drugs

ills and ells with loffs of toffs and pleures of bells

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With about a dozen trucks an hour setting off from the avocado belt in Mexico’s western state of Michoacán for the U.S., armed robbers are zeroing in on the fast-growing, multibillion-dollar industry. The rise in avocado-related crime has turned parts of the state into no-go areas even for the police. […]

Until recently, Mexico’s organized crime groups’ main source of revenues from avocados centred around extortion — demands for protection money from farmers. But the sharp fall in the price of Mexican opium paste has forced them to diversify, according to analysts.

Increasingly they have started hijacking truckloads of fruit for export. […] The rise in avocado crime is thus indirectly linked to America’s opioid crisis. Americans’ increased use of fentanyl, a synthetic opioid used for pain relief, pushed down the price of heroin, which in turn slashed the price of Mexican opium. […]

Demand for avocados jumps ahead of the Super Bowl, America’s biggest sporting event, with Mexico shipping a record 127,000 tonnes to the U.S. for the occasion. Overall production is rising, hitting 1.09 million tonnes in the 2018-19 season, up nearly 4 per cent from the 1.05 million produced in 2017-18. Exports last season rose 5.4 per cent. Sales to the U.S., the largest importer of Mexican avocados, bring in almost US$2 billion a year, much of it going to smallholders.

{ Financial Post | Continue reading }

art { Evan Roth, Landscapes, 2016-ongoing }

‘so many ankles out on this freakishly warm day, so few of them lotioned’ –Doreen St. Félix

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He had diabetes, and he had signed up for a study to see if taking a “statin” – a kind of cholesterol-lowering drug – might help. So far, so normal.

But soon after he began the treatment, his wife began to notice a sinister transformation. A previously reasonable man, he became explosively angry and – out of nowhere – developed a tendency for road rage. During one memorable episode, he warned his family to keep away, lest he put them in hospital. […]

In 2018, a study uncovered the same effect in fish. Giving statins to Nile tilapia made them more confrontational and – crucially – altered the levels of serotonin in their brains. This suggests that the mechanism that links cholesterol and violence may have been around for millions of years.

Golomb remains convinced that lower cholesterol, and, by extension, statins, can cause behavioural changes in both men and women, though the strength of the effect varies drastically from person to person. […]

The world is in the midst of a crisis of over-medication, with the US alone buying up 49,000 tonnes of paracetamol every year – equivalent to about 298 paracetamol tablets per person. [..]

Mischkowski’s own research has uncovered a sinister side-effect of paracetamol. For a long time, scientists have known that the drug blunts physical pain by reducing activity in certain brain areas, such as the insular cortex, which plays an important role in our emotions. These areas are involved in our experience of social pain, too – and intriguingly, paracetamol can make us feel better after a rejection.

And recent research has revealed that this patch of cerebral real-estate is more crowded than anyone previously thought, because it turns out the brain’s pain centres also share their home with empathy. […] results revealed that paracetamol significantly reduces our ability to feel positive empathy – a result with implications for how the drug is shaping the social relationships of millions of people every day. […] Technically, paracetamol isn’t changing our personalities, because the effects only last a few hours and few of us take it continuously.

{ BBC | Continue reading }

photo { Logan White }

I am dying, Egypt, dying

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A new drug, created to treat just one patient, has pushed the bounds of personalized medicine and has raised unexplored regulatory and ethical questions.

The drug, described in The New England Journal of Medicine, is believed to be the first “custom” treatment for a genetic disease. It is called milasen, named after the only patient who will ever take it: Mila (mee-lah) Makovec, who lives with her mother, Julia Vitarello, in Longmont, Colo. […]

Milasen is believed to be the first drug developed for a single patient (CAR-T cancer therapies, while individualized, are not drugs). But the path forward is not clear, Dr. Yu and his colleagues acknowledged. There are over 7,000 rare diseases, and over 90 percent have no F.D.A.-approved treatment […]

Tens of thousands of patients could be in Mila’s situation in the United States alone. But there are nowhere near enough researchers to make custom drugs for all who might want them.

And even if there were, who would pay? Not the federal government, not drug companies and not insurers, said Dr. Steven Joffe, professor of medical ethics and health policy at the University of Pennsylvania.

“Unfortunately, that leaves it to families,” he added. “It feels awfully uncomfortable, but that is the reality.”

That means custom drugs would be an option only for the very wealthy, those with the skills to raise large sums of money, or those who gain the support of foundations.

