Wednesday, August 24, 2022

Magic mushrooms plus psychotherapy can quell heavy drinking, study shows


Giving psilocybin -- the psychedelic substance found in magic mushrooms -- to patients with alcohol use disorder, along with psychotherapy, helped reduce heavy drinking more than psychotherapy alone, new research shows. 
Photo by Shots Studio/Shutterstock



Aug. 24 (UPI) -- Adding psychedelics to psychotherapy helped treat adults' heavy drinking problem more than psychotherapy alone, a study published Wednesday says.

Giving high-dose psilocybin -- the psychedelic, mind-altering compound found in magic mushrooms -- twice to patients with alcohol use disorder, combined with psychotherapy, helped reduce the number of heavy drinking days more than a placebo medication and therapy.

And eight months after their first dose, 48% of the study's participants who received psilocybin stopped drinking completely.

That's the gist of research findings published in JAMA Psychiatry.

These results provide support for further study of psilocybin-assisted treatment for alcohol use disorder, according to the research team led by Dr. Michael P. Bogenschutz, a professor in the Department of Psychiatry at the NYU Grossman School of Medicine.

Bogenschutz also is director of the NYU Langone Center for Psychedelic Medicine, where he has studied psilocybin for the past decade.

The investigators said that although classic psychedelic medications have shown promise in treating alcohol use disorder, the efficacy of psilocybin is just being studied now.


During a press conference in New York on Wednesday, Bogenschutz described alcohol use disorder as a very serious, undertreated problem -- and said the effectiveness of current medications and psychotherapies, unlike psilocybin, tends to be minimal and don't work for many patients.

He was joined at the press conference by two study participants whose treatment with the new regimen was successful.

Jon Kostas, a middle-aged man who said he went to his first Alcoholics Anonymous meeting at age 16 and described his drinking problem as treatment-resistant, said of the NYU psilocybin study: "It definitely affected my life. I think it saved my life."


Paul Mavis, who said he'd been drinking for four decades, but decided he needed help in 2018, described his participation in the study as "a game changer in every single way."

Neither had ever used psychedelics, they said. And neither found the experience something they wanted to repeat.

"This was the exact opposite of a 'high' ... a very profound thing" that should be conducted under medical supervision, Mavis said.

"It's tough work, and I think that's why it works so well," Kostas said of being treated with psilocybin.

Psilocybin "definitely alters people's subjective experience," said lead researcher Bogenschutz. But this may be quite pleasant or highly disorienting.

"You can't just say, 'I want to feel good, I'm going to use psilocybin,'" he said. "It's definitely strongly mind-altering, but not a 'feel-good' drug."

Other researchers are trying to determine the psychedelic substance's usefulness in treatment for other woes.

In February, Johns Hopkins Medicine reported that two doses of psilocybin was effective in easing the symptoms of major depressive disorder for most patients for up to one year.

Johns Hopkins, which runs the Center for Psychedelic & Consciousness Research, is recruiting for a new study to investigate whether psilocybin can help people with depression who drink regularly.

The NYU-led study was a double-blind, randomized clinical trial offering participants 12 weeks of psychotherapy, and randomly assigning them to receive either psilocybin or diphenhydramine, an antihistamine medication, during two day-long medication sessions at weeks four and eight.

In the first session, people were given 25 milligrams per 70 kilograms of psilocybin or 50 mg. of diphenhydramine. In the second session, they received 25 to 40 mg. per 70 kg. of psilocybin, or 50 to 100 mg. of diphenhydramine.

Alongside this, they received motivational enhancement therapy and cognitive behavioral therapy.

Use of marijuana, hallucinogens soared to new high in 2021, NIH says

Use of marijuana and hallucinogens among young adults in the United States reached an all-time high in 2021, the National Institutes of Health reported Monday. 
Photo by Photographee.eu/Shutterstock

Aug. 22 (UPI) -- Use of marijuana and hallucinogens among young adults in the United States reached an all-time high in 2021, the National Institutes of Health reported Monday.

Use of these drugs, as self-reported by adults aged 19 to 30 years old, increased significantly last year compared to five and 10 years ago -- with marijuana use reaching its highest level in this age group since these trends were first monitored in 1988.

