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Heroin Epidemic Is Yielding to a Deadlier Cousin: Fentanyl

From The New York Times:

Fentanyl, which looks like heroin, is a powerful synthetic painkiller that has been laced into heroin but is increasingly being sold by itself — often without the user’s knowledge. It is up to 50 times more powerful than heroin and up to 100 times more potent than morphine. A tiny bit can be fatal.

In some areas in New England, fentanyl is now killing more people than heroin. In New Hampshire, fentanyl alone killed 158 people last year; heroin killed 32. (Fentanyl was a factor in an additional 120 deaths; heroin contributed to an additional 56.)

Fentanyl represents the latest wave of a rolling drug epidemic that has been fueled by prescription painkillers, as addicts continue to seek higher highs and cheaper fixes.

Nationally, the total number of fentanyl drug seizures reported in 2014 by forensic laboratories jumped to 4,585, from 618 in 2012. More than 80 percent of the seizures in 2014 were concentrated in 10 states: Ohio, followed by Massachusetts, Pennsylvania, Maryland, New Jersey, Kentucky, Virginia, Florida, New Hampshire and Indiana.

It was only last March that the Drug Enforcement Administration issued a nationwide alert about fentanyl, saying that overdoses were “occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety.”

Its chief characteristic is that it is fast acting.

Joanne Peterson, executive director of Learn to Cope, a statewide support network for families involved with addiction, said fentanyl works so quickly that there is often little time to administer naloxone, which reverses the effects of an overdose.

“At least with heroin, there is a chance that if someone relapses, they can get back into recovery,” she said. But with fentanyl, she said, it is only a matter of moments before an addict can be dead.

Posted: 3/28/2016 9:05:00 AM

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Four Things You Need to Know About Molly

From the influence:

Thanks to a string of name-checks by pop stars like Miley Cyrus, Madonna and Kanye West, as well as several tragic deaths at music festivals, ”molly”—aka MDMA—has rarely been far from the headlines in recent years.

 Last winter, a bad batch sent nearly a dozen Wesleyan students to the hospital. Then over the summer, a 19-year-old girl became the second young woman to die after taking the drug at Echostage, a Washington, DC music venue. And in 2013, a University of Virginia student passed away after taking molly—the same weekend two Electric Zoo attendees died after reportedly taking the drug.

 Let’s keep some perspective: Despite its potential to make people sick, it’s also important to remember that the majority of partiers popping molly across the globe don’t end up in the hospital. But why is it that some do?

 “The only people we see either through the emergency room or arrests are people having some kind of significant adverse effect, so we don’t really know what percentage of people who use it end up with these adverse effects,” says Dr. Barry Logan, a toxicologist who has studied molly.

 His insight, along with the published research, dispelled four common misconceptions about the popular party drug.

 1. Molly is not pure MDMA

Dr. Logan swabbed the saliva of 60 attendees who said they took molly at Miami’s Ultra music festival last year, and the results were damning: Only about 17% had ingested actual MDMA.

 Of those 60 people, about 35% had taken ethylone; 25% had taken methylone, and 13% had taken Alpha-PVP. These are all new psychoactive substances similar to MDMA, with A-PVP having more stimulant effects than methylone and ethylone. These newer drugs were, Dr. Logan says, synthesized in response to the prohibition of MDMA. And now they’re routinely passed off as MDMA.

 2. Deaths aren’t always the result of overdose

 Although higher doses of MDMA (and the synthetic cathinones often sold as MDMA) are generally considered riskier, low doses of MDMA can be dangerous too. A 2001 study in the Canadian Medical Association Journal found that while most MDMA-related “serious toxicity or fatality” involves blood levels of MDMA 40 times higher than the typical recreational dose, some fatalities involved doses considered “normal” among recreational users.

“With any drug and with MDMA and some of these substitutes, you absolutely can overdose on them if you take enough,” Dr. Logan says, “but I would say the adverse effects are typically not because people are overdosing. It’s because they’re taking it in a pattern of intensive use—they have some pre-existing risk factor [like a cardiac disease], or they’re taking it in an environment where they’re not hydrating or it’s already hot and they’re increasing their risk.”

 3. The club might not be the best place for molly

 The idea of using molly might evoke a crowd of pulsating partiers illuminated by a club’s light show. But taking molly in a hot, crowded club where water is only accessible behind the bar is a practice with plenty of negatives.

