced from the everyday. In contrast the indigenous cultures have combined indigenous cosmology with Christian morality. Within this cosmology spirit and matter retain a contrastive relationship, but the difference between them is perspectival rather than ontological. The worlds of humans, animals, and spirits interpenetrate, and are mediated by social and moral relationships. Indigenous hunters, for example, take care to maintain a respectful relationship with the spirit "owners" of the forest and its animals in order to insure fruitful hunting. Likewise, plant drugs such as ayahuasca are materializations of spirit beings, and their ingestion can initiate the perspectival changes that define the boundaries between worlds by crossing them.

Copyright 2011, Project Cork

Lange JE; Daniel J; Homer K; Reed MB; Clapp JD. Salvia divinorum: Effects and use among YouTube users. Drug and Alcohol Dependence 108(1-2): 138-140, 2010. (8 refs.)

Salvia divinorum (salvia) is an intense, short-acting hallucinogenic plant gaining popularity among adolescents in the United States. There has been little scientific documentation of salvia's effects. The popular video-sharing website YouTube has received literally thousands of video-posts of people using salvia. The objective of this study was to assess the effects of salvia use through systematic observations of YouTube videos. A sample of salvia videos was obtained using the search term "salvia." The videos were further screened and only videos that captured the entire drug "trip" without video edits were included in the analyses described here (n = 34). Three trained research assistants independently watched the videos and rated their observations on 42 effects in 30-s intervals. Onset of symptoms was quick (often less than 30 s) and tended to dissipate within 8 min. Further, there was a relationship between salvia dose and effect duration. Since salvia's effects on humans are largely undocumented, this study provides the look at users in a non-laboratory environment (e.g. self-taped videos) exhibiting impairments and behaviors consistent with this powerful hallucinogen. Also, this study demonstrates the feasibility and shortcomings of using YouTube videos to assess emerging drugs and drug effects.

Copyright 2010, Elsevier Science

Laussmann T; Meier-Giebing S. Forensic analysis of hallucinogenic mushrooms and khat (Catha edulis FORSK) using cation-exchange liquid chromatography. Forensic Science International 195(1-3): 160-164, 2010. (17 refs.)

Hallucinogenic mushrooms (e. g. Psilocybe and Panaeolus species) as well as leaves and young shoots of the khat tree (Catha edulis FORSK) are illicit drugs in many countries. The exact concentration of the hallucinogenic alkaloids psilocin and psilocybin in mushrooms and the sympathomimetic alkaloids cathinone and cathine in khat is usually essential for jurisdiction. Facing an increasing number of mushroom and khat seizures by German customs authorities, a convenient comprehensive quantitative HPLC method based on cation-exchange liquid chromatography for these rather "exotic'' drugs has been developed which avoids time-consuming multi-step sample preparation or chemical derivatization procedures. Using this method a number of different hallucinogenic fungi species and products that are mainly distributed via the internet have been analysed (dried and fresh Psilocybe cubensis SINGER as well as P. cubensis collected from "grow boxes'', Panaeolus cyanescens BERKELEY AND BROOME and so-called "philosopher stones'' (sclerotia of Psilocybe species)). Highest total amounts of psilocin have been detected in dried P. cyanescens reaching up to 3.00 +/- 0.24 mg per 100 mg. The distribution of khat alkaloids in different parts of the khat shoots has been studied. High concentrations of cathinone have not only been detected in leaves but also in green parts and barks of stalks. Additionally, the sample treatment for fresh mushroom and khat samples has been optimised. Highest amounts of alkaloids were found when fresh material was freeze-dried.

Copyright 2010, Elsevier Science

Licht CL; Christoffersen M; Okholm M; Damgaard L; Fink-Jensen A; Knudsen GM et al. Simultaneous polysubstance use among Danish 3,4-methylenedioxymethamphetamine and hallucinogen users: Combination patterns and proposed biological bases. Human Psychopharmacology: Clinical and Experimental 27(4): 352-363, 2012. (58 refs.)

Objective To describe patterns of simultaneous polysubstance use (SPU) among Danish 3,4-methylenedioxymethamphetamine (MDMA) (Ecstasy) and hallucinogen users. Methods A cross-sectional survey of 98 active MDMA and/or hallucinogen users recruited through homepage advertisements, flyers, and word of mouth in Denmark. Lifetime and recent substance use and SPU at last recalled use was described by structured interviews. Hair samples from a subset of participants were analyzed for MDMA. Results The participants had used an average of 12.6 (95% confidence interval: 11.713.4) psychoactive substances during their lifetime. SPU was prevalent among MDMA, d-lysergic acid diethylamide (LSD), and psilocybin users, in particular with alcohol and cannabis. Among MDMA users, 69% had combined MDMA with amphetamines, 56% with hallucinogens, and 47% with cocaine. At last recalled use, MDMA was taken with 2.1 +/- 1.2 substances in 32 different combinations. The participants preferred specific drug combinations and named several, which in their experience enhanced or counteracted each other. Alcohol and cannabis were typically used before, during, and after MDMA, LSD, and psilocybin, whereas amphetamines were predominantly taken before these substances. When LSD was combined with MDMA, the majority took MDMA after LSD. Conclusions Simultaneous polysubstance use was common among Danish MDMA and hallucinogen users, and patterns of preferred substance combinations were evident.

Copyright 2012, Wiley-Blackwell

Lim MSC; Hellard ME; Hocking JS; Spelman TD; Aitken CK. Surveillance of drug use among young people attending a music festival in Australia, 2005-2008. Drug and Alcohol Review 29(2): 150-156, 2010. (14 refs.)

Introduction and Aims. In order to monitor trends in illicit drug use among youth, surveillance of drug use behaviours among a variety of populations in different settings is required. We monitored drug use among music festival attendees. Design and Methods. Cross-sectional studies of young people's reported drug use were performed at a music festival in Melbourne from 2005 to 2008. Self-administered questionnaires collected information on drug use, demographics and other risk behaviour. Results. From 2005 to 2008, over 5000 questionnaires were completed by people aged 16-29; 2273 men and 3011 women. Overall, use of any illicit drug in the past month was reported by 44%. After adjusting for demographic and behavioural characteristics, the prevalence of recent illicit drug use decreased significantly from 46% in 2005 to 43% in 2008 (OR 0.92, 95% CI 0.87-0.97). After adjusting for age and sex the downwards trend was repeated for amphetamines and cannabis, but a significant increase in prevalence was observed in hallucinogen, ecstasy and inhalant use. Drug use was more common among men, older participants and those engaging in high-risk sexual behaviour. Discussion and Conclusions. Illicit drug use was much more common in this sample than in the National Drug Strategy Household survey, but the direction of trends in drug use were similar; drug use prevalences were much lower than in the Ecstasy and Related Drugs Reporting System, the Illicit Drug Reporting System or National Needle and Syringe Program Survey. Music festival attendees are a potentially useful group for monitoring trends in illicit drug use.

