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Sociology

Does psychedelic drug use reduce risk of suicidality? Evidence from a longitudinal community-based cohort of marginalised women in a Canadian setting

Abstract

OBJECTIVE:
This study aimed to longitudinally investigate whether ever having used a psychedelic drug can have a protective effect on incidence of suicidality among marginalised women.
DESIGN:
Longitudinal community-based cohort study.
SETTING:
Data were drawn from a prospective, community-based cohort of marginalised women in Metro Vancouver, Canada.
PARTICIPANTS:
766 women completed the baseline questionnaire between January 2010 and August 2014. Participants who did not report suicidality at baseline and who completed at least one follow-up visit were included.
MAIN OUTCOME MEASURE:
Extended Cox regression was used to model predictors of new suicidality (suicide ideation or attempts) over 54-month follow-up.
RESULTS:
Nearly half (46%; n=355) of participants reported prior suicidality and were thus excluded from the present analyses. Of 290 women eligible at baseline, 11% (n=31) reported recent suicidality during follow-up, with an incidence density of 4.42 per 100 person-years (95% CI 3.10 to 6.30). In multivariable analysis, reported lifetime psychedelic drug use was associated with a 60% reduced hazard for suicidality (adjusted HR (AHR) 0.40; 95% CI 0.17 to 0.94). Crystal methamphetamine use (AHR 3.25; 95% CI 1.47 to 7.21) and childhood abuse (AHR 3.54; 95% CI 1.49 to 8.40) remained independent predictors of suicidality.
CONCLUSION:
The high rate of suicidality identified in this study is of major concern. Alongside emerging evidence on the potential of psychedelic-assisted therapy to treat some mental illness and addiction issues, our findings demonstrate that naturalistic psychedelic drug use is independently associated with reduced suicidality, while other illicit drug use and childhood trauma predispose women to suicidality. While observational, this study supports calls for further investigation of the therapeutic utility of psychedelic drugs in treating poor mental health and promoting mental wellness.
Argento, E., Strathdee, S. A., Tupper, K., Braschel, M., Wood, E., & Shannon, K. (2017). Does psychedelic drug use reduce risk of suicidality? Evidence from a longitudinal community-based cohort of marginalised women in a Canadian setting. BMJ open7(9), e016025. 10.1136/bmjopen-2017-016025
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The 21st century psychedelic renaissance: heroic steps forward on the back of an elephant

Abstract

Given the plethora of new studies and published papers in the scientific press and the increasingly emerging presence of articles about positive psychedelic experiences appearing in the popular media, there is little doubt that we are in the midst of a Psychedelic Renaissance. The classical psychedelic drugs LSD and psilocybin and the entactogen MDMA are showing promise as tools to assist psychotherapy for a wide range of mental disorders, with multiple pilot studies demonstrating their safety and efficacy. In this article, the author describes how MDMA in particular has inherent characteristics that make it well suited for assisting trauma-focused psychotherapy in a population of patients who have experienced child abuse. But despite these advances, there remain many obstacles ahead of the widespread mainstream acceptance of psychedelic medicines. The author argues that the Misuse of Drugs Act 1971 is one such obstacle. Other impediments include a prevailing attitude of pseudoscience and rigidity from within the non-scientific psychedelic community itself. Resolution of these conflicts must be sought if medicine and society are to see psychedelics gaining a place in mainstream culture and science.
Sessa, B. (2017). The 21st century psychedelic renaissance: heroic steps forward on the back of an elephant. Psychopharmacology, 1-10. 10.1007/s00213-017-4713-7
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Constructing drug effects: A history of set and setting