 Dr. Harold Kalant, author of the Canadian study noted earlier, wrote that “perhaps the most dangerous form of toxicity induced by ‘ecstasy’ is a hyperplexic pattern of toxicity that closely resembles heatstroke.”

 Most strikingly, this particularly dangerous reaction to MDMA “has become increasingly frequent since the adoption of MDMA by participants in raves.” MDMA increases body temperature a bit—but dancing in a hot crowd without hydrating greatly exacerbates this effect.

4. The “comedown” is heavily influenced by external factors

 The molly “comedown” is such a dreaded part of the experience that some users find it can sully the high, making them too anxious about how they’ll feel once the molly wears off to relax and enjoy their roll.

 Combining molly with other drugs and alcohol, a predisposition to mental illness, lack of sleep, or the simple fact of going from high to sober have all been linked to negative mood after a roll.
 

Posted: 2/9/2016 3:04:00 PM

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Three arrested in Paris over 'devil's breath' drug that turns victims into willing 'zombies'

From The Telegraph (UK):

Police have seized two Chinese women and a man in Paris suspected of using a powerful Colombian drug dubbed "the devil’s breath" that turns victims into “zombies” devoid of free will and rob them.

It is thought the three are part of an international Triad-style criminal gang running a multimillion-pound operation around the planet.

The women, aged 42 and 59, approached strangers in Paris’ 20th arrondissement and blew the substance into their faces. It is thought to contain scopolamine, a hazardous drug extracted from a South American tree related to deadly nightshade.

In strong doses it is lethal.

Paris’ judicial police believe the Chinese suspects administered the substance on “dozens” of victims in the French capital in the first reported case of such crimes.

"They managed to isolate their victims, then got them to breathe in a mixture of plants on the grounds they had powerful curative qualities – even protecting them from misfortune.”

Once they inhaled, all the victims recounted falling into a kind of “hypnotic state under the total sway of their handlers,” said the investigative source.

“They then took advantage by getting the victims to take them to their home, where they asked them to put all their jewellery and money into a bag and hand it over to them.”

Scopolamine is made from the seeds of a tree called Borrachero – roughly translated as “drunken binge” – which blooms with deceptively beautiful white and yellow flowers. It is mainly produced in Colombia via a chemical process that results in a white powder resembling cocaine.

Daily marijuana use among U.S. college students highest since 1980

From Michigan News:

Daily marijuana use among the nation's college students is on the rise, surpassing daily cigarette smoking for the first time in 2014.

A series of national surveys of U.S. college students, as part of the University of Michigan's Monitoring the Future study, shows that marijuana use has been growing slowly on the nation's campuses since 2006.

Daily or near-daily marijuana use was reported by 5.9 percent of college students in 2014—the highest rate since 1980, the first year that complete college data were available in the study. This rate of use is up from 3.5 percent in 2007. In other words, one in every 17 college students is smoking marijuana on a daily or near-daily basis, defined as use on 20 or more occasions in the prior 30 days.

Other measures of marijuana use have also shown an increase: The percent using marijuana once or more in the prior 30 days rose from 17 percent in 2006 to 21 percent in 2014. Use in the prior 12 months rose from 30 percent in 2006 to 34 percent in 2014. Both of these measures leveled in 2014.

In addition, the use of synthetic marijuana (also called K-2 or spice) has been dropping sharply since its use was first measured in 2011. At that time, 7.4 percent of college students indicated having used synthetic marijuana in the prior 12 months; by 2014 the rate had fallen to just 0.9 percent, including a significant decline in use in 2014. One reason for the decline in synthetic drug use is that an increasing number of young people see it as dangerous.

Cigarette smoking continued to decline among the nation's college students in 2014, when 13 percent said they had smoked one or more cigarettes in the prior 30 days, down from 14 percent in 2013 and from the recent high of 31 percent in 1999—a decline of more than half. As for daily smoking, only 5 percent indicated smoking at that level, compared with 19 percent in 1999—a drop of nearly three fourths in the number of college students smoking daily.

Unfortunately, the appreciable declines in cigarette smoking have been accompanied by some increases in the use of other forms of tobacco or nicotine. Smoking tobacco using a hookah (a type of water pipe) in the prior 12 months rose substantially among college students, from 26 percent in 2013 to 33 percent in 2014.