Copyright 2010, Wiley-Blackwell

Mackowick KM; Heishman SJ; Wehring HJ; Liu F; McMahon RP; Kelly DL. Illicit drug use in heavy smokers with and without schizophrenia. Schizophrenia Research 139(1-3): 194-200, 2012. (75 refs.)

Objective: The prevalence of cigarette smoking among people with schizophrenia is greater than that of the general population. Because smoking and use of other drugs co-vary, we examined illicit drug use in current smokers not trying to quit or reduce their tobacco use. We recruited outpatient participants who had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder (schizophrenia, n=70) and a control group who had no Axis I psychiatric disorders (control, n=97). During a 2-3-hour session, participants completed demographic and research questionnaires, including the Drug Use Survey (DUS). Results: Participants with schizophrenia were older than controls (p<0.001) and smoked more cigarettes per day (p=0.01), but did not differ in degree of nicotine dependence. Ever using a drug was similar between the groups, except that significantly more participants with schizophrenia reported ever using hallucinogens (p<0.001) and inhalants (p=0.001). For alcohol, cocaine, and marijuana, fewer participants with schizophrenia were current users, but more participants with schizophrenia were past users (ps<0.0001). Heavy smokers from the general population continued to use illicit drugs throughout their lives, while schizophrenia participants had the highest period of illicit drug use in their 20s. Conclusions: These data suggest that illicit drug use tends to be high in heavy cigarette smokers, regardless of a schizophrenia diagnosis. However, while illicit drug use is high across the lifespan of heavy smokers in the general population, heavy smokers with schizophrenia use illicit drugs mostly in the first decade of their illness.

Copyright 2012, Elsevier Science

Mahapatra S; Belgrad JL; Adeoye MA. Psychotropic drug-related eosinophilia with systemic symptoms after acute caffeine ingestion. Pediatrics 127(1): E235-E238, 2011. (12 refs.)

Drug-related eosinophilia with systemic symptoms (DRESS) is a potentially life-threatening, multiorgan condition that can result from drug treatment. Antiepileptic medications have provided the best-studied link of any class of medications. Here, we report the case of a 16-year-old boy with long-standing bipolar disorder who was chronically treated with aripiprazole and fluoxetine and developed DRESS syndrome after ingestion of high doses of caffeine. His classic presentation with fever, morbilliform rash, lymphadenopathy, and visceral involvement, including leukocytosis, eosinophilia, and hepatitis, was consistent with this diagnosis. Furthermore, the patient's symptoms dramatically improved after corticosteroid therapy and discontinuation of all psychotropic medications. We propose that the development of DRESS syndrome is a net result of inconsistent medication adherence coupled with the ingestion of near-toxic doses of caffeine, which can lead to rhabdomyolysis and, through renal impairment, lead to the accumulation of toxic oxidative metabolites of either or both psychotropic medications. We also present one of the few reported cases of caffeine-induced rhabdomyolysis and propose its role in the development of DRESS in this patient.

Copyright 2011, American Academy of Pediatrics

Marona-Lewicka D; Nichols CD; Nichols DE. An animal model of schizophrenia based on chronic LSD administration: Old idea, new results. Neuropharmacology 61(3, special issue): 503-512, 2011. (34 refs.)

Many people who take LSD experience a second temporal phase of LSD intoxication that is qualitatively different, and was described by Daniel Freedman as "clearly a paranoid state." We have previously shown that the discriminative stimulus effects of LSD in rats also occur in two temporal phases, with initial effects mediated by activation of 5-HT(2A) receptors (LSD30), and the later temporal phase mediated by dopamine D2-like receptors (LSD90). Surprisingly, we have now found that non-competitive NMDA antagonists produced full substitution in LSD90 rats, but only in older animals, whereas in LSD30, or in younger animals, these drugs did not mimic LSD. Chronic administration of low doses of LSD (>3 months, 0.16 mg/kg every other day) induces a behavioral state characterized by hyperactivity and hyperirritability, increased locomotor activity, anhedonia, and impairment in social interaction that persists at the same magnitude for at least three months after cessation of LSD treatment. These behaviors, which closely resemble those associated with psychosis in humans, are not induced by withdrawal from LSD; rather, they are the result of neuroadaptive changes occurring in the brain during the chronic administration of LSD. These persistent behaviors are transiently reversed by haloperidol and olanzapine, but are insensitive to MDL-100907. Gene expression analysis data show that chronic LSD treatment produced significant changes in multiple neurotransmitter system-related genes, including those for serotonin and dopamine. Thus, we propose that chronic treatment of rats with low doses of LSD can serve as a new animal model of psychosis that may mimic the development and progression of schizophrenia, as well as model the established disease better than current acute drug administration models utilizing amphetamine or NMDA antagonists such as PCP.

Copyright 2011, Elsevier Science

Mason K; Cottrell AM; Corrigan AG; Gillatt DA; Mitchelmore AE. Ketamine-associated lower urinary tract destruction: A new radiological challenge. Clinical Radiology 65(10): 795-800, 2010. (10 refs.)

AIM: Ketamine is a short-acting dissociative anaesthetic whose hallucinogenic side effects have led to an increase in its illicit use amongst club and party goers. There is a general misconception amongst users that it is a safe drug with few long term side effects, however ketamine abuse is associated with severe urinary tract dysfunction. Presenting symptoms include urinary frequency, nocturia, dysuria, haematuria and incontinence. MATERIALS AND METHODS: We describe the radiological findings found in a series of 23 patients, all with a history of ketamine abuse, who presented with severe lower urinary tract symptoms (LUTS). Imaging techniques used included ultrasonography (US), intravenous urography (IVU), and computed tomography (CT). These examinations were reviewed to identify common imaging findings. All patients with positive imaging findings had also undergone cystoscopy and bladder wall biopsies, which confirmed the diagnosis. The patients in this series have consented to the use of their data in the ongoing research into ketamine-induced bladder pathology. RESULTS: Ultrasound demonstrated small bladder volume and wall thickening. CT revealed marked, generalized bladder wall thickening, mucosal enhancement, and perivesical inflammation. Ureteric wall thickening and enhancement were also observed. In advanced cases ureteric narrowing and strictures were identified using both a and IVU. Correlation of clinical history, radiological and pathological findings was performed to confirm the diagnosis. CONCLUSION: This case series illustrates the harmful effects of ketamine on the urinary tract and the associated radiological findings. Delayed diagnosis can result in irreversible renal tract damage requiring surgical intervention. It is important that radiologists are aware of this emerging clinical entity as early diagnosis and treatment are essential for successful management.