Overall, 43% of young adults reported past-year marijuana use in 2021, up from 34% in 2016 and 29% in 2011, a news release said. Daily pot use also climbed to involve 11% of young adults in 2021, up from 8% in 2016 and 6% in 2011.

In 2021, 8% of young adults reported past-year hallucinogen use: an all-time high since the category was first surveyed in 1988 -- and up from 5% in 2016 and 3% in 2011. Types of hallucinogens reported by participants included LSD, MDMA, mescaline, peyote, "shrooms" or psilocybin and PCP, the release said.

That's according to the latest Monitoring the Future panel study. Researchers have been surveying substance use annually since 1975 among a nationally representative sample of teens, following up to track participants' drug use through adulthood.

The latest data also show that rates of nicotine vaping in the past month, which have gradually increased in young adults over the past four years, continued their general upward trend to 16% in 2021 after leveling off in 2020. That compares to a 6% rate of nicotine vaping in 2017, when the practice was first monitored.

And marijuana vaping in the past month, which had significantly fallen in 2020, rebounded to pre-pandemic levels in 2021: doubling to 12% in 2021 from 6% in 2017.

Alcohol remains the most used substance among adults in the study, though rates of past-year, past-month and daily drinking have been decreasing over the last decade.

Binge drinking -- of five or more drinks in a row in the past two weeks -- rebounded in 2021 from a historic low in 2020 during the early stages of the COVID-19 pandemic.

And "high-intensity" drinking -- having 10 or more drinks in a row in the past two weeks -- has been steadily increasing over the past decade. In 2021, it reached its highest level ever recorded since first measured in 2005, a news release said.

"As the drug landscape shifts over time, this data provides a window into the substances and patterns of use favored by young adults. We need to know more about how young adults are using drugs like marijuana and hallucinogens, and the health effects that result from consuming different potencies and forms of these substances," National Institute on Drug Abuse Director Dr. Nora Volkow said in the release.

The study's participants self-reported their drug use across three primary time periods: lifetime, past year and past month. The research is conducted by scientists at the University of Michigan's Institute for Social Research in Ann Arbor, and funded by NIDA.

Data for the 2021 survey were collected online from April through October 2021.

The investigators followed up with participants to assess their outcomes over a 32-week, double-blind period after the first dose of medication.

They found the percentage of heavy drinking days over the 32 weeks was 9.7% for the psilocybin group and 23.6% for the diphenhydramine group. Also, daily alcohol consumption -- the number of standard drinks per day -- also was lower in the psilocybin group.

And they found no serious side effects among the people who received psilocybin.

The study included 93 adults 25 to 65 years old who had been diagnosed with alcohol dependence and had at least four heavy drinking days during the 30 days before screening.

It excluded people who had major psychiatric and drug use disorders, hallucinogen use, medical conditions that wouldn't allow the use of the study's medications and those in treatment for alcohol use disorder.

Use of LSD rising among young Americans


By Steven Reinberg,
 HealthDay News

The increase in hallucinogen use is likely caused by a decrease in the perception of the drug as risky, a recent study suggests
. Photo by Dick Stuert/Wikimedia Commons

If you think hallucinogens like LSD are a thing of the past, think again.

New research estimates that the use of mind-altering LSD rose from less than 1% in 2002 to 4% in 2019 among people aged 18 to 25. And, overall, 5.5 million Americans used some kind of hallucinogen in 2019.

"According to our results, hallucinogen use is a growing public health concern, warranting prevention strategies given the growing risk of unsupervised use," said lead researcher Dr. Ofir Livne. He's a postdoctoral fellow in the department of epidemiology at Columbia University's Mailman School of Public Health in New York City.

The increase in hallucinogen use is likely caused by a decrease in the perception of the drug as risky, Livne noted.

"Studies now indicate that certain hallucinogens, such as LSD and psilocybin, can improve cognitive [mental] function, productivity and mental health," Livne explained. "Nowadays, we see 'micro-doser' communities, essentially individuals who are exploring the reported positive effects of micro-doses of LSD without experiencing any negative effects."