Set and setting is a term which refers to the psychological, social, and cultural parameters which shape the response to psychedelic drugs. The concept is considered fundamental to psychedelic research and has also been used to describe nonpharmacological factors which shape the effects of other agents such as alcohol, heroin, amphetamines, or cocaine. This paper reviews the history and evolution of the concept of set and setting from the 19th-century Parisian Club des Hashischins, through to 1950s psychotomimetic research on nondrug determinants of psychopharmacology, the use of extra-drug techniques by psychedelic therapists of the 1950s, and the invention of the concept of set and setting by Leary. Later developments and expansions on the concept of set and setting are discussed, and the term of collective set and setting is suggested as a theoretical tool to describe the social forces which shape individual set and setting situations. The concept of set and setting, it is argued, is crucial not only for psychedelic research but also for advancing drug research and developing more effective drug policy.
Hartogsohn, I. (2017). Constructing drug effects: A history of set and setting. Drug Science, Policy and Law3, 2050324516683325.
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Shaping Strong People: Napo Runa Therapeutic Narratives of Medicinal Plant Use

Abstract

Indigenous people living in contemporary Upper Amazonia marshal their ethnomedical knowledge and praxis to greet pressing challenges and to derive meaning from phenomena operating at wider scales of influence. In this chapter, I provide ethnographic examples of how Napo Runa deploy subaltern therapeutic narratives about medicinal plant use that contest violence they experience in their everyday lives and that reaffirm the purpose and consequences of social circulation of medicinal plants. These therapeutic narratives situate bodies in contexts of lived experience by drawing on historical, social–political, and environmental realties of the people crafting them. Here, ethnomedical knowledge is leveraged to contend with transnational processes that have direct and dangerous impacts on individual bodies. This work seeks not only to document how Napo Runa use plants to promote health and well-being but also to demonstrate that how they talk about their plant use illustrates their resistance to everyday forms of violence.

Bridges, N. C. (2016). Shaping Strong People: Napo Runa Therapeutic Narratives of Medicinal Plant Use. In Plants and Health (pp. 93-116). Springer International Publishing. 10.1007/978-3-319-48088-6_4

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Psychological and neuropsychological assessment of regular hoasca users

Abstract

BACKGROUND: Hoasca (also called ayahuasca) is a N,N-dimethyltryptamine (DMT) – containing psychedelic brew originally used for magico-religious purposes by Amerindian populations of the Amazon Basin. Recently, Brazilian syncretic churches have helped spread the ritual use of hoasca to Western societies. The aim of this study was to evaluate substance use, and neuropsychological and psychological functioning of regular hoasca users within a religious setting.

METHODS: Assessment of socio-economic status, mood, personality traits, impulsiveness, drug use, quality of life, extrinsic and intrinsic religiosity, and neuropsychological function was performed on 30 volunteers from a U.S. branch of União do Vegetal (UDV), a Brazilian religion which uses hoasca ritually. We also assessed 27 non-hoasca-using control subjects matched by socio-demographic profile and church attendance. Mann-Whitney U, chi-squared and Fisher tests were used to analyze differences between groups. Spearman’s association and simple logistic regression tests were used to analyze the impact of frequency of hoasca use on dependent variables.

RESULTS: Relative to the control group, the UDV group demonstrated lower scores for depression (p=0.043, r=.27) and confusion (p=0.032, r=.29) as assessed by the Profile of Mood States (POMS); higher scores on the instrument Big Five Inventory (BFI) for the personality traits agreeableness (p=0.028, r=.29) and openness (p=0.037, r=.28); higher scores on the quality life domain role limitations due to physical health as determined by the instrument Medical Outcomes Study Short Form-36 – SF-36 (p=0.035, r=.28); less recent use of alcohol (p<0.001, φc=.57), greater past use of alcohol to intoxication (p=0.007, φc=.36) and past use of cannabis (p=0.001, φc=.45) as measured by the Addiction Severity Index (ASI), 5th edition; better score on a measure of memory vulnerability to proactive interference as measured by the California Verbal Learning Test – CVLT (p=0.040, r=.27). Lifetime use of hoasca was positively correlated with role limitations due to physical health (p=0.032, rs=.39) and negatively associated with lifetime heavy alcohol use (p=0.034, OR=0.979).

CONCLUSIONS: The findings indicate that religious use of hoasca does not adversely affect neuropsychological functioning and may have positive effects on substance abuse and mood.