Copyright 2010, The Royal College of Radiologists

Meyer EG; Writer BW. Salvia divinorum. Psychosomatics 53(3): 277-279, 2012. (18 refs.)

Salvia divinorum's (Salvia) psychogenic properties were first utilized by the Mazateca to achieve ceremonial visions over a millennium ago. Colloquially referred to as Divine's Sage, Seer's Sage, Magic Mint, SkaPastora, and Sally-D. Salvia is an unregulated substance that is readily accessible to consumers. Traditionally consumed as a tea, Salvia is commonly dried and smoked or the raw leaves are chewed as a �quid.� Concentrated oil can also be administered sublingually. Although dosing varies between identically marketed packaging,4 studies have determined that Salvinorin A, the active component in Salvia, is effective at 200-500 mg. This can be compared with lysergic acid diethylamide's (LSD) effective dose of 20-100 mq. Animal literature suggests that Salvinorin Aenhances brain dopaminergic levels through partial agonist activation of mu-opioid receptors. while indirectly increasing cannabinoid activity via subsequent second messenger systems. Based on these activities, Salvinorin A has been theorized to produce potentially beneficial antidepressant and anxiolytic effects, along with a relatively less desirable neuropsychological profile consisting of mood, perceptual, and neurocognitive symptoms. The Drug Enforcement Agency has cites the following responses to salvia: �perceptions of bright lights, vivid colors and shapes, as well as body movements and body or object distortions. Other effects include dysphoria, uncontrolled laughter, a sense of loss of body, overlapping realities, and hallucinations � adverse physical effects may include incoordination, dizziness, and slurred speech. The author describes the case of an individual who was hospitalized following a psychotic reaction to Salvia ingestion. It was the first reported use, and was taken based on its recommendation for its calming effects. The symptoms resolved within 24 hours, with no re-occurence throughout the following 9 months. There is a review of the very limited literature of the pharmacological properties and the acute effects.

Copyright 2012, American Psychiatric Asssociation

Meyer MR; Maurer HH. Absorption, distribution, metabolism and excretion pharmacogenomics of drugs of abuse. (review). Pharmacogenomics 12(2): 215-233, 2011. (220 refs.)

Pharmacologic and toxic effects of xenobiotics, such as drugs of abuse, depend on the genotype and phenotype of an individual, and conversely on the isoenzymes involved in their metabolism and transport. The current knowledge of such isoenzymes of frequently abused therapeutics such as opioids (oxycodone, hydrocodone, methadone, fentanyl, buprenorphine, tramadol, heroin, morphine and codeine), anesthetics (y-hydroxybutyric acid, propofol, ketamine and phencyclidine) and cognitive enhancers (methylphenidate and modafinil), and some important plant-derived hallucinogens (lysergide, salvinorin A, psilocybin and psilocin), as well as of nicotine in humans are summarized in this article. The isoenzymes (e.g., cytochrome P450, glucuronyltransferases, esterases and reductases) involved in the metabolism of drugs and some pharmacokinetic data are discussed. The relevance of such data is discussed for predicting possible interactions with other xenobiotics, understanding pharmacokinetic behavior and pharmacogenomic variations, assessing toxic risks,

Copyright 2011, Future Medicine

Morgan CJA; Muetzelfeldt L; Muetzelfeldt M; Nutt DJ; Curran HV. Harms associated with psychoactive substances: Findings of the UK National Drug Survey. Journal of Psychopharmacology 24(2): 147-153, 2010. (6 refs.)

Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views of the harms of drugs using the same scale. As users' drug choices are not solely based on harms, we additionally assessed perceived benefits. The survey was hosted at http: UK residents reported their experience of 20 commonly used substances; those with direct experience of a substance rated its physical, dependence-related and social harms as well as benefits. A total of 1501 users completed the survey. There was no correlation between the classification of the 20 drugs under the Misuse of Drugs Act and ranking of harms by users. Despite being unclassified substances, alcohol, solvents and tobacco were rated within the top ten most harmful drugs. There was a remarkably high correlation (r = 0.896) overall between rankings by users' and by experts. Ecstasy, cannabis and LSD were ranked highest by users on both acute and chronic benefits. These findings imply that users are relatively well informed about the harms associated with the drugs they use. They also suggest that the current UK legal classification system is not acting to inform users of the harms of psychoactive substances.

Copyright 2010, Sage Publications

Moro L; Noreika V. Sacramental and spiritual use of hallucinogenic drugs. (editorial). Behavioral and Brain Sciences 34(6): 319-320, 2011. (0 refs.)

Arguably, the religious use of hallucinogenic drugs stems from a human search of metaphysical insight rather than from a direct need for cognitive, emotional, social, physical, or sexual improvement. Therefore, the sacramental and spiritual intake of hallucinogenic drugs goes so far beyond other biopsychosocial functions that it deserves its own category in the drug instrumentalization list.

Copyright 2011, Cambridge University Press

Mrazova K; Navratil T; Pelclova D. Use and accidental exposure to hallucinogenic agents reported to the Czech Toxicological Information Centre from 1995 to 2008. Substance Use & Misuse 46(4): 460-465, 2011. (24 refs.)

Intoxication by hallucinogenic agents is relatively common in the Czech Republic, with most cases of the use of these agents being by adolescents and young people. The objective of the study was to evaluate the number, trends, gender and age of the subjects, and the severity of exposure in intoxication by hallucinogenic plant and mushroom substances, in comparison with synthetic drugs, brought to the attention of the Toxicological Information Centre (TIC) through inquiries over the past 14 years (1995--2008) (from total 3,702 calls concerning the use of both natural and synthetic drugs, 917 calls were due to the use of hallucinogenic plants and mushrooms).

Copyright 2011, Informa Healthcare

Muhuri PK; Gfroerer JC. Mortality associated with illegal drug use among adults in the United States. American Journal of Drug and Alcohol Abuse 37(3): 155-164, 2011. (58 refs.)

Objectives: To examine all-cause and cause-specific mortality over a 15-year follow-up period in relation to at-baseline reported lifetime use of illegal drugs from five classes (marijuana, cocaine, heroin, hallucinogens, and inhalants) among adults in the United States (US) household population. Methods: The study involved 20,983 sample adults who responded to the 1991 National Health Interview Survey Drug and Alcohol Use supplemental questionnaire and also met the eligibility criteria for mortality follow-up. Cox proportional hazards models were estimated to examine the relationships. Results: Adults who at baseline reported lifetime heroin use were at significantly higher risk of all-cause death over the follow-up period (hazard rate ratio or HR = 2.02; 95% confidence interval or CI 1.26-3.23), compared with those who did not report using drugs from any of the five classes, even after adjusting for age, sex, race, education, marital status, cigarette smoking status, and alcohol use status. Those who at baseline reported lifetime cocaine (no heroin) use had a significantly higher rate of death associated with human immunodeficiency virus diseases over the follow-up period than nonusers of drugs from any of the five classes. Several limitations of the analysis are discussed. Conclusions: Further research is needed to understand and track the elevated mortality associated with illegal drug use and the correlates of drug-poisoning deaths.

