Posts Tagged ‘david nutt’

From the K-Hole to K-Cramps and K-Hell:
The Hidden Dangers of Ketamine

Yet another drug headline with ketamine in the news lately, after a recent study in Bristol (Mason, et al, 2010) found that some users are suffering long-term bladder damage – a few even needing their bladders replaced at the tender age of twenty.

A Class C drug in the UK (or Schedule III in the US), ketamine is not generally seen to be one of the more harmful illegal drugs. The evidence to date seemed to show ketamine to be a relatively safe drug when coming from pure, pharmaceutical grade vials. Originating as a liquid, ketamine is usually ‘cooked’ into a crystalline powder which can be snorted like cocaine, although heavier users prefer to use the liquid form for intramuscular injections, as would be given in a medical setting.

Ketamine is widely stereotyped as a ‘horse tranquilizer’. Actually ketamine is an anesthetic that has been used in both human and veterinary medicine since the 1960s (although less so in humans today due to some patients’ negative reactions to hallucinations or ‘emergence reactions’ as the medical community calls them).

In much smaller (recreational) doses, ketamine can have paradoxical stimulatory and dissociative effects. Some users take small ‘bumps’ up the nose when out clubbing – others take a larger dose to find themselves in the famed ‘k-hole’, a dissociated state where one can have out-of-body and near-death experiences, or seemingly travel to other mystical and magical places.

While ketamine is generally associated with the dance and rave scene, at these higher doses ketamine is safest taken at home, in a familiar environment to offset the possible dangers of being in a dissociative state in public surroundings. Many taking ketamine fall into the ‘psychonaut‘ category, like this user in a UK study on ketamine use (Muetzelfeldt, et al, 2008), who stated that ketamine allowed “new ways of thinking and an understanding of the mind/body question which 3 years of a philosophy degree could not reach.”

There is some interesting potential for ketamine use in exploring consciousness and success has been documented using ketamine to treat alcoholism and depression. What doesn’t seem to be properly investigated is the extent to which ketamine is harmful to the body, and in what quantities it becomes so.

The most obvious danger of ketamine is of injuring oneself while in the dissociative state. This has been the downfall of several respected members of the psychonaut community such as D M Turner:

“On New Years Eve, 1996, the noted author and lay-psychedelic researcher known only by the pseudonym D.M. Turner drew a hot bath, injected himself with an unknown amount of ketamine, and settled in for the last trip of his life. When his body was found weeks later, the cause of death was determined to be natural causes. It is assumed that Mr. Turner lost consciouness at some point during the evening, slid under the water, and quietly drowned.”

Another tragic loss to the community was Marcia Moore, the heiress to the Sheraton Hotel fortune, a yoga teacher and world famous writer on astrology and ‘hypersentience’:

“Marcia Moore named what she perceived to be the ‘highest’ level of her experiences ‘the cosmic matrix’ or ‘cosmatrix’, the source from which everything was said to be derived. She noted that ketamine produced a ‘higher, clearer and more real trip’ than LSD, although some people just felt ‘disconcertingly whacked out’, and that ketamine produced fragmentation into subpersonalities, including her role as ‘priestess of the Goddess Ketamine’. ‘The Priestess’, aged 50, disappeared on a freezing winter’s night in January, 1979. Her bleached skeleton was found two years later. She had gone at night into a nearby forest, and frozen to death after injecting herself with all the ketamine she could find.”

Aside from the danger of unsupervised pyschonautic exploration, the overall health risks of ketamine cannot yet be quantified. The Bristol study was not large enough to extrapolate the correlation between ketamine use and bladder destruction for light recreational users, with some in the study reporting incredibly heavy use of more than two grams a day (and others refusing to report the extent of their use altogether). Indeed perhaps another unexplored aspect of ketamine use is its potential for addiction; while not physically addictive, there seems to be a high potential for compulsive use to become a serious issue (even for its most thoughtful and educated users, as seen with D M Turner, Marcia Moore, and John Lilly).