Barbosa, P. C. R., Strassman, R. J., da Silveira, D. X., Areco, K., Hoy, R., Pommy, J., … & Bogenschutz, M. (2016). Psychological and neuropsychological assessment of regular hoasca users. Comprehensive Psychiatry, 71, 95-105. 0.1016/j.comppsych.2016.09.003

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Underreporting of ecstasy use among high school seniors in the US

Abstract

Background: National surveys suggest ecstasy (3,4-methylenedioxymethamphetamine [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][MDMA]) use has decreased substantially among adolescents in the US since 2001; however, the recent phenomenon of “Molly” (ecstasy marketed as “pure MDMA”) may be leading to underreporting of use as not all users are aware that “Molly” is a form of ecstasy.

Methods: We examined 2014 data from Monitoring the Future, a nationally representative survey of high school seniors in the US (N = 6250, modal age: 18). Three randomly distributed survey forms asked about ecstasy use, and one included “Molly” in the definition. Self-reported lifetime, 12-month, and 30-day ecstasy use were compared to determine whether including “Molly” in the definition was associated with higher prevalence or frequency of use.

Results: The form including “Molly” in the definition had significantly higher prevalence than the two (combined) forms that did not. Lifetime use (8.0% vs. 5.5%) and 12-month use (5.1% vs. 3.6%) were significantly higher with “Molly” in the definition. Lifetime prevalence remained higher with “Molly” in the definition when controlling for correlates of ecstasy use; however, 12-month use did not. Differences in prevalence were associated with lifetime occasions of use, with lower concordance between forms at lower levels of lifetime occasions (e.g., 1–2 times). Survey form was not related to number of times used among more frequent users.

Conclusions: Prevalence of ecstasy use appears to be underestimated when “Molly” is not included in the definition of ecstasy/MDMA. Surveys should include “Molly” in the definition of ecstasy to more adequately assess prevalence of use.

Palamar, J. J., Keyes, K., & Cleland, C. M. (2016). Underreporting of ecstasy use among high school seniors in the US. Drug and Alcohol Dependence. http://dx.doi.org/10.1016/j.drugalcdep.2016.06.001
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"Quite a Profoundly Strange Experience": An Analysis of the Experiences of Salvia divinorum Users

Abstract

Salvia divnorum (an intense hallucinogen) is currently illegal in New Zealand under the 2014 Psychoactive Substances Amendment Act. Despite this, there is a scarcity of research surrounding Salvia divinorum and its effects in a New Zealand context. To explore the experiences of Salvia divinorum users, an anonymous questionnaire was advertised through flyers placed in locations where young adults congregate. A total of 393 people took part in the online questionnaire in 2010-2011, while salvia was legally available in New Zealand; 167 respondents had used salvia. Thematic analysis was used to analyze the resulting open-ended questionnaire data and three key themes were identified: the effects of salvia; the importance of set and setting; salvia use and pleasure/not-pleasure. Recreational use of salvia was situated within a broader drug landscape, with participants being drug experienced and “drug wise” (Measham, Aldridge, and Parker 2001). Use of salvia also appeared to be intermittent, with its use referred to as a novel experience. Thus, the recent criminalization of salvia under the 2014 Act may see a significant decline in use as experienced drug users look elsewhere for novel drug experiences.

Hutton, F., Kivell, B., & Boyle, O. (2016). “Quite a Profoundly Strange Experience”: An Analysis of the Experiences of Salvia divinorum Users. Journal of Psychoactive Drugs, 1-8. http://dx.doi.org/10.1080/02791072.2016.1179376

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“Quite a Profoundly Strange Experience”: An Analysis of the Experiences of Salvia divinorum Users

