Long Term Marijuana Use + Mental Health?

[Yardener]

gryphonart ... Felix the Cat?!? That's fucking awesome

Regarding relative risk (between cannabis, heroin, alcohol, etc):
Here's one of the most key references from one of the top med journals:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/abstract

here's the money figure. Basically, risk is worse w/ the red dots in the top right. That's risk calculated as a metric of lots of factors, including dependence potential, death, injury, harm to others, crime, etc.
As you can see, alcohol and tobacco are orange, while cannabis, LSD, ecstasy are in yellow. When you factor in availability, alcohol is the worst (heroin 2nd, crack 3rd).

edit: also note - only heroin and cocaine have more dependence potential than tobacco

 

[rorydaboss]

What is khat? Is that a name for ketamine?

 

[Yardener]

What is khat? Is that a name for ketamine?

It's a plant that's widely used in Somalia, Yemen, and elsewhere as a stimulant (it's chewed just like the Inca chew coca leaves, and for the same reasons). In terms of medicinal chemistry - it's the basis for bath salts actually. Obviously, bath salts are much stronger (it's like crack is to coca leaves, as bath salts are to khat).

 

[Yardener]

What is khat? Is that a name for ketamine?

ketamine is an NMDA antagonist (amongst other things) that is actually derived from PCP. They're both dissociative anesthetics. But PCP causes much more psychosis (which is a bad side effect), so only ketamine is used clinically (and is a Schedule III narcotic) while PCP is an illegal Schedule I.

 

[Tycho- Taylor's Version]

Where are you a professor exactly? I could picture my Drugs and Behaviour prof rolling around the Sherdog forums, come to think of it.

Great info itt.

 

[rorydaboss]

ketamine is an NMDA antagonist (amongst other things) that is actually derived from PCP. They're both dissociative anesthetics. But PCP causes much more psychosis (which is a bad side effect), so only ketamine is used clinically (and is a Schedule III narcotic) while PCP is an illegal Schedule I.

Hilariously DXM is actually a stronger dissociative than ketamine but it is available over the counter in just about any cold medicine available.

On a side note I LOVE ketamine. What is your opinion on ketamine as a treatment of depression?

 

[Yardener]

Hilariously DXM is actually a stronger dissociative than ketamine but it is available over the counter in just about any cold medicine available.

On a side note I LOVE ketamine. What is your opinion on ketamine as a treatment of depression?

Yes, DXM is also an NMDA antagonist (so is nitrous oxide). But, you have to take pretty huge doses to dissociate, which...be careful. I understand the appeal, but don't get lost in the k-hole.
Oh, man. I literally did an hour long grand rounds presentation on ketamine for depression. Ketamine does a LOT more than just block NMDA receptors. Don't even know where to begin. Not a ton of evidence (but the evidence that exists is quite compelling), an entirely different mechanism of action, the results and therapeutic effect remind me most of ECT.

 

[rorydaboss]

Yes, DXM is also an NMDA antagonist (so is nitrous oxide). But, you have to take pretty huge doses to dissociate, which...be careful. I understand the appeal, but don't get lost in the k-hole.
Oh, man. I literally did an hour long grand rounds presentation on ketamine for depression. Ketamine does a LOT more than just block NMDA receptors. Don't even know where to begin. Not a ton of evidence (but the evidence that exists is quite compelling), an entirely different mechanism of action, the results and therapeutic effect remind me most of ECT.

Ketamine always made me feel AWESOME. I could see how you could get addicted to it really easily. When done in small doses it would give me a nice drug feeling but you keep a clear mind. Then all of a sudden you are sober. There was absolutely no come down. You are high and then you are not. lol, I wish I could get some ketamine. Shit was awesome. Canada had cheap and amazing ketamine.

 

[Yardener]

Where are you a professor exactly? I could picture my Drugs and Behaviour prof rolling around the Sherdog forums, come to think of it.

Great info itt.

I'm at a VA hospital (That's like an army veterans' hospital) in a large U.S. city. We're affiliated with two major universities (and nursing schools and such). My faculty appointment is with the pharmacy school, actually. But, in practice, I'm mostly training medical students and psych residents when they're on their acute inpatient psychiatry rotation. I'm like the drugs consultant. Then the academic stuff of lectures and such.

(what does "itt" mean)????

 

[rorydaboss]

Yes, DXM is also an NMDA antagonist (so is nitrous oxide). But, you have to take pretty huge doses to dissociate, which...be careful. I understand the appeal, but don't get lost in the k-hole.
Oh, man. I literally did an hour long grand rounds presentation on ketamine for depression. Ketamine does a LOT more than just block NMDA receptors. Don't even know where to begin. Not a ton of evidence (but the evidence that exists is quite compelling), an entirely different mechanism of action, the results and therapeutic effect remind me most of ECT.