In 2014, the use of e-cigarettes in the past 30 days stood at 9.7 percent, while use of flavored little cigars stood at 9.8 percent, of regular little cigars at 8.6 percent and of large cigars at 8.4 percent. The study will continue tracking the extent to which these alternate forms of tobacco use are changing in popularity, not only among college students, but also among their age peers not in college and among secondary school students.

Posted: 9/1/2015 3:38:00 PM

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Users Say the 'Smart Drug' Modafinil Is the New Adderall — Only Better

From Vice News:

In the not-so-dark corners of the internet, there are groups of people talking about a drug they've nicknamed "moda," but they're not taking it to have a good time. They're taking it to work better, be more focused, and stay awake.

Moda is short for modafinil, which has been approved by the Food and Drug Administration to treat narcolepsy, and is sold in the US under the brand name Provigil. Some people are taking it off-label and without a prescription — having obtained the drug illegally — in the hopes of improving their cognitive abilities.

A review of 24 studies dating back to 1990 thrust the drug into the spotlight this month because it concluded that the drug does indeed improve cognition, but the researchers say their findings were more nuanced than headlines suggested.

Modafinil drawn comparisons to Adderall and Ritalin, which are FDA-approved amphetamines that are used to treat attention deficit hyperactivity disorder (ADHD) and some sleep disorders. All three drugs are popular among healthy people without these disorders who take them to study or work on big projects.

Unlike Adderall and Ritalin, modafinil doesn't come with a sense of euphoria. It's not thought to have the same potential for addiction and abuse, according to the Drug Enforcement Administration, which is why it's classified as a Schedule IV substance, while Adderall and Ritalin are listed in the more tightly restricted Schedule II category. Still, VICE News spoke to several "moda" users who purchase the drug illegally for non-medical use.

About 137,000 American college students start abusing prescription stimulants each year, according to a report by the federal Substance Abuse and Mental Health Services Administration released last week. The report, which is based on an annual survey of 67,500 people, doesn't name specific stimulants, but peak usage occurred in November, December, and April — key times in the academic calendar. A smaller, less scientific survey published in The Tab, a British publication, estimated that one in five UK university students had used modafinil.

Posted: 9/1/2015 10:26:00 AM

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The science behind forensic toxicology

From Quartz:

When we get our blood tested for cholesterol, it doesn’t take long to get the results. And if someone turns up at the hospital with what looks like a drug overdose, doctors can perform a quick test to verify their suspicions before treatment.

But unlike popular crime series like CSI, in which investigators whip up test results in the span of a quick montage, most forensic toxicology reports take anywhere from a few weeks to a few months. This can be an excruciating wait after mysterious deaths and unsolved crimes. Why does it take so long?

Quartz spoke with Robert Middleberg, a toxicologist from NMS Labs in Willow Grove, Pennsylvania, to find out.

Unlike other medical tests, where technicians isolate a specific compound like cholesterol, Middleberg says that you don’t always know what you’re looking for with forensic toxicology. “If you have a young person who is found dead in bed and there’s no history of drug abuse, you’re looking for the proverbial needle in a haystack,” he tells Quartz.

After a body is found and an autopsy is performed by a pathologist, a separate lab will look for any environmental or pharmaceutical toxins that could be the killers. Without any clear clues, Middleberg says they will start testing for about 400 different substances. “We never know what we’re going to get,” he notes. It takes creative intuition to guide a cycle of testing and interpreting the results of tests to inform further testing.

Once an initial analysis returns a match for a particular substance, toxicologists must gather more specifics for the official report. Bodies that have already started decaying produce some toxins naturally, like ethanol (another name for the alcohol we drink) and cyanide, so toxicologists may have to perform additional tests to determine whether these played an active role in the cause of death.

All of this is further complicated by the fact that samples often arrive in less than ideal conditions. “If somebody is pulled out of the water after being missing for two or three weeks, these samples are very, very bad,” Middleberg says.

Not every test is a complicated affair—despite all of the unknowns, Middleberg says that most labs try to have a turnaround time of 3-5 days for ruling things out and 7-10 days for identifying the specific factors leading to death.