Reading through frequent ketamine users’ discussions and reports online, aside from the common bladder complaints, there is recurring talk of what have been mysteriously termed ‘k-cramps’ – a kind of severe gastric pain. As the 2008 UK study cited above states:

“The classification of ketamine-associated ulcerative cystitis has recently been established, however the etiology and treatments of ‘K-cramps’ are still unknown. Nevertheless, it seems to be a prevalent symptom which may represent a broader public health concern if the use of ketamine continues to increase.”

Unaddressed by the medical community at large, here’s one user’s description of his ‘k-cramps’:

“Ketamine causes ulcers in high habitual dosing. There is little information on this on the internet but if you search just hard enough you will hear rumors of it. Well why isn’t this a known fact? Well one would have to take ketamine daily or semi daily at least to get this nasty side effect.

I was unfortunate enough to have this happen on 3 separate occasions. The first time on a cruise ship, resulting in collapsing on the deck screaming for my life, which resulted in a diagnosis of ‘gastritis’ and a double shot of morphine. The second time at home which kept me pent in bed in the fetal position a few days. The third time in the snow in the midst of a rock scramble/ice climb, which made for a difficult, cold, and dire crawl two miles to safety.

From communication with 3 other habitual ketamine abusers this phenomena was familiar with all 3 and equally as gruesome. For the record all 3 consumed a minimum of 3-5 grams a week often more.

Now the physiology of it seems to be a disruption in the pH of the gall bladder causing an ungodly acid reflux. (literally feels like the acids going to eat clear through to your skin)

The way to end the agony is stop using ketamine till it subsides. It can take up to 3 days for it to go away with abstinence. Pink Bismuth (pepto bismol) was found to alleviate some of the pain, as did pain killers. Thought I would share as it took me nearly a year to figure it out, and found next to no information on the net about it.”

This is but one of dozens of reports of excruciating pain by ketamine users, accounts that can be found by googling ‘k-cramps’ and ‘ketamine’.

Once thought to be a ‘safe’ drug in terms of abuse due to the absence of physical dependence, ketamine is now known to be associated with bladder dysfunction when abused, but its effects on the gall bladder, liver and gastrointestinal system have been largely ignored.

The only two studies relevant to this phenomena I’ve been able to locate originate from Hong Kong, where ketamine has long been the party drug of choice. Those more medically inclined may find the following two studies of interest, certainly a place to start for UK and US investigation into this phenomena:

“Dilated common bile ducts mimicking choledochal cysts in ketamine abusers”
(Wong, et al., 2009)
“Upper gastrointestinal problems in inhalational ketamine abusers”
(Poon, et al., 2010)

As a general explanation for these mysterious pains, one American periodical notes:

“In addition to urological problems, ketamine abusers may develop hepato-biliary toxicity manifested as recurrent epigastric pain, abnormal liver function, and biliary tree dilatation. The proposed mechanism for ketamine-induced cystitis is direct toxicity of ketamine metabolites on urinary tract mucosa. Because ketamine is metabolized in the liver and excreted in bile, mucosal toxicity has also been postulated as the cause of dilated bile ducts.”

The Daily Transmission does not believe any drugs should be illegal, but if one is to have a classification of drugs surely it should be based on relative harm. The UK has LSD and MDMA in Class A, cannabis in Class B, and ketamine in Class C. The US has cannabis, LSD, and MDMA as Schedule I, and ketamine as Schedule III.

David Nutt, the UK government’s former chief drugs advisor, was proposing reclassification of drugs such as MDMA, cannabis, and ketamine based on scientific evidence. Then he was sacked for being out of line with government policy. Which leaves us with politicians upholding the status quo at the expense of the health of the people.

I can’t see what kind of logic these categorizations are meant to be based on, but it would seem its time for a serious rethink (and some proper research) before more and more people find their way from the ‘K-hole’ to ‘K-Hell’.