Copyright 2011, Informa Healthcare

Natarajan M, ed. Drugs of Abuse: The International Scene. The Library of Drug Abuse and Crime, Volume I. Surrey UK: Ashgate, 2010. (Chapter refs.)

The chapters (previously published journal articles) highlight drug abuse as a worldwide problem, affecting countries in both the developed and developing worlds. The contains 28 articles which are divided into four parts. Most of the articles have been recently published and cover some aspect of the globalisation of drug abuse. Part I, "Drug Abuse in the Developing World," with 7 papers addresses drug abuse in the developing world, drawing upon the experiences in seven different countries, and involving different substances, from opiates to cocaine, to methamphetamine to ecstasy, routes of drug administration, and drug use patterns. Part II, "The Emergence of New Drugs and Polydrug use" has five articles. The "new" drugs reviewed include ecstasy, LSD and ketamine. The typical user (young people) is described and where these drugs tend to be used (in nightclubs and dance parties). The poly drug use papers include substances such as opioid, cocaine and methamphetamine use. Part III "The Normalization Thesis and Gateway Drugs," has four papers on each of these topics. The Normalization Thesis is used to explain how young people normalise social drug use, with cannabis and 'dance drugs' (LSD, ecstasy, etc.) being the primary drugs discussed. One interesting finding was the high number of abstainers who tolerate or approve of social drug use amongst their peers, particularly is the drug is cannabis. The gateway papers continue to investigate the sequential and developmental pathways of drug use. This pathway is described as alcohol/tobacco first, then cannabis, and then 'hard' drugs. Gender differences in this pathway are described as well as the impact of age on the gateway process. Part IV, "Methodological Developments in Researching Drug Abuse," has eight papers. Macro- and micro-level epidemiological studies are discussed, along with how to capture hidden drug use populations, limitations of sentinel data (arrests, treatment admissions), rapid assessment and response (RAR) methods, and capture-recapture models. These methods are evaluated and any epidemiological or longitudinal findings are discussed.

Copyright 2010, Project Cork

Nyi PP; Lai EP; Lee DY; Biglete SA; Torrecer GI; Anderson IB. Influence of age on salvia divinorum use: Results of an internet survey. Journal of Psychoactive Drugs 42(3): 385-392, 2010. (14 refs.)

An Internet-based survey of Salvia divinorum ("salvia") users was conducted to identify correlates surrounding its use. Salvia-knowledgeable persons were recruited via "social networking Internet websites" (n = 23) where notices were posted on recreational salvia group message boards (n = 69). Data collection included demographics, use circumstances, experiences, and age (current and at first salvia use). A total of 219 surveys were analyzed. Salvia users who were young adults (<= 21 yrs) at first use favored salvia for fun (OR = 1.94, CI = 1.08-3.49, p = 0.03) or to relieve boredom (OR = 2.06 CI = 1.09-3.91, p = 0.02), while salvia users who were adults (>= 22 yrs) at first use favored salvia for spiritual effects (OR = 2.63, CI = 1.02-6.75, p = 0.04). Being an adult at first use was associated with higher odds of concurrent marijuana (OR = 2.68, CI = 1.50-4.78, p = 0.0007) or tobacco use (OR = 1.94, CI = 1.05-3.60, p = 0.03). Over half of all respondents reported use reduction or cessation in the past 12 months (114 of 219, 52%), citing dislike of the high (33.3%) or loss of interest in salvia (28.9%). Reports of cessation suggest salvia use may be more attributed to curiosity than continual abuse.

Copyright 2010, Haight-Ashbury Publishing

Odden HL. Alcohol, tobacco, marijuana and hallucinogen use in Samoan adolescents. Drug and Alcohol Review 31(1): 47-55, 2012. (49 refs.)

Introduction and Aims. Adolescent substance use has increased with globalisation, and yet few data exist from lower- and middle-income countries and the Pacific Islands. This study examines the prevalence of three aspects of substance use over the past 30 days in Samoan adolescents: (i) use of alcohol, tobacco and other drugs; (ii) polysubstance use; and (iii) possible substance use problems. Design and Methods. A survey was administered to secondary school children (n = 879) between 12 and 19 years of age at a single school in Apia, the capital of Samoa, in August 2008. Results. There were important gender differences in substance use with boys reporting significantly higher rates of any use of each substance and polysubstance use. Boys were also three times more likely to report behaviours indicative of substance use problems. There were no significant differences in regular use of any substance with the exception of marijuana. Although the use of hallucinogens is prominent for boys and girls in the younger age group (12-15), consumption decreases with age. Boys showed substantial increases in any use of alcohol and marijuana and daily use of tobacco by age. There was also a significant increase in the number of boys reporting behaviours indicative of disordered use by age to 21% of 16-to 19-year-old boys. Discussion and Conclusions. One of few studies on substance use in Samoa, the data provide a basis for setting priorities to address health risks posed by adolescent use and understanding the influence of rapid change.

Copyright 2012, Wiley-Blackwell

Olthuis JV; Klein RM. On the measurement of the effects of alcohol and illicit substances on inhibition of return. (review). Psychopharmacology 221(4): 541-550, 2012. (52 refs.)

Inhibition of return (IOR) refers to the delayed orienting of attention to previously inspected locations in favour of novel locations. Given its implications for visual attention and search, researchers have begun to investigate whether IOR may be impaired by the use of alcohol or illicit substances (e.g. d-amphetamine). The present paper reviews the existing literature exploring the impact of alcohol and other drugs on IOR through the use of the model spatial cueing task developed by Posner. Studies were located that investigated IOR paradigm with respect to either (a) acute effects of alcohol or other psychoactive substances and (b) hallucinogenic drug states as models for psychosis. Findings suggest that alcohol, d-amphetamine and some hallucinogens may alter the timecourse of IOR. This review also yields a critical qualitative analysis of the methodology of studies in this field of research and the implications of particular methodological features for interpreting previous findings. The importance of using multiple stimulus onset asynchronies, employing a cue-back to centre paradigm and distinguishing between acute and chronic substance use are emphasized. Furthermore, questions are raised as to whether findings suggest an impact of psychoactive substances on the subcortical mechanisms that play a critical role in the generation of IOR or are an indirect effect resulting from impairment of the cortical mechanisms responsible for voluntary disengagement of attention. Directions for future research and particular methodological approaches are highlighted.

Copyright 2012, Springer

Perron BE; Ahmedani BK; Vaughn MG; Glass JE; Abdon A; Wu LT. Use of salvia divinorum in a nationally representative sample. American Journal of Drug and Alcohol Abuse 38(1): 108-113, 2012. (20 refs.)

