The history (and future) of psychedelic science —

Back in 2010, the journal Nature Reviews Neuroscience published an article looking at the neurobiology of psychedelic drugs and why researchers were returning to this field after 40 years of stagnation. As part of that, they commissioned four of the best neuroscience bloggers on the Internet to write posts about the history of psychedelic psychiatry and the possible ways we could use these drugs to help people. I stumbled across this collection recently, and thought you all might enjoy it. — Maggie •

How much caffeine is too much caffeine? —

To overdose on caffeine, you'd probably have to drink around 75 8oz cups of brewed coffee over the course of just a few hours. The effects vary from person to person, but that's a good estimate for a toxic dose. On the other hand, it doesn't take much caffeine at all to start experiencing negative side-effects, like heart palpitations or mood swings. A review of 200 studies suggests that a safe dose for an adult is only about 3 8oz cups. — Maggie •

FDA wants Ambien doses cut for women because users are crashing cars the morning after —

The Food and Drug Administration today announced it will require the makers of popular sleeping pills like Ambien and Zolpimist to reduce the recommended dosage in half for women, "after laboratory studies showed that the medicines can leave patients drowsy in the morning and at risk for car accidents." Women eliminate the drugs from their bodies more slowly than men. (NYT) — Xeni •

This is a really important long read that we all need to pay attention to. It concerns how we treat people with who are suffering from paranoid delusions — and how we treat people whose families worry that they are a threat to others. It concerns the relationships between doctors and the pharmaceutical industry. It concerns the ethics of clinical trials — the risks we run as we test potential treatments that could help many, or hurt a few, or both. If we want to reform mental health care, this needs to be part of the discussion.

In 2004, Dan Markingson committed suicide. The story behind that death is complicated and depressing. At the Molecules to Medicine blog, Judy Stone documents the whole thing in three must-read chapters. Many people find help in psychiatric drugs, and credit those drugs with making their lives better. (Full disclosure, I'm one of them. I have used Ritalin for several years. I am temporarily on an anti-depressant.) But we have to pay attention to how those drugs get to us. This isn't just about treating people. It's about the process that gets us there. Because, if that process is compromised, the treatments we get won't be as effective and lives will be lost along the way.

Markingson began to show signs of paranoia and delusions in 2003, believing that he needed to murder his mother. He was committed to Fairview Hospital involuntarily after being evaluated by Dr. Stephen Olson, of the University of Minnesota. He was subsequently enrolled on a clinical trial of antipsychotic drugs—despite protests from his mother. This study was a comparison of atypical antipsychotics for the treatment of first episodes of schizophrenia (aka the CAFÉ study), sponsored by AstraZeneca. The study’s structure was that of a Phase 4 randomized, double-blind trial comparing the effectiveness of three different atypical antipsychotic drugs: Zyprexa (olanzapine), Risperdal (risperidone) and Seroquel (quetiapine), with each patient to be treated for a year.

After about two weeks on study treatment in the hospital, Markingson was discharged to a halfway house—again over his mother’s objections. Over the coming months, Dan’s mother, Mary Weiss, continued to express concerns about her son’s deterioration, even asking if her son might have to kill himself before anyone else would take notice…then, in fact, her son violently committed suicide on May 7, 2004, mutilating himself with a box cutter. The University of Minnesota and their IRB have maintained that the study was conducted appropriately and that they have no responsibility for Dan’s death. Dan’s mother and bioethicist Carl Elliott believe otherwise.

We’ll explore some of the major issues of contention in this case over several posts, as illustrative of basic clinical research principles, including adequacy of informed consent, IRB oversight, conflicts of interest, and coercion, including threats to a bioethicist whistleblower.

Read the first part of the story

Read the second part: How clinical trials should be done and how they were done in this case.

Read the third part: Conflicts of interest between the researchers and the pharmaceutical industry.

Image: Pills (white rabbit), a Creative Commons Attribution (2.0) image from erix's photostream

Ramez Naam's debut novel Nexus is a superbly plotted high-tension technothriller about a War-on-Drugs-style crackdown on brain/computer interfaces. Kaden and his friends are Bay Area grad students who've hacked Nexus 3, a recreational party drug that nano-infests its users brains and makes them weakly telepathic while they dance the night away. What Kaden and his fellow bio-hackers do is build a Turing-complete virtual machine on top of this platform, port a lightweight version of GNU/Linux (or fictional analog) to it, and start running software on their own minds, arranging for strongly telepathic, hive-mind-style linkups.

This turns out to be a completely prohibited activity in the USA, where enforcement of a convention against posthuman and transhuman enhancement has spawned a DHS-on-steroids (heh) that can render its arrestees to internment camps without trial. The enforcement apparatus is nominally aimed at fighting neuroslavery, ghastly human trafficked sexbots, and apocalyptic cults whose followers are infected with god-viruses that make them worship the leaders as messiahs and render them pliant to their will. But the convention doesn't distinguish between hackers who conduct legitimate scientific inquiry and slavers and terrorists. Any advance in this sort of technology represents an existential threat to the human race, and it is not permitted, period.

Nexus tells the story of Kaden's kidnapping and blackmailing by the anti-trafficking enforcement side, who have the power of life and death over his friends and their wider circle of pals/experimental subjects. He is turned into an intelligence asset, charged with militarizing his research, and sent to entrap one of China's leading neuroscientists.

What follows is a beautifully plotted thriller, one that is full of delicious, thoughtful moral ambiguity. The power and cost of technology is thoroughly examined, turned over and peered at from every angle, and even the worst bad guys have at least a colorable claim on our sympathy at one moment or another. Naam is a hacker-turned-futurist who's run a nanotech startup, so the nerdly stuff all has the ring of truth. This is combined with excellent spycraft, kick-ass action scenes, and a chilling look at a future cold war over technology and ideology, making a hell of a read.