~ ♥ ♥ ♥ ♥ ♥ ~

Sources:

‘Ketamine-associated lower urinary tract destruction: a new radiological challenge’
(Mason, et al, 2010)

‘Journey through the K-hole: Phenomenological aspects of ketamine use’
(Muetzelfeldt, et al, 2008)

For one of the more complete accounts of ketamine use and its effects, see Karl Jansen’s “Ketamine: Dreams and Realities”

~ ♥ ♥ ♥ ♥ ♥ ~

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Posted: March 4th, 2011
Categories: Consciousness, Drugs, Politics
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Overlooked in the News: So Far This Summer…

As the Daily Transmission is on a summer hiatus, here are a few not-to-be-missed headlines that should keep those juices flowing:

‘Why do we so willfully cover up the failure of the war on drugs?’ asks Angus Macqueen in The Guardian. Macqueen has just completed a documentary series for Channel 4 called ‘Our Drugs War’ which is a well-needed examination of the global ‘War on Drugs’. (Save for another time a discussion of what exactly constitutes a ‘drug’ in the first place… possibly the ‘War on Drugs’ belongs in the same failed category as the ‘War on Terror’?)

For further evidence of failed drug policy look no further than ‘Mephedrone found not guilty, but the next legal high may be a killer’ from former Lib Dem MP Evan Harris. We’re on a road to nowhere, attempting to ban each new pharmaceutical ‘high’ that comes out of a lab. It seems the recipe that got MDMA banned still works: Take tabloid headlines, scare stories and incomplete research, mix in some panicked political bravado, season with a bit of ignorance, and bam! You got yourself a mephedrone ban.

And for a shining example of where rational thought ends and politics begins, Sky News reports on why legalizing prostitution works (in Australia) – but ends telling us why prostitution laws in England are not likely to be changed any time soon:

There are not many votes to be won by decriminalisation and, potentially, many votes to be lost if it sparked a moral crusade by opponents of reform.

But that’s why we elect politicians, isn’t it? So they can get in power and ignore what they think is right in order to ensure getting re-elected?

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The Hazy Politics of Drug Policy:
Where Science Gets Left Behind

Last night I had the pleasure of attending UK ex-chief drug advisor David Nutt’s lecture here in London at the Hub Islington, one of a dozen such Hub communities that bring together people working for social change across the globe.

David Nutt was fired for standing up for scientific evidence that showed, for example, that ecstasy, cannabis, and LSD are less dangerous than alcohol. Or that more people die falling off horses every year than taking ecstasy (see his article on Equasy vs Ecstasy.) But it didn’t take long for Professor Nutt to get back on his feet: he’s just started the new Independent Council on Drug Harms with some of the top scientists in the field, which will rival the government’s Advisory Council on the Misuse of Drugs.

The most crucial data that the government doesn’t want to deal with appears in the graph below, from the 2007 Lancet article ‘Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse’:

Drug Harm Ranking

The paper, co-authored by Prof Blakemore and Prof David Nutt, et al. , ‘presents a scale of harms based on three scales – physical harm, dependence and social harm – which were independently assessed by two groups of experts from the fields of chemistry, pharmacology, forensic science, psychiatry and other medical specialties.’

There was a surprisingly poor correlation between drugs’ class according to the Misuse of Drugs Act and their actual harm scores. Alcohol, ketamine, tobacco, and solvents (all unclassified at the time of assessment) were ranked as more harmful than LSD and ecstasy (class A drugs).

It’s obvious that something’s wrong here.

Professor Nutt talked about politicians feeling the pressure to be tough on drugs – but it turns out that at the time cannabis was reclassified as a Class B drug, two thirds of the public wanted cannabis to remain Class C or less. Maybe one of the answers is that we the public need to be more vocal in our desire for drug policy reform.

During the lecture at times I believe many of us didn’t know whether to laugh or cry, like when we read MP Vernon Coaker’s statement that “We look for evidence to support our policy decisions.” Surely it should be the other way around?