Background: Salvia divinorum has known hallucinogenic effects and is legal in most parts of the United States. Given that this psychoactive substance has a potential of misuse and abuse, further data regarding the clinical and psychosocial factors associated with use are needed. Objectives: To examine the clinical and psychosocial characteristics associated with use of salvia. Methods: The study uses data from the National Survey on Drug Use and Health, 2008 (N = 55,623). Results: The results of this study suggest that salvia use is most common among young adults aged 18-25 years as well as individuals who had engaged in risk-taking behaviors (selling illicit drugs, stealing) or illicit drug use (especially other hallucinogens/ecstasy). Self-reported depression and anxiety were also associated with salvia use. Conclusions/Scientific Significance: The results provide evidence that salvia use is part of a broader constellation of psychosocial and behavioral problems among youth and young adults. The accessibility, legal status, and psychoactive effects of salvia can be a potentially complicating health risk to young people, especially among those with existing substance use problems.

Copyright 2012, Informa HealthCare

Petroianu A; dos Reis DCF; Cunha BDS; de Souza DM. Prevalence of alcohol, tobacco and psychotropic drug consumption by medical students of the "Universidade Federal de Minas gerais". Revista da Associacao Medica Brasileira 56(5): 568-571, 2010. (34 refs.)

OBJECTIVE. The purpose of this study was to assess the prevalence of alcohol, tobacco and psychotropic drug consumption by students of the Medical School of the Federal University of Minas Gerais, Brazil, and to verify aspects related to those addictions. METHODS. This study was carried out with students of all years of the medical course invited to participate anonymously, by answering a self-applied questionnaire which was previously evaluated and adapted to Brazilian reality. It was based upon the World Health Organization's Guidelines for Student Substance Use Survey and included 25 questions about drug addiction. Student's t test and chi-square test were applied to assess differences between the mean and proportions of data. RESULTS. Alcohol and tobacco were the more frequently used by the students, 85.2% and 16.3% respectively. Among psychotropic drugs, marijuana was reported by 16.5% of students, LSD by 6.9%, sedatives by 12%, amphetamines by 7.5% and inhalant substances by 16.8%. Cocaine, crack, opiates, anti-cholinergics and anabolics consumption were rarely mentioned. CONCLUSION. Alcohol was the drug most used and was related to other drug addictions. Drugs were most frequently used by single, male students, who live alone and do not support themselves.

Copyright 2010, Association Medica Brasileira

Preti A; Usai I; Pintus E; Sardu C; Petretto DR; Masala C. Left-handedness is statistically linked to lifetime experimentation with illicit drugs. Laterality 17(3): 318-339, 2012. (100 refs.)

Handedness has been linked to an enhanced risk of alcohol abuse, while less is known about other drugs. A convenience sample of 1004 male and female Italian participants (females = 58%) from the general community (18 to 65 years old: average age = 30; standard deviation = 10, median = 25) was asked about: handedness (preference in writing); lifetime use of alcohol, tobacco, and illicit drugs; levels of psychological distress, as measured by the General Health Questionnaire (GHQ); and levels of delusion proneness, as measured by the Peters et al. Delusions Inventory (PDI). Overall, 92 individuals (9.2%) were classified as left-handed, with no significant difference reported among genders. Lifetime use of illicit drugs, primarily cannabis, was reported by 20% of the sample. In a multiple logistic regression analysis, after taking into account sex, age, and caseness on GHQ and PDI, left-handed people in the sample were statistically more likely to report lifetime experimentation with heroin, ecstasy/amphetamine, and, marginally, hallucinogens, but not alcohol or tobacco. Different mechanisms might contribute to an explanation of greater lifetime experimentation with some illicit drugs among left-handed people as compared to right-handed people. However, replications with clinical samples are necessary before any definitive statements can be made.

Copyright 2012, Psychology Press

Ramtekkar UP; Striley CW; Cottler LB. Contextual profiles of young adult ecstasy users: A multisite study. Addictive Behaviors 36(3): 190-196, 2011. (47 refs.)

These analyses assess contextual profiles of 612 young adult ecstasy users, 18-30 years of age, from St. Louis (USA), Miami (USA) and Sydney (Australia). Bivariate analyses revealed different contextual factors influencing ecstasy use. Friends were the most common sources of ecstasy at all sites and most used with friends. St. Louis and Miami use mostly occurred in residences, whereas in Sydney use was mostly at clubs, bars or restaurants. Ecstasy consumption at public places and in cars, trains or ferries was significantly higher in Miami (89% and 77%) than in St. Louis (67% and 65%) and Sydney (67% and 61%). At all sites, simultaneous use of LSD/mushroom and nitrous oxide with ecstasy was common; concurrent amphetamines predominated in Sydney and heroin/opiates in St. Louis Contextual factors influencing ecstasy use among young adults vary by geographic region. Their inclusion may help tailor effective prevention programs to reduce or ameliorate ecstasy use.

Copyright 2011, Elsevier Science

Rassool GH. Addiction for Nurses. Chichester: Wiley-Blackwell, 2010

This is an introductory textbook directed to nurses. The book begins with a discussion of the different settings in which nursing interventions can occur from community-based services and specialist alcohol and drug services, to hospital-based settings. The first chapter considers the historical, cultural and social context of alcohol and substance use and the cultural understandings of addiction. Current UK policy initiatives, strategies and guidelines for treatment are highlighted. The next chapters address the nature of addiction, screening and assessment, and interventions. Individual chapters are then devoted to the major substances - alcohol, nicotine, opiates, cannabis, stimulants, and hallucinogens. These include material on screening tools, assessment and interventions strategies relevant to each substance. Management of overdose and withdrawal is explored for each substance, and evidence-based pharmacological interventions are described. The author highlights the importance of psychological interventions and refers particularly to the benefits of opportunistic brief interventions, motivational interviewing and relapse prevention strategies. The importance of developing a 'therapeutic alliance' between the worker and client is stressed. Harm minimisation strategies are explored, as are nursing emergencies, special needs and diverse populations, the family, and self-help. It concludes issues related to professional development.

Copyright 2011, Project Cork

Riley S; Thompson J; Griffin C. Turn on, tune in, but don't drop out: The impact of neo-liberalism on magic mushroom users' (in)ability to imagine collectivist social worlds. International Journal of Drug Policy 21(6): 445-451, 2010. (28 refs.)