Posted: 8/17/2015 7:54:00 AM

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Arthritis Drug May Help Eczema Patients, Too

From eMPR.com:

A drug used to treat rheumatoid arthritis (RA) was effective in patients with moderate to severe eczema, according to a study conducted by researchers from the Yale School of Medicine. Study findings are published in the Journal of American Academy of Dermatology.

Study authors hypothesized that tofacitinib citrate, a janus kinase (JAK) inhibitor, could interrupt the immune response that causes eczema. Previous studies had shown that tofacitinib citrate reversed two skin conditions: vitiligo and alopecia areata.

Study findings suggest tofacitinib may be beneficial for the treatment of eczema. More research is needed to assess the drug's long-term efficacy and safety in patients with eczema.

Posted: 7/28/2015 2:41:00 PM

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Monsanto prevails in PCB lawsuit

From the St. Louis Post-Dispatch:

A St. Louis County jury has found that Monsanto is not liable in a series of deaths and illnesses suffered by people who were exposed to the PCBs manufactured by the company until the late 1970s.

The jury found in favor of the agriculture giant after a full day of deliberations Monday, according to a St. Louis County Circuit Court clerk. The trial, involving plaintiffs from around the country, took nearly a month.

The lawsuit, filed against Monsanto, Solutia, Pharmacia and Pfizer, sought relief for plaintiffs who developed lymphohematopoietic cancer after being exposed to PCBs, or polychlorinated biphenyls, made by Monsanto. The company was the primary U.S. manufacturer of PCBs from 1929 to 1977, according to the lawsuit. They were used in a range of products, including food packaging and paint, before being banned in the late 1970s.

“The jury found the evidence doesn’t support the assertion that Monsanto’s conduct or the historic use of PCB products was the cause of the plaintiffs’ harms,” the company said in a written statement that also made reference to a similar jury decision last year in California.

An attorney for the plaintiffs did not return a call seeking comment.

Posted: 7/28/2015 2:37:00 PM

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Legal Loophole Closed on Potent Designer Drug

From Courthouse News Service:

The Drug Enforcement Administration issued a final order Friday placing an extremely potent street drug on the schedule of controlled substances after dozens of deaths.

Acetyl fentanyl, which the agency says is 15.7 times more potent than morphine and up to five times more powerful than heroin, is particularly dangerous because the range between the effective dose and the lethal dose is narrow.

The Center of Disease Control issued an alert on acetyl fentanyl in June 2013, after 14 deaths in Rhode Island were attributed to the drug over a three month period.

A total of 39 known deaths have been reported in Rhode Island, North Carolina, California, Louisiana, Oregon and Pennsylvania.

But the Drug Enforcement Administration says it is likely that emergency room admissions and deaths due to this drug are under-reported because "standard immunoassays cannot differentiate acetyl fentanyl from fentanyl."

Other "clandestinely produced fentanyl-like substances, commonly known as designer drugs" have surfaced since the late 1970s and 1980s and been placed on Schedule 1 of the Controlled Substance Act, the Drug Enforcement Administration said.

Due to the "imminent hazard to public safety," today's action by the DEA temporarily places the drug on Schedule 1 under the CSA, and it is effective immediately for up to two years, with a possible extension of one additional year, pending completion of the permanent scheduling process.

Posted: 7/20/2015 11:50:00 AM

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California scientists test Ecstasy as anxiety-reducer for gravely ill

From Reuters:

California scientists are testing whether the illegal psychoactive drug commonly known as Ecstasy could help alleviate anxiety for terminally ill patients, the trial's principal funder said on Tuesday.

At least a dozen subjects with life-threatening diseases like cancer, and who are expected to live at least 9 months, will participate in the double-blind trial over the next year in Santa Cruz, said Brad Burge, spokesman for the Multidisciplinary Association for Psychedelic Studies, in Santa Cruz.

Each subject will be randomly given either a full dose - 125 milligrams of MDMA, or an "active placebo" dose of 30 milligrams, Burge said.

Burge said the goal is to test whether gravely ill patients suffering from debilitating anxiety, fear or depression due to their diagnoses can find a measure of peace during the extended ecstasy-influenced psychotherapy sessions.

"Our hypothesis is that something is happening with MDMA that makes psychotherapy easier," Burge said.

Posted: 5/27/2015 9:34:00 AM

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