Last but not least is media bias. Scottish graduate Alasdair J M Forsyth wrote his PhD having looked at every single newspaper report of drug deaths in Scotland from 1990 to 1999 and then compared them with the coroners’ data. Check out the results below:

Out of the 2,255 drug deaths that decade, only certain drugs tended to attract media attention. 1 out of 265 involving paracetamol, 1 out of 72 involving morphine, 1 out of 48 involving diazepam – the media were clearly not interested in these drugs. They were more interested in cocaine (8:1), amphetamines (3:1) and heroin (5:1). But unbelievably, out of the 28 deaths from ecstasy in ten years, 26 were reported, meaning a near 1:1 ratio. An astounding bias.

Professor Nutt also pointed out that cannabis is not on this chart because cannabis doesn’t kill – you cannot die of a cannabis overdose. Of course alcohol is also missing off that list. Alcohol alone will have killed between 2000-3000 people in Scotland in that same decade – the same as all the other drugs combined. Makes you wonder why it is we consider alcohol in a separate category from the drugs we classify due to their potential harm.

One final example of how even some scientific reporting about drugs is biased. A study that made front page headlines claiming that ‘ecstasy fries your brain’ was later quietly retracted when the researchers realized they had given their subjects methamphetamine instead of ecstasy. Oops!

It’s enough to fry your brain without the drugs.

Sources:

‘Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse’
D Nutt, LA King, W Saulsbury, C Blakemore
Lancet 2007: 369, 1047-1053

‘Distorted? a quantitative exploration of drug fatality reports in the popular press’
A Forsyth
International Journal of Drug Policy, Volume 12, Issue 5, Pages 435-453

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Posted: February 18th, 2010
Categories: Drugs, Politics
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Cutting Edge: Articles for a New Age

As we start to sink our teeth into 2010, here is the Daily Transmission’s pick of the most interesting reads from the past weeks:

First head over to Brainwaving, where you’ll find the brilliant David Nutt’s article on the comparative dangers of taking ecstasy and horse-back riding:

Is Equasy More Dangerous Than Ecstasy?

Reading the full version of his article alerted me to an astounding set of statistics:

“A telling review of 10-year media reporting of drug deaths in
Scotland illustrates the distorted media perspective very well
(Forsyth, 2001). During this decade, the likelihood of a newspa-
per reporting a death from paracetamol was in per 250 deaths,
for diazepam it was 1 in 50, whereas for amphetamine it was
1 in 3 and for ecstasy every associated death was reported.”

Talk about distorting perception of danger…

Also at Brainwaving is an excellent review of the movie Avatar by Dr. Ralph Metzner, for anyone who’s interested in looking deeper into this newest cultural phenomenon:

Avatar: A Mythic Masterpiece For Our Troubled Time

A reprint at Reality Sandwich alerted me to Michael Garfield’s September 2009 article in H+ magazine on The Psychedelic Transhumanists. A dense read, but rich and thought-provoking if you have the time to dig in.

While you’re there you might want to watch the video of a man playing the piano with only his brain. Completely surreal: By Thought Alone: Mind Over Keyboard.

Back in the here and now, Naomi Klein makes a compelling argument that ties in corporate branding, Barack Obama, and “No Logo” over at the Guardian: Naomi Klein on how corporate branding has taken over America

Finally, a bit of a trend alert in the Evening Standard: The New Psychedelia. A cleverly compiled overview of the coolest new psychedelia-influenced fashion, art, music, and film.

The 60s are in the air… let’s just hope this trend goes beyond swirly prints and trippy sci-fi.

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New Study Shows ‘Drug Users Know Their Stuff’

Brilliant study at University College of London (UCL) published this week confirms what ex-government advisor David Nutt was saying before he got fired by the UK government for saying it. The classification of a drug as illegal has no correlation to it’s harmfulness, especially when compared to legal substances such as alcohol and tobacco. On top of it all, the study found that drug users’ ratings of the relative safety of different legal and illegal substances had a high correlation to the harm ratings made by scientific experts. In other words, the scientists know it and the drug users know it. Isn’t it time the government caught on?

Maybe we need to start questioning exactly whose interest it is in to have substances like alcohol and cigarettes legal while prosecuting the use of cannabis and other psychedelic drugs.

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Posted: November 30th, 2009
Categories: Drugs, Politics
Tags: , , ,
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