Nexus

Free Kindle preview of first three chapters

Photo: Shutterstock. "Young man eating leaves of hemp. Shoot in the field of marijuana."

“We’ve got bigger fish to fry,” Obama told ABC News' Barbara Walters, speaking about marijuana smokers in Colorado and Washington.

In those two states, recreational use is now legal, but the DEA still has a hard-on for weed prohibition, as demonstrated by the agency's ongoing and aggressive dispensary raids in CA. According to the president, going after potsmokers in states where it's legal is no longer a high (heh) priority.

“It would not make sense for us to see a top priority as going after recreational users in states that have determined that it’s legal,” he said. 

“This is a tough problem, because Congress has not yet changed the law,” Obama told Walters of the legalization in Colorado and Washington. “I head up the executive branch; we’re supposed to be carrying out laws. And so what we’re going to need to have is a conversation about, how do you reconcile a federal law that still says marijuana is a federal offense and state laws that say that it’s legal?”

More in the Washington Post.

California Youth Crime Plunges to All-Time Low, a paper from the Center on Juvenile and Criminal Justice, analyzes recent data from the California Department of Justice’s Criminal Justice Statistics Center, and concludes that decriminalizing marijuana was correlated with an unheard-of 20% drop in the youth crime rate. The California youth crime rate is now the lowest it's been in recorded state history.

A large proportion of the drop in youth crime is directly attributable to a drop in arrests for possession of small amount of marijuana, but the rest seems to be a dividend from keeping kids out of the criminal justice system. That is, if you stop jailing kids for holding a little weed, they won't go to juvie and become career criminals.

California is still jailing some kids for holding, though, thanks to the provision in law that makes possessing marijuana in or near a school into a special offense.

Males said he suspects that many of the 5,831 marijuana arrests of juveniles in California last year may have occurred on school grounds. He doesn’t have data yet to check his theory, however.

In his police briefing, Males also notes that juvenile arrests in California were the lowest ever recorded since statewide statistics were first compiled in 1954. The decline, Males said, wasn’t due just to fewer marijuana arrests.

Drug-related juvenile arrests overall fell by 47 percent between 2010 and 2011. Violent crime arrests fell by 16 percent; homicide arrests by 26 percent; rape arrests by 10 percent; and property-crime arrests by 16 percent. Nationwide, according to the FBI Uniform Crime Reports, arrests of juveniles for all offenses decreased 11.1 percent in 2011 when compared with the 2010 number; arrests of adults declined 3.6 percent.

Marijuana Decriminalization Drops Youth Crime Rates by Stunning 20% in One Year [Alternet] (via Reddit)

Cocaine Halloween Nights —

A gentleman in England "mistakenly handed out his cocaine stash to children" instead of Halloween candy, earning him 130 hours of community service and a fine. [Reuters] — Rob •

Lisa Rein from the Timothy Leary estate writes,

Fifty years after being cut loose by Harvard for being too enthusiastic regarding the successful results of his experiments with psilocybin and LSD, the only complete collection of Timothy Leary's published works, including the papers of the original Harvard psychedelic research, has been acquired by the university that banished him and his partner, Richard Alpert (Ram Dass), in 1963.

The Leary collection is just one of the many jewels in the Ludlow-Santo Domingo Library of Geneva that the prestigious Houghton Library recently acquired on long-term loan. Virtually unknown to the public, it is the greatest library of psychoactive drug history, literature, science and culture on the planet, formed over a decade by a visionary and committed collector, Julio Santo Domingo (1958-2009).

Leary and Alpert took their banishment from Academia in stride, and helped further the budding Psychedelic Revolution, which subsequently was itself banished from western society. So in a sense, Leary is making a comeback, just as psychedelic research appears to be. With all the printed work by and about him in one place, presently being processed and catalogued (it will take a while), students and historians will be able to study the research and truly assess the role of Leary, Alpert, Metzner, and the most famous mind drug in history.

Timothy Leary and Harvard, Reunited At Last

An excellent long read on the growing phenomenon of prescription drug overdoses in Southern California, which a Los Angeles Times investigative team reports "now claim more lives than heroin and cocaine combined, fueling a doubling of drug-related deaths in the United States over the last decade."

Health and law enforcement officials seeking to curb the epidemic have focused on how OxyContin, Vicodin, Xanax and other potent pain and anxiety medications are obtained illegally, such as through pharmacy robberies or when teenagers raid their parents' medicine cabinets. Authorities have failed to recognize how often people overdose on medications prescribed for them by their doctors.

A Los Angeles Times investigation has found that in nearly half of the accidental deaths from prescription drugs in four Southern California counties, the deceased had a doctor's prescription for at least one drug that caused or contributed to the death. Reporters identified a total of 3,733 deaths from prescription drugs from 2006 through 2011 in Los Angeles, Orange, Ventura and San Diego counties.

Not one of them was from marijuana, which remains a schedule 1 narcotic and is responsible for zero overdose deaths because one cannot die from a marijuana overdose.

Read the rest. Reporting by Scott Glover, Lisa Girion, with photos and video by Liz Baylen.

The new Dutch government has scrapped plans to issue "weed passes" to permanent Dutch residents, and require these passes in order to purchase cannabis products in Amsterdam's famed marijuana "coffee shops." Other cities will be free to ban foreigners from their own cannabis coffee shops, should they choose, but the national government will not impose this upon them.

Incoming Dutch government ditches 'weed pass' plan (via Reddit)