Mila’s drug development was mostly paid for by the foundation run by her mother, but she and Dr. Yu declined to say how much was spent.

{ NY Times | Continue reading }

screenprint on Perspex { Bridget Riley, Untitled [Fragment 3/11], 1965 }

The eye could not see from any point

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There’s been an explosion of interest in the use of psychedelics in psychiatry. […]

Psychedelics have mostly been investigated in small studies run by true believers. […] Some of the most exciting psychedelic findings have already failed to replicate […]

Ketamine is the best comparison for psychedelics. […] Like psychedelics, it got hyped as an exciting new innovation that was going to revolutionize everything in psychiatry (in this case, depression treatment). But it’s been in pretty common (albeit non-formulary) use for five years now, and nothing has been revolutionized. […]

Between 10% and 50% of Americans have tried psychedelics. If psychedelics did something shocking, we would already know about it. […]

Even if all of the above are wrong and psychedelics work very well, the FDA could kill them with a thousand paper cuts. Again, look at ketamine: the new FDA approval ensures people will be getting the slightly different esketamine, through a weird route of administration, while paying $600 a pop, in specialized clinics that will probably be hard to find. Given the price and inconvenience, insurance companies will probably restrict it to the most treatment-resistant patients, and it probably won’t help them (treatment-resistant patients tend to stay that way). Given the panic around psychedelics, I expect it to be similarly difficult to get them even if they are legal and technically FDA-approved. Depressed people will never be able to walk into a psychiatrist’s office and get LSD. They’ll walk into a psychiatrist’s office, try Prozac for three months, try Wellbutrin for three months, argue with their insurance for a while, eventually get permission to drive to a city an hour away that has a government-licensed LSD clinic, and get some weird form of LSD that might or might not work, using a procedure optimized to minimize hallucinations.

{ Slate Star Codex | Continue reading }

Light travels faster than sound, this is why some people appear bright until they speak

Case of Tetanus, in Which a Large Quantity of the Tincture of Opium Was Administered by Mistake (1819)

On the Cure of Tetanus by Opium and the Warm Bath (1812)

{ PubMed }

Disorderly houses. Lord knows where they are gone.

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The war against cocaine rests on a simple idea: If you restrict its supply, you force up its price, and fewer people will buy it. Andean governments have thus deployed their armies to uproot the coca bushes that provide cocaine’s raw ingredient. Each year, they eradicate coca plants covering an area 14 times the size of Manhattan, depriving the cartels of about half their harvest. But despite the slashing and burning, the price of cocaine in the U.S. has hardly budged, bobbing between $150 and $200 per pure gram for most of the past 20 years. How have the cartels done it?

In part, with a tactic that resembles Wal-Mart’s. The world’s biggest retailer has sometimes seemed similarly immune to the laws of supply and demand, keeping prices low regardless of shortages and surpluses. Wal-Mart’s critics say that it can do this in some markets because its vast size makes it a “monopsony,” or a monopoly buyer. Just as a monopolist can dictate prices to its consumers, who have no one else to buy from, a monopsonist can dictate prices to its suppliers, who have no one else to sell to. If a harvest fails, the argument goes, the cost is borne by the farmers, not Wal-Mart or its customers. […]

The raw leaf needed to make one kilogram of cocaine powder costs about $400 in Colombia; in the U.S., that kilogram retails for around $150,000, once divided into one-gram portions. So even if governments doubled the price of coca leaf, from $400 to $800, cocaine’s retail price would at most rise from $150,000 to $150,400 per kilogram. The price of a $150 gram would go up by 40 cents—not much of a return on the billions invested in destroying crops. Consider trying to raise the price of art by driving up the cost of paint. […]

A dollar spent on drug education in U.S. schools cuts cocaine consumption by twice as much as spending that dollar on reducing supply in South America; spending it on treatment for addicts reduces it by 10 times as much.

{ Wall Street Journal | Continue reading }

photo { Robert Frank, Bar, New York City, 1955-56 }

(The freckled face of Sweny, the druggist, appeals in the disc of the soapsun.)

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Marijuana is one of the most commonly used drugs in the United States, and use during adolescence — when the brain is still developing — has been proposed as a cause of poorer neurocognitive outcome. Nonetheless, research on this topic is scarce and often shows conflicting results, with some studies showing detrimental effects of marijuana use on cognitive functioning and others showing no significant long-term effects.

