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Tag: benzodiazepines

  • Cannabis Initiation Associated With Significant Reductions in Anxiety, Depression

    The consumption of THC-dominant cannabis products is associated with sustained reductions in anxiety and depression, according to newly published data in the Journal of Affective Disorders.

    Investigators affiliated with the Johns Hopkins University School of Medicine in Baltimore assessed the use of state-authorized medical cannabis products in a cohort of 33 participants with clinically significant anxiety or depression. Subjects in the study were naïve to cannabis. Study participants used a variety of cannabis products, including botanical and edible preparations, as needed for six months.

    “Initiation of THC-dominant medicinal cannabis was associated with acute reductions in anxiety and depression, and sustained reductions in overall symptom severity over a 6-month period,” researchers reported. Improvements in patients’ quality of life and overall health satisfaction were also observed. Medicinal cannabis use was not associated with the development of physical or psychological problems.

    “Collectively these data offer insights into the therapeutic effects of medicinal cannabis when it is used by a population with clinically significant anxiety and depression,” the study’s authors concluded. “The positive response, reflected by reductions in anxiety and/or depression by most participants, support the need for continued investigation of medicinal cannabis or related cannabinoid therapeutics as pharmacological treatments for anxiety and depression symptom relief, ideally with randomized, placebo-controlled trials.”

    NORML’s Deputy Director Paul Armentano said that the study’s findings are “consistent with those of prior assessments concluding that cannabis provides patients with sustained ‘statistically significant improvements’ on validated measurements of anxiety and depression.” Armentano also acknowledged that the adoption of cannabis legalization laws is associated with declines in prescriptions of anxiolytic drugs like benzodiazepines, as well as anti-depressants.

    According to survey data, those who acknowledge consuming cannabis for purposes of self-medication are most likely to report doing so to alleviate pain, anxiety, sleep disturbances, and/or depression.

    An abstract of the study, “Acute and chronic effects of medicinal cannabis use on anxiety and depression in a prospective cohort of patients new to cannabis,” appears in the Journal of Affective Disorders.

    NORML

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  • Can Cannabinoids Help People Wean Off Opioids? | High Times

    Can Cannabinoids Help People Wean Off Opioids? | High Times

    Doctors desperately need tools to battle the opioid epidemic, and they’re turning to cannabinoids for new ways to approach the problem of opioid use disorder (OUD). Recently researchers aimed to create an open-access framework designed to help people wean off and eventually replace opioids with cannabinoids as an alternative. 

    Last August, a study provided a clinical framework for cannabinoids in the battle against the opioid epidemic. The study, entitled “An answered call for aid? Cannabinoid clinical framework for the opioid epidemic,” was published in Harm Reduction Journal.

    Researchers provided an evidence-based clinical framework for the utilization of cannabinoids to treat patients with chronic pain who are dependent on opioids, seeking alternatives, and tapering off of opioids.

    “Based on a comprehensive review of the literature and epidemiological evidence to date, cannabinoids stand to be one of the most interesting, safe, and accessible tools available to attenuate the devastation resulting from the misuse and abuse of opioid narcotics,” researchers wrote. “Considering the urgency of the opioid epidemic and broadening of cannabinoid accessibility amidst absent prescribing guidelines, the authors recommend use of this clinical framework in the contexts of both clinical research continuity and patient care.”

    Recent research has shown a role for CBD in treating cannabis use disorder, and likewise, the compound could be useful in treating OUD. Researchers are also exploring the potential of THC and acidic cannabinoids as well. Cannabis is known anecdotally for the treatment of low-to-moderate amounts of pain despite working in very different ways than opiates.

    The open-access framework includes opioid tapering recommendations that are in accordance with the CDC’s latest clinical practice guidelines for managing opioids for pain. 

    “As opioid deaths continue to be a global problem, patients are increasingly self-medicating with cannabis while researchers struggle to standardize protocols and providers feel uncomfortable recommending cannabinoids amidst absent prescribing guidelines,” researchers wrote. “If we consider cannabis as a harm reduction tool that patients are already using without medical guidance, we can realign our focus to supporting researchers and providers with a clinical framework for standardizing research and recommending cannabinoids more informatively as safe, effective, accessible tools for assisting in the management of chronic pain. To our knowledge, this is one of the first comprehensive evidence-based peer-reviewed clinical frameworks for the safe use of cannabinoid products for chronic pain and OUD.”

    The researchers acknowledged that many of their patients have already begun their own self-guided journey into pain management with cannabinoids.

    The Devastating Toll of Opioid Overdoses

    Opioids continue to wreak havoc on people in America, leading to confusion about who needs powerful opioids and who doesn’t, and overdose deaths continue a steady pace of devastation.

    According to The National Center for Health Statistics (NCHS) under the U.S. Centers for Disease Control and Prevention, drug overdose deaths rose from 2019 to 2021 with over 106,000 drug overdose deaths reported in 2021. Deaths involving synthetic opioids—primarily fentanyl and excluding methadone—continued its death march with 70,601 overdose deaths reported in 2021. Fentanyl in particular kills 150 Americans per day.