Background: Between 2002 and 2005 fresh or unprepared psilocin-based 'magic' mushrooms were legal to possess and traffic in the UK, and commercial sales demonstrated a significant market for this hallucinogenic drug. During and after this time there has been relatively little analysis concerning how magic mushroom users accounted for their drug use, nor on the wider political and cultural discourses that might have shaped this sense making. Method: In this paper we present a critical analysis of contemporary discourses around magic mushroom use in the UK through a multi-level discourse analysis of focus group data from 20 magic mushroom users (13 male and 7 female, mean age 25 years), taken at a time when magic mushrooms were being legally sold in the UK. Results: Locating participants' use of magic mushrooms within the context of a culture of intoxication, neo-liberalism and the legacy of 1960s psychedelic philosophy, we identify six interpretative repertoires in their talk, which were subsumed within two overarching discourses. The first discourse drew on neo-liberal rhetoric, constructing participants as rational risk managing subjects engaged in a form of calculated hedonism that was legitimated as an act of personal freedom and consumer choice. The second discourse, identified as 'post-psychedelic', both celebrated and problematised a collective, connected 'hippy' form of spirituality. Conclusion: The paper analyses the relationships between identity, consumption and citizenship by arguing that people's ability to imagine collectivist, spiritual or interconnected social worlds has been contained within neo-liberalism rhetoric.

Copyright 2010, Elsevier Science

Roettger ME; Swisher RR; Kuhl DC; Chavez J. Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: Evidence from longitudinal panels of males and females in the United States. Addiction 106(1): 121-132, 2011. (52 refs.)

Aims: One-eighth of young adults in the United States report that their biological father has ever been incarcerated (FEI). This study is the first to examine associations between FEI and trajectories of substance use during the transition from adolescence into young adulthood for the US population. Design: Using multi-level modeling techniques, trajectories of marijuana and other illegal drug use are examined, with FEI as the primary independent variable. Setting: Data are from the first three waves of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US adolescents beginning in 1995. Participants: Panels of 7157 males and 7997 females followed from adolescence (7th-12th grades) into early adulthood (ages 18-27 years). Measurements: Dependent variables included an ordinal measure of marijuana frequency of use in last thirty days, and a dichotomous measure for whether respondent had any use in the last thirty days of illegal drugs such crystal meth, cocaine, heroin, hallucinogens, PCP, LSD, speed, and ecstasy. Findings: Among males and females, respectively, FEI is associated with an increased frequency of marijuana use, and increased odds of any other illegal drug use. Interactions between FEI and age further reveal that FEI is associated with an accentuated trajectory (i.e. a steeper slope) of marijuana use, and an elevated risk (i.e. higher mean level) of other illegal drug use. Conclusions: Analysis provides some of the first evidence that paternal incarceration is significantly associated with drug use among U.S. males and females, even after controlling for a number of family background, parental, and individual characteristics.

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs

Rosenberg H; Bonar EE; Pavlick M; Jones LD; Hoffmann E; Murray S et al. Associations between university students' reported reasons for abstinence from illicit substances and type of drug. Journal of College Student Development 53(1): 91-105, 2012. (35 refs.)

We recruited 211 undergraduates to rate the degree to which each of 34 listed reasons for not taking drugs had influenced their abstinence from MDMA/ecstasy, cocaine, marijuana, and hallucinogens. Participants rated reasons such as personal and family medical histories, religion, and physiological consequences of drug use as having little or no impact on abstention from all four substances. Consistent with previous research and developmental theory, concerns about drug-induced impairment and drug use being contrary to one's self-image reportedly inhibited students' consumption of notably different types of illicit substances.

Copyright 2012, Johns Hopkins University Press

Shannon LM; Havens JR; Oser C; Crosby R; Leukefeld C. Examining gender differences in substance use and age of first use among rural Appalachian drug users in Kentucky. American Journal of Drug and Alcohol Abuse 37(2): 98-104, 2011. (40 refs.)

Background: Previous research suggests gender differences exist in types of substances used and age of first use. Recent studies exploring contextual differences in substance use between rural Appalachian and urban environments show different patterns of substance use in rural environments. Objective: This study explores whether previously established differences in gender and age of first use exist within a rural Appalachian environment. Methods: Data are from a community-based study of drug users in rural Appalachia (N = 400). Self-reported substance use was recorded using an interviewer-administered questionnaire with questions from the Addiction Severity Index (ASI). Results: On average, participants were 32 years old ((X) over bar = 32.33; median = 31.00; interquartile range (IQR) = 12) and the majority were male (59%). Examining the past 30-day substance use, more males reported alcohol (adjusted odds ratio (AOR): 2.11, 95% CI: 1.36, 3.23; p = .001) and any illegal drug use (AOR: 1.85, 95% CI: 1.16, 2.95; p = .010), which included heroin, cocaine, crack cocaine, methamphetamine, marijuana, and hallucinogens, after controlling for sociodemographic characteristics. ANCOVA analyses showed that males reported the use of alcohol (p = .000), marijuana (p = .007), and hallucinogens (p = .009) at a significantly younger age than females. Conclusion: Findings: suggest more men report the use of alcohol and "street" drugs, including heroin, crack cocaine, methamphetamine, marijuana, and hallucinogens. Furthermore, males report the use of alcohol, marijuana, and hallucinogens at a significantly younger age. Scientific Significance: Understanding gender differences in substance use as well as other differences among individuals living in rural Appalachia presents important opportunities to incorporate this knowledge into substance abuse early intervention, prevention, and treatment efforts.

Copyright 2011, Informa Health

Smith GW; Farrell M; Bunting BP; Houston JE; Shevlin M. Patterns of polydrug use in Great Britain: Findings from a national household population survey. Drug and Alcohol Dependence 113(2-3): 222-228, 2011. (55 refs.)

Background: Polydrug use potentially increases the likelihood of harm. As little is known about polydrug use patterns in the general population, it is difficult to determine patterns associated with highest likelihood. Methods: Latent class analysis was performed on nine illicit substance groups indicating past year use of cannabis, cocaine, amphetamines, ecstasy, LSD, mushrooms, amyl nitrate, tranquillisers and heroin or crack. Analyses were based on data from a large multi-stage probability sample of the population of Great Britain (n=8538) collected in 2000. Multinomial logistic regression was performed highlighting associations between classes, and demographic and mental health variables. Results: A three class solution best described patterns of polydrug use; wide range, moderate range, and no polydrug use. For males and young people, there was a significantly increased chance of being in the wide and moderate range polydrug use groups compared to the no polydrug use class. Hazardous drinking was more likely in the wide and moderate polydrug classes with odds ratios of 9.99 and 2.38 (respectively) compared to the no polydrug use class. Current smokers were more likely to be wide and moderate range polydrug users compared to the no polydrug use class with odds ratios of 4.53 and 5.85 respectively. A range of mental health variables were also related to class membership. Conclusions: Polydrug use in Great Britain can be expressed as three distinct classes. Hazardous alcohol use and tobacco use were strongly associated with illicit polydrug use, polydrug use appeared to be significantly associated with mental health, particularly lifetime suicide attempts.