The purpose of the present study was to examine the associations of marijuana use with changes in intellectual performance in two longitudinal studies of adolescent twins (n = 789 and n = 2,277). We used a quasiexperimental approach to adjust for participants’ family background characteristics and genetic propensities, helping us to assess the causal nature of any potential associations. Standardized measures of intelligence were administered at ages 9–12 y, before marijuana involvement, and again at ages 17–20 y. Marijuana use was self-reported at the time of each cognitive assessment as well as during the intervening period.

Marijuana users had lower test scores relative to nonusers and showed a significant decline in crystallized intelligence between preadolescence and late adolescence. However, there was no evidence of a dose–response relationship between frequency of use and intelligence quotient (IQ) change. Furthermore, marijuana-using twins failed to show significantly greater IQ decline relative to their abstinent siblings.

Evidence from these two samples suggests that observed declines in measured IQ may not be a direct result of marijuana exposure but rather attributable to familial factors that underlie both marijuana initiation and low intellectual attainment.

{ Proceedings of the National Academy of Sciences }

photo { Julia Margaret Cameron, Paul and Virginia, 1864 }

Orpheus with his lute made trees

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News of the successful use of ether anesthesia on October 16, 1846, spread rapidly through the world. […] Incredibly, this option was not accepted by all, and opposition to the use of anesthesia persisted among some sections of society decades after its introduction.

We examine the social and medical factors underlying this resistance. […] Complications of anesthesia, including death, were reported in the press, and many avoided anesthesia to minimize the considerable risk associated with surgery. Modesty prevented female patients from seeking unconsciousness during surgery, where many men would be present. Biblical passages stating that women would bear children in pain were used to discourage them from seeking analgesia during labor. […] In certain geographical areas, notably Philadelphia, physicians resisted this Boston-based medical advance, citing unprofessional behavior and profit seeking.

{ Journal of Anesthesia History | Continue reading }

photo { Peter Martin, Greenwich Village Nudes, Figure #1, 1951 }

My name’s Elvira but you can call me tonight

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State-of-the-art forensic technology from South Africa has been used to try and unravel the mystery of what was smoked in tobacco pipes found in the Stratford-upon-Avon garden of William Shakespeare.

Residue from clay tobacco pipes more than 400 years old from the playwright’s garden were analysed. […] Results of this study (including 24 pipe fragments) indicated cannabis in eight samples, nicotine in at least one sample, and in two samples definite evidence for Peruvian cocaine from coca leaves.

{ The Independent | Continue reading }

photos { 1 | John K. }

Thursday: not a good day either for a mutton kidney at Buckley’s.

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Healthy people who were given the serotonin-boosting antidepressant citalopram were willing to pay twice as much to prevent harm to themselves or others, compared to those given a placebo. By contrast, those who were given a dose of the dopamine-enhancing Parkinson’s drug levodopa made more selfish decisions, overcoming an existing tendency to prefer harming themselves over others.

{ IB Times | Continue reading }

‘We should not be upset that others hide the truth from us, when we hide it so often from ourselves.’ –La Rochefoucauld

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Many people spontaneously use the word (or sound) “Um” in conversation, a phenomenon which has prompted a considerable volume of academic attention. A question arises though, can someone be induced to say “Um” by chemical means – say with the use of a powerful anaesthetic? Like, for example Ketamine? […]

[V]olunteers who were given “low doses” and “high doses” of Ketamine tended to use the words “um” and “uh” significantly more than those who received a placebo only.

{ Improbable | Continue reading }

‘You could die, but the desert would hide the secret of your death, it would remain after you, to cover your memory with ageless wind and heat and cold.’ –John Fante

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Four drug deaths last month in Britain have been blamed on so-called “Superman” pills being sold as Ecstasy, but actually containing PMMA, a synthetic stimulant drug with some MDMA-like effects that has been implicated in a number of deaths and hospitalizations in Europe and the U.S. The “fake Ecstasy” was also under suspicion in the September deaths of six people in Florida and another three in Chicago. An additional six deaths in Ireland have also been linked to the drug.

PMMA, or paramethoxymethamphetamine, causes dangerous increases in body temperature and blood pressure, is toxic at lower doses than Ecstasy, and requires up to two hours in order to take effect. […]

The Spice products—synthetic cannabinoids—are still the most common of the novel synthetic drugs. Hundreds of variants are now on the market. Science magazine recently reported on a UK study in which researchers discovered more than a dozen previously unknown psychoactive substances by conducting urine samples on portable toilets in Greater London.

{ Addiction Inbox | Continue reading }

photo { Todd Papageorge, Studio 54, 1978–80 }