Abstract

Salvia divnorum (an intense hallucinogen) is currently illegal in New Zealand under the 2014 Psychoactive Substances Amendment Act. Despite this, there is a scarcity of research surrounding Salvia divinorum and its effects in a New Zealand context. To explore the experiences of Salvia divinorum users, an anonymous questionnaire was advertised through flyers placed in locations where young adults congregate. A total of 393 people took part in the online questionnaire in 2010-2011, while salvia was legally available in New Zealand; 167 respondents had used salvia. Thematic analysis was used to analyze the resulting open-ended questionnaire data and three key themes were identified: the effects of salvia; the importance of set and setting; salvia use and pleasure/not-pleasure. Recreational use of salvia was situated within a broader drug landscape, with participants being drug experienced and “drug wise” (Measham, Aldridge, and Parker 2001). Use of salvia also appeared to be intermittent, with its use referred to as a novel experience. Thus, the recent criminalization of salvia under the 2014 Act may see a significant decline in use as experienced drug users look elsewhere for novel drug experiences.

Hutton, F., Kivell, B., & Boyle, O. (2016). “Quite a Profoundly Strange Experience”: An Analysis of the Experiences of Salvia divinorum Users. Journal of Psychoactive Drugs, 1-8. http://dx.doi.org/10.1080/02791072.2016.1179376

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How psychoactive drugs shape human culture: a multi-disciplinary perspective

Abstract

Psychoactive drug use occurs in essentially all human societies. A range of disciplines contribute to our understanding of the influence of drugs upon the human world. For example pharmacology and neuroscience analyse biological responses to drugs, sociology examines social influences upon people’s decisions to use drugs, and anthropology provides rich accounts of use across a variety of cultural contexts. This article reviews work from multiple disciplines to illustrate that drugs influence aspects of culture from social life to religion, politics to trade, while acting as enablers of cultural change throughout human history. This broad view is valuable at a time when the influence not only of traditional drugs but a growing armoury of novel drugs is felt and debated.

Wadley, G. (2016). How psychoactive drugs shape human culture: a multi-disciplinary perspective. Brain Research Bulletin. http://dx.doi.org/10.1016/j.brainresbull.2016.04.008
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Meta-analysis of executive functioning in ecstasy/polydrug users

Abstract

Ecstasy/3,4-methylenedioxymethamphetamine (MDMA) use is proposed to cause damage to serotonergic (5-HT) axons in humans. Therefore, users should show deficits in cognitive processes that rely on serotonin-rich, prefrontal areas of the brain. However, there is inconsistency in findings to support this hypothesis. The aim of the current study was to examine deficits in executive functioning in ecstasy users compared with controls using meta-analysis. We identified k = 39 studies, contributing 89 effect sizes, investigating executive functioning in ecstasy users and polydrug-using controls. We compared function-specific task performance in 1221 current ecstasy users and 1242 drug-using controls, from tasks tapping the executive functions – updating, switching, inhibition and access to long-term memory. The significant main effect demonstrated overall executive dysfunction in ecstasy users [standardized mean difference (SMD) = -0.18, 95% confidence interval (CI) -0.26 to -0.11, Z = 5.05, p < 0.001, I 2 = 82%], with a significant subgroup effect (χ 2 = 22.06, degrees of freedom = 3, p < 0.001, I 2 = 86.4%) demonstrating differential effects across executive functions. Ecstasy users showed significant performance deficits in access (SMD = -0.33, 95% CI -0.46 to -0.19, Z = 4.72, p < 0.001, I 2 = 74%), switching (SMD = -0.19, 95% CI -0.36 to -0.02, Z = 2.16, p < 0.05, I 2 = 85%) and updating (SMD = -0.26, 95% CI -0.37 to -0.15, Z = 4.49, p < 0.001, I 2 = 82%). No differences were observed in inhibitory control. We conclude that this is the most comprehensive analysis of executive function in ecstasy users to date and provides a behavioural correlate of potential serotonergic neurotoxicity.

Roberts, C. A., Jones, A., & Montgomery, C. (2016). Meta-analysis of executive functioning in ecstasy/polydrug users. Psychological medicine, 1-16. http://dx.doi.org/10.1017/S0033291716000258

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