Copyright 2011, Elsevier Science

Stella L; Vitelli MR; Palazzo E; Oliva P; De Novellis V; Capuano A et al. Datura stramonium intake: A report on three cases. Journal of Psychoactive Drugs 42(4): 507-512, 2010. (23 refs.)

This article describes three cases of Datura stramonium intake on two nonconsecutive days. In the first case, the patient took a small amount of D. stramonium seeds without showing any symptoms of intoxication. The other two patients had taken a considerable amount of seeds and reported a sudden surge in strength and energy, with sonic aggressive compulsion towards their peers. They showed delirium as well as confusion and disorientation. The absence of any specific legislation makes D. stramonium a tempting alternative to other psychoactive substances. Thus, it is extremely important to be able to recognize its symptoms so as to be able to diagnose any signs of intoxication properly.

Copyright 2010, Haight-Ashbury

Takagi MJ; Yucel M; Lubman DI. The dark side of sniffing: Paint colour affects intoxication experiences among adolescent inhalant users. Drug and Alcohol Review 29(4): 452-455, 2010. (11 refs.)

Introduction and Aims. Inhalant abuse among adolescents is a significant health concern in many countries; however, limited research has explored whether the intoxication experience differs between commonly used inhalants. The aim of the present study was to examine how exposure to different types of paints (chrome vs. non-chrome) were experienced by adolescent users. Design and Methods. Sixteen adolescent (aged 15-19 years) regular inhalant users completed a semistructured questionnaire enquiring about their inhalant use. Participants were divided into two groups based on paint colour preference [chrome paints (n = 10) and non-chrome paints (n = 6)] and were compared using appropriate statistical tests. Results. Relative to non-chrome users, the chrome-using group were more likely to report deliberately inhaling to experience altered perceptions (such as visual and auditory hallucinations). In addition, a significantly greater proportion of chrome users reported that the perceptual alterations they experienced after sniffing paint differed between paint colours, with chrome colours being associated with more vivid hallucinations. Discussion and Conclusion. While both chrome and non-chrome users reported a comparable level of pleasure from paint sniffing, chrome paint users were more likely to be motivated by the potential to hallucinate. Our findings suggest that the type of inhalant used is an important consideration that may have relevance to clinical treatment.

Copyright 2010, Wiley-Blackwell

van Amsterdam J; Opperhuizen A; van den Brink W. Harm potential of magic mushroom use: A review. (review). Regulatory Toxicology and Pharmacology 59(3): 423-429, 2011. (65 refs.)

In 2007, the Minister of Health of the Netherlands requested the CAM (Coordination point Assessment and Monitoring new drugs) to assess the overall risk of magic mushrooms. The present paper is an updated redraft of the review, written to support the assessment by CAM experts. It summarizes the literature on physical or psychological dependence, acute and chronic toxicity, risk for public health and criminal aspects related to the consumption of magic mushrooms. In the Netherlands, the prevalence of magic mushroom use was declining since 2000 (last year prevalence of 6.3% in 2000 to 2.9% in 2005), and further declined after possession and use became illegal in December 2008. The CAM concluded that the physical and psychological dependence potential of magic mushrooms was low, that acute toxicity was moderate, chronic toxicity low and public health and criminal aspects negligible. The combined use of mushrooms and alcohol and the quality of the setting in which magic mushrooms are used deserve, however, attention. In conclusion, the use of magic mushrooms is relatively safe as only few and relatively mild adverse effects have been reported. The low prevalent but unpredictable provocation of panic attacks and flash-backs remain, however, a point of concern.

Copyright 2011, Elsevier Science

Vindenes V; Jordbru D; Knapskog AB; Kvan E; Mathisrud G; Slordal L et al. Impairment based legislative limits for driving under the influence of non-alcohol drugs in Norway. (review). Forensic Science International 219(1-3): 1-11, 2012. (138 refs.)

Aims: When non-alcohol drugs are detected in blood samples from apprehended drivers in Norway, individualised expert opinions are required to evaluate degree of impairment. For alcohol, legislative limits have been in use since 1936. To harmonize the current practice for driving under the influence of alcohol and non-alcohol drugs, a judicial reform with legislative limits for non-alcohol drugs has been suggested. Methods: Impairment limits, representing drug concentrations in blood likely to be accompanied by a degree of impairment comparable to a blood alcohol concentration (BAC) of 0.02%, were proposed for 20 psychotropic drugs, including the most prevalent benzodiazepines, cannabis, GHB, hallucinogens and opioids. Limits for graded sanctions, representing drug concentrations in blood likely to induce impairment comparable to BACs of 0.05% and 0.12%, were defined for 13 of the 20 substances. The suggested limits were based on assessments of impairment after single doses of the drugs in naive individuals. The proposed limits will not apply to individuals with valid prescriptions for medicinal drugs, where the present system with individualised expert evaluations will be maintained. Conclusion: Norway is the first country planning to implement legislative limits for non-alcohol drugs corresponding to impairment seen at increasing BACs. The background and justification for the suggested limits are presented herein.

Copyright 2012, Elsevier Science

Vohra R; Seefeld A; Cantrell FL; Clark RF. Salvia divinorum: Exposures reported to a statewide poison control system over 10 years. Journal of Emergency Medicine 40(6): 643-650, 2011. (14 refs.)

Background: Salvia divinorum, a hallucinogenic herb, has in recent years become popular among teenagers and young adults. Salvia is presently marketed as a "legal" alternative to other drugs of abuse, but little is known about the clinical toxicity of this substance. Objectives: The purpose of this study is to describe the clinical and demographic features of this emerging substance of recreational abuse using data obtained from the records of a poison control center. Methods: We performed retrospective review of exposures to the herbal hallucinogen Salvia divinorum as reported to the California Poison Control System (CPCS) over the last 10 years. Demographic and clinical data were collected and compiled from the computerized records of the CPCS for the search terms "salvia" and "sage." Results: There were 37 exposures to S. divinorum and 96 exposures to non-hallucinogenic Salvia species. Eighteen (49%) of the exposures were to S. divinorum alone. Intentional Salvia exposures resulted in a variety of neurologic, cardiovascular, and gastrointestinal effects. Notably, the use of concomitant substances of abuse was associated with a high rate of complications and psychomotor disturbances. Conclusions: Intentional use of S. divinorum, whether alone or in combination with alcoholic beverages and other drugs, causes neurologic, cardiovascular, and gastrointestinal effects. This poison-center-based review helps to characterize the clinical toxicity of S. divinorum, but more clinical and pharmacologic research is warranted for this rapidly emerging substance of abuse.

Copyright 2011, Elsevier Science

Vollenweider FX; Kometer M. OPINION. The neurobiology of psychedelic drugs: Implications for the treatment of mood disorders. (review). Nature Reviews. Neuroscience 11(9): 642-651, 2010. (149 refs.)