Yeah I have never tried DXM. My friend used to drink robotussin but that shit is gross. It is also REALLY bad for you to ingest the other ingredients in high doses. I heard there are certain pills that are just dxm and filler (Corticedent cough and cold and sucrettes) but I don't know if they are like that any more.

 

[Yardener]

Ketamine always made me feel AWESOME. I could see how you could get addicted to it really easily. When done in small doses it would give me a nice drug feeling but you keep a clear mind. Then all of a sudden you are sober. There was absolutely no come down. You are high and then you are not. lol, I wish I could get some ketamine. Shit was awesome. Canada had cheap and amazing ketamine.

And the addiction/abuse potential will be an issue, clinically. But, docs give out xanax and benzos all the time, which are more addicting, so....
regardless, the treatment would be (if it ever comes to fruition) like a short in-clinic procedure; and not an outpatient Rx.
smaller doses are not dissociative. You need to exceed a certain mg/kg threshold to k-hole. Here's another reference, so I'm not just giving out drugs advice (but, I'm old, so...be careful, don't be stupid, know your limits, do your research, practice moderation. ok...). It has dosing and other constructive, objective info

http://www.erowid.org

 

[Tycho- Taylor's Version]

I'm at a VA hospital (That's like an army veterans' hospital) in a large U.S. city. We're affiliated with two major universities (and nursing schools and such). My faculty appointment is with the pharmacy school, actually. But, in practice, I'm mostly training medical students and psych residents when they're on their acute inpatient psychiatry rotation. I'm like the drugs consultant. Then the academic stuff of lectures and such.

(what does "itt" mean)????

That sounds like an awesome job. The prof that you made me remember loved teaching that particular course, because the students were always so enthusiastic. He even offered a bonus mark for people who submitted their own stories about their experiences with drugs, and then he would read the better stories at the end of the relevant lectures. The hallucinogen ones were hilarious.

He toed the professionalism line pretty closely sometimes lol. Learned a shitload in that class though.

 

[Yardener]

That sounds like an awesome job. The prof that you made me remember loved teaching that particular course, because the students were always so enthusiastic. He even offered a bonus mark for people who submitted their own stories about their experiences with drugs, and then he would read the better stories at the end of the relevant lectures. The hallucinogen ones were hilarious.

He toed the professionalism line pretty closely sometimes lol. Learned a shitload in that class though.

Ha! Sounds like my kinda guy! Yeah, I'm, uh, kinda out there in terms of relative to the straight-laced medical profession overall. But, it fits with my specialty, so I get cut a lot of slack. Plus the students and residents dig my approach (usually). I love teaching and we have some super interesting cases, so it makes for a good rotation.

 

[Yardener]

Yeah I have never tried DXM. My friend used to drink robotussin but that shit is gross. It is also REALLY bad for you to ingest the other ingredients in high doses. I heard there are certain pills that are just dxm and filler (Corticedent cough and cold and sucrettes) but I don't know if they are like that any more.

ok, I kinda feel bad for pulling the old man on ya. And you were asking for info, so lemme (briefly) answer instead of just telling you to look it up. Then I'll stop hijacking this thread....

DXM = dextromethorphan. Read labels. You're right, most cough/cold meds have other ingredients like antihistamines, decongestants, etc. Coricidin has a normal OTC dose of DXM, 30 mg, and a normal OTC dose of an antihistamine. I've had patients whose #1 problem was DXM abuse, and they told me they got 30mg caps of pure DXM off the interwebs.
Not an endorsement, but, if you're going to experiment with drugs - use the right stuff in the right dose the right way.

 

[rorydaboss]

ok, I kinda feel bad for pulling the old man on ya. And you were asking for info, so lemme (briefly) answer instead of just telling you to look it up. Then I'll stop hijacking this thread....

DXM = dextromethorphan. Read labels. You're right, most cough/cold meds have other ingredients like antihistamines, decongestants, etc. Coricidin has a normal OTC dose of DXM, 30 mg, and a normal OTC dose of an antihistamine. I've had patients whose #1 problem was DXM abuse, and they told me they got 30mg caps of pure DXM off the interwebs.
Not an endorsement, but, if you're going to experiment with drugs - use the right stuff in the right dose the right way.

Oh, I'm too old for that. I have kids now. I stick to alcohol and occasional weed. I doubt I will ever do anything harder for the rest of my life.

 

[shunyata]

Oh, I'm too old for that. I have kids now. I stick to alcohol and occasional weed. I doubt I will ever do anything harder for the rest of my life.

Clearly weed is a gateway drug that leads to parenthood.