Still, "in light of our findings, we believe there is a need for a comprehensive examination of the motives behind the use of LSD and other hallucinogens, especially since previous studies have reported increased risks of negative outcomes, such as cognitive impairments and mood disorders," Livne added. "Before hallucinogen use becomes 'normalized,' there needs to be a larger body of literature that can help discern safe use from hazardous use."

The research was published online Monday in the journal Addiction.

These findings mirror those of a new federal government study published this week that found that the use of hallucinogens like LSD, MDMA, mescaline, peyote, "shrooms," psilocybin and PCP started to increase in 2021 after staying relatively stable until 2020.

In 2021, 8% of young adults used a hallucinogen in the past year, an all-time high, that study found. In comparison, only 5% of young adults reported using a hallucinogen in the past year in 2016, while only 3% used one in 2011. The only hallucinogen that saw a decrease in use was MDMA (ecstasy or Molly), where use dropped from 5% in 2016 and 2020 to 3% in 2021.

Pat Aussem, associate vice president for consumer clinical content development at the Partnership to End Addiction, said that the increased use of hallucinogens may be a result of newfound interest in their beneficial effects on some mood disorders.

"While many hallucinogens are designated as Schedule 1 drugs with 'no currently accepted medical use,' they are increasingly being discussed on social media, at research institutes and in other forums as alternatives to more traditional pharmaceuticals for certain mental health problems," she said.

"Both personal anecdotes and promising clinical trials have given rise to the use of hallucinogens to address depression, anxiety, PTSD [post-traumatic stress disorder] and substance use disorders, as well as to improve cognitive functioning," Aussem explained.

The promise that hallucinogens can potentially treat depression, PTSD and other mental health ills - in some cases more quickly and with less onerous side effects - has played a role in the growing interest in these drugs, she said.

"There is also the commercial side of the equation, as by some estimates, the market is anticipated to grow from $2 billion in 2020 to over $10 billion in 2027. Huge investments are being made to capitalize on growing consumer interest in these substances," Aussem noted.

In 2019, the U.S. Food and Drug Administration approved a medication called Spravato for patients with severe depression who are not responding to other treatments. It's closely related to the psychedelic drug ketamine, but it is not the same as ketamine that someone might buy on the street. It also has to be given with an antidepressant in a supervised setting, she said.

Psilocybin is also being studied in clinical trials to treat depression and anxiety, she added.

Meanwhile, MDMA has been studied in clinical trials to address PTSD.

"It is expected to be approved by the FDA in 2023. Again, it is important to note that although ecstasy and MDMA are often used interchangeably, ecstasy may contain MDMA, but also be formulated with other substances that may be harmful," Aussem said.

Hallucinogens may work for some, but not all people, and for certain conditions they have risks, she said. The use of hallucinogens may be contraindicated if there is a personal or family history of psychosis, schizophrenia, bipolar disorder or suicidal ideation, as well as heart problems and seizures.

Depending upon the hallucinogen, there can be a wide range of short- and long-term effects, including nausea, increased heart rate, intense sensory experiences, relaxation, paranoia and persistent psychosis. They can also be riskier if mixed with alcohol and other substances, including prescription medications, Aussem said.

There is also a significant difference between the safety of hallucinogens used in a clinical trial and what people get on the street, she noted.

"It is especially important to note that street MDMA has been laced with fentanyl, a powerful pain reliever that is driving skyrocketing overdoses in our country," Aussem said.

"It can be tempting to try hallucinogens, especially if a person is struggling with mental health, but street drugs are not the answer," Aussem said. "The composition, strength, dosing and therapeutic oversight of the hallucinogens in the clinical trials underway and the FDA-approved medications are not a 'do-it-at-home' remedy. A person interested in pursuing hallucinogens may benefit by seeking guidance from their healthcare provider and investigating participation in clinical trials."

More information

For more on hallucinogens, head to the U.S. National Institute on Drug Abuse.

Copyright © 2022 HealthDay. All rights reserved.



Medical marijuana for pain linked to higher risk for heart arrhythmia

By Amy Norton, 
HealthDay News

Among 1.6 million people with chronic pain, those prescribed medical marijuana were 64% more likely to suffer a heart rhythm disturbance in the next six months, a recent study found.
 Photo by Circe Denyer/publicdomainpictures



People who use medical marijuana to treat chronic pain may have a slightly heightened risk of heart arrhythmias, a preliminary study suggests.