After a pause of nearly 40 years in research into the effects of psychedelic drugs, recent advances in our understanding of the neurobiology of psychedelics, such as lysergic acid diethylamide (LSD), psilocybin and ketamine have led to renewed interest in the clinical potential of psychedelics in the treatment of various psychiatric disorders. Recent behavioural and neuroimaging data show that psychedelics modulate neural circuits that have been implicated in mood and affective disorders, and can reduce the clinical symptoms of these disorders. These findings raise the possibility that research into psychedelics might identify novel therapeutic mechanisms and approaches that are based on glutamate-driven neuroplasticity.

Copyright 2010, Nature Publishing

Wesson DR. Psychedelic drugs, hippie counterculture, speed and phenobarbital treatment of sedative-hypnotic dependence: A journey to the Haight Ashbury in the Sixties. Journal of Psychoactive Drugs 43(2): 153-164, 2011. (34 refs.)

The 1960s were a time of social upheaval, wars, vibrant creativity and missed opportunity. Mainstream culture and a psychedelic drug-using counterculture shared a belief in "better living through chemistry," but they disagreed about the particular chemistry. The Vietnam war and the cold war with the Soviet Union, racial discrimination, and gender roles fueled political activism. "Yes we can" was not a slogan of the time but political activists clearly believed they could change the beliefs, attitudes and behavior of mainstream culture; and they did. Hippie counterculture on the other hand was largely alienated and strove primarily to develop a separate culture with its own mores, beliefs and lifestyles. Although there was some overlap between hippies and activists, hippies didn't generally have the same sense of political empowerment. Hippie enclaves developed in New York; Boston; Seattle; Austin, Texas and elsewhere; but the epicenter was arguably the Haight-Asbury District of San Francisco. Psychedelic drugs, marijuana and the Vietnam war were among many wedge issues. This paper conjures up a personal history related to the evolution of the hippie counterculture, changing drug use patterns in the Haight-Ashbury, and the origins of a technique of withdrawing patients from barbiturates and other sedative-hypnotics using phenobarbital variously known as the "Phenobarbital Withdrawal Protocol, or the "Smith and Wesson Protocol."

Copyright 2011, Haight-Ashbury Publishing

Wu LT; Pan JJ; Yang CM; Reeve BB; Blazer DG. An item response theory analysis of DSM-IV criteria for hallucinogen abuse and dependence in adolescents. Addictive Behaviors 35(3): 273-277, 2010. (30 refs.)

Aim: This study applied both item response theory (IRT) and multiple indicators-multiple causes (MIMIC) methods to evaluate item-level psychometric properties of diagnostic questions for hallucinogen use disorders (HUDs), differential item functioning (DIF), and predictors of latent HUD. Methods: Data were drawn from 2004-2006 National Surveys on Drug Use and Health. Analyses were based on 1548 past-year hallucinogen users aged 12-17 years. Substance use and symptoms were assessed by audio computer-assisted self-interviewing methods. Results: Abuse and dependence criteria empirically were arrayed along a single continuum of severity. All abuse criteria indicated middle-to-high severity on the IRT-defined HUD continuum, while dependence criteria captured a wider range from the lowest (tolerance and time spent) to the highest (taking larger amounts and inability to cut down) severity levels. There was indication of DIF by hallucinogen users' age, gender, race/ethnicity, and ecstasy use status. Adjusting for DIF, ecstasy users (vs. non-ecstasy hallucinogen users), females (vs. males), and whites (vs. Hispanics) exhibited increased odds of HUD. Conclusions: Symptoms of hallucinogen abuse and dependence empirically do not reflect two discrete conditions in adolescents. Trends and problems related to hallucinogen use among girls and whites should be examined further to inform the designs of effective gender-appropriate and culturally sensitive prevention programs.

Copyright 2010, Elsevier Science

Wu LT; Woody GE; Yang CM; Blazer DG. How do prescription opioid users differ from users of heroin or other drugs in psychopathology: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Addiction Medicine 5(1): 28-35, 2011. (26 refs.)

Objectives: To study substance use and psychiatric disorders among prescription opioid users, heroin users, and nonopioid drug users in a national sample of adults. Methods: Analyses of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). Results: Four groups were identified among 9140 illicit or nonprescribed drug users: heroin-other opioid users (1.0%; used heroin and other opioids), other opioid-only users (19.8%; used other opioids but never heroin), heroin-only users (0.5%; used heroin but never other opioids), and nonopioid drug users (78.7%; used drugs but never heroin or other opioids). After adjusting for variations in socioeconomic characteristics, history of substance abuse treatment, and familial substance abuse, heroin-other opioid users had greater odds of several substance use disorders (SUDs; cocaine, hallucinogen, sedative, amphetamine, and tranquilizer) when compared with the other groups; heroin-only users had reduced odds of sedative and tranquilizer use disorders when compared with other opioid-only users. Nonopioid drug users had reduced odds of all SUDs and other mental disorders (mood, anxiety, pathologic gambling, and personality) when compared with other opioid-only users. Past-year other opioid-only users also reported slightly lower scores on quality of life than past-year nonopioid drug users. Conclusions: All opioid users had higher rates of SUDs than nonopioid drug users, and these rates were particularly increased among heroin-other opioid users. The findings suggest the need to distinguish between these 4 groups in research and treatment as they may have different natural histories and treatment needs.

Copyright 2011, Lippincott, Willams & Wilkins

Wu LT; Woody GE; Yang C; Blazer DG. Subtypes of nonmedical opioid users: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 112(1-2): 69-80, 2010. (44 refs.)

Aims: To identify subtypes of nonmedical opioid users, gender variations in psychiatric disorders, and quality of life in a representative sample of adults. Methods: Analyses of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093). Latent class analysis (LCA) and multinomial logistic regression procedures examined subtypes of nonmedical opioid users. Results: Approximately 5% (n=1815) of adults used nonmedical opioids. LCA identified four subtypes: opioid-marijuana users (33%), opioid-other prescription drug users (9%), opioid-marijuana-hallucinogen users (28%), and opioid-polydrug users (30%). Subtypes were distinguished by race/ethnicity, gender, familial substance abuse, personal history of substance abuse treatment, and patterns of psychiatric disorders. Whites and men had increased odds of being in the opioid-polydrug and opioid-marijuana-hallucinogen subtypes. The opioid-other prescription drug use subtype had disproportionately affected women who were characterized by high rates of mood/anxiety disorders and low quality of life. Across all subtypes, women and men had similarly problematic substance use disorders: however, women had more major depression and disability in the mental health domain. Conclusions: The generally high prevalence of psychiatric disorders among nonmedical opioid users, particularly women, underscores the need for comprehensive assessment and coordinated delivery of services to match needs with treatment, as well as continued monitoring of trends in opioid use and related problems.

Copyright 2010, Elsevier Science