Researchers found that among 1.6 million people with chronic pain, those prescribed medical marijuana were 64% more likely to suffer a heart rhythm disturbance in the next six months.

The absolute risk was small: about 0.9% of patients on medical marijuana developed an arrhythmia, compared to 0.5% of those not taking the drug.

Plus, experts said, the findings do not prove that medical marijuana, per se, is to blame.


Still, chemicals in marijuana are known to affect the cardiovascular system - including heart rate, blood pressure and the tendency to form blood clots. And the findings add to concerns about the risks of using the drug, medicinally or otherwise, the study authors said.

"Just because something is 'natural' doesn't mean it's safe," said Robert Page, a professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences.

Page, who was not involved in the study, was lead author on an American Heart Association scientific statement on the cardiovascular risks of marijuana. It said that a number of studies have linked marijuana use to increased risks of conditions as serious as heart attack and stroke.


But those types of studies are unable to prove cause and effect: Most look back at the medical records of people who use marijuana and those who do not, and cannot account for all of the other differences between those two groups.

That's true of the current study, too, Page said.

He pointed to a key reason for the lack of strong data on marijuana's health effects: The drug was illegal for many years across the globe, and under federal law, it remains a Schedule 1 controlled substance in the United States, which limits the research that can be done.


Yet attitudes toward marijuana are rapidly shifting. Medical marijuana is now legal in most U.S. states, while 19 states and Washington, D.C., allow adults to use the drug recreationally, according to the National Conference of State Legislatures.

But legalization, Page said, should not be mistaken as proof of effectiveness or safety.

At the very least, he said, people should avoid smoking or vaping marijuana, due to all the other chemicals they would be inhaling. But "edibles" have their issues, too, Page noted. Their effects take longer to set in, and people may "stack" doses - which could expose them to high amounts of THC (the chemical famous for the marijuana "high").

Some widely available cannabis products claim to contain only the non-intoxicating chemical cannabidiol (CBD). But there's no way to know how much CBD (if any) a product contains, Page said.

"The problem is: They're unregulated. So it's buyer beware," he said.

The new findings come from Denmark, where medical marijuana was approved in 2018. Doctors there can prescribe it for chronic pain after all standard treatments, including opioid painkillers, fail to help.

The researchers used a national database with medical records from 1.6 million patients with chronic pain (related to cancer, arthritis, neurological conditions and other causes). Just under 4,600 of them filled at least one prescription for medical cannabis.

In Denmark, there are three approved forms of the drug, all taken orally, said researcher Dr. Nina Nouhravesh of Gentofte University Hospital. They include oral solutions and sprays of CBD; teas containing a mix of THC and CBD; and dronabinol, a synthetic form of THC.

Overall, the study found, pain patients on any form of medical marijuana were more likely to develop a heart arrhythmia in the six months after their first prescription, versus other patients.

Nouhravesh was scheduled to present the findings Monday at a meeting of the European Society of Cardiology, in Barcelona. Studies released at meetings are generally considered preliminary until they are published in a peer-reviewed journal.

One issue, Page said, is that people in chronic pain often have other health problems, and take multiple medications.

That was, indeed, the case in this study. And patients on medical marijuana were much more likely to be taking opioids than other pain patients were: 42%, versus 12%.

That's an important difference, said Dr. Jim Cheung, chairman of the American College of Cardiology's electrophysiology council.

Opioid use typically signals severe pain -- which itself could contribute to some arrhythmias, Cheung explained.

He also noted that some arrhythmias are more serious than others, and it's unclear whether medical marijuana was tied to any particular forms.

"I think this study highlights what we don't know," Cheung said. And that's important in itself, he noted. Patients and doctors should be aware the drug is associated with safety "signals" that need to be studied further.

"We don't want to disregard that there may be benefits for patients," Cheung said. "But we also want to be vigilant, just as we would with any medication, about the possible risks."

More information

Harvard Medical School has more on marijuana and heart health.

Copyright © 2022 HealthDay. All rights reserved.



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