    Over-prescription of opioids could be part of the problem. A 2018 longitudinal analysis showed that prescriptions for all opioids in the U.S. fell by 14.4% when medical cannabis dispensaries opened—particularly for hydrocodone and morphine, but also for benzodiazepines, stimulants, and many other medications known to be over-prescribed and addictive. 

    In some states, opioid use disorder is a qualifying condition for the use of medical cannabis. Researchers are still learning about the efficacy of cannabinoids in animal and human trials.

    Studies on Cannabis and Opioid Abuse Vary

    Opioid addiction is a complex phenomenon, and studies vary in their results of whether or not cannabinoids are effective. One study concluded that there is “no evidence that cannabis reduces opioid misuse.”

    According to research published in the American Journal of Psychiatry, researchers instead found “no evidence” showing that cannabis may not be an effective long-term strategy for reducing opioid abuse.

    “There are claims that cannabis may help decrease opioid use or help people with opioid use disorders keep up with treatment. But it’s crucial to note those studies examine short-term impact and focus on treatment of chronic pain and pain management, rather than levels of opioid use in other contexts,” Dr Jack Wilson, the lead author of the study and a postdoctoral research fellow at The Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney in Australia, said in a statement.

    “Our investigation shows that cannabis use remains common among this population, but it may not be an effective long-term strategy for reducing opioid use,” he added.

    Recent studies show the vast potential of cannabis in the fight against the opioid epidemic that continues to ravage the U.S.

    Benjamin M. Adams

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  • Doctors Warn About Emergence of ‘Trip-Killers’

    Doctors Warn About Emergence of ‘Trip-Killers’

    In the event of a bad psychedelic trip, you may be better off riding it through than taking additional drugs to extinguish the trip—which can actually be more dangerous.

    In a new study, doctors are warning about so-called “trip-killers,” or drugs used to counteract the effects of a psychedelic trip. What they found is that over half of anecdotal recommendations online call for benzodiazepines, antipsychotics, alcohol, and other remedies, but found that trip-killers are often more dangerous than the psychedelics themselves. This LSD Reddit thread, for instance, has trip-killer recommendations. Less than 2% of recommendations they found were for CBD or cannabis to lessen a trip. 

    The study, “Trip-killers: a concerning practice associated with psychedelic drug use,” was published in Emergency Medicine Journal on Dec. 19. It was announced in a news release the same day.

    There’s no Narcan to end a psychedelic trip, but people have tried various drugs to do just that. Researchers found that drugs such as benzodiazepines and antipsychotics are the options most frequently recommended, but warnings about their potential side effects are rarely included, they noticed. 

    Benzodiazepines or benzos, are central nervous system (CNS) depressants primarily used to treat anxiety. Benzos are dangerous in numerous ways—notably there’s a risk of overdose, and also a risk of powerful dependence that can lead to dementia. Like fentanyl, benzodiazepines can stop breathing, and there are few ways to reverse a benzo overdose.

    The intensity of a psychedelic trip can lead to distress, agitation, and  psychosis, and researchers cited recent data indicating that more than 8% of drug-related trips to emergency rooms in Europe involve psychedelic drugs.

    The study was led by Manchester-based Dr. Gregory Yates, in the U.K., who thinks there is a huge lack of peer-reviewed research showing how these drugs are being used and the risks involved.

    Instead of going to a doctor, which is pretty much impossible to do during a trip, psychonauts are turning to Reddit.

    “There are multiple ways to control a ‘bad trip’ and avoid hospitalization. One is to take psychedelics under the supervision of a ‘trip-sitter’—a non-intoxicated friend who can provide psychological support. Another is to use additional psychoactive drugs—‘trip-killers’—to attenuate or prematurely end the psychedelic experience. Trip-killers are not new, but have received increased attention on social media in recent years.”

    “Information on trip-killers is not available through drug advice services, despite the probable risks they pose,” researchers wrote. “To our knowledge, no relevant papers have been published in the medical literature. It was the aim of our study to gather descriptive data on the use of psychedelic trip killers by analysing posts made on Reddit, a publicly accessible, anonymous social media website.”

    Researchers analyzed posts on social media platforms like Reddit, and found 128 threads created between 2015 and 2023, with a total of 709 posts.

    “The most recommended trip-killer, with 440 recommendations, comprising nearly half (46%) of all the trip-killers mentioned in posts, were benzodiazepines, known for their sedative effects and physical dependence. Benzos were followed by several different antipsychotics (171;18%).

    One in 10 recommendations were for antidepressants, while 1 in 20 were for alcohol. Opioids, antihistamines, herbal remedies, such as camomile and valerian, and prescribed sleeping pills, attracted 3% each. Cannabis and cannabidiol each took 2% of the vote share.”

    Trip-killers were mostly discussed in reference to countering the effects of LSD (235 recommendations), magic mushrooms (143), and MDMA, popularly known as ecstasy (21).

    Trip Sitters in Europe

    Set and setting are so important when it involves psychedelics and hallucinogens. Not observing set and setting, or disregarding the profound nature of psychedelics can lead to bad trips, which can be terrifying.

    Much like the United States, leaders in Europe are currently figuring out how to incorporate psychedelic therapy into its healthcare landscape most effectively.

    A European lobby group representing developers and professionals within the industry advocates for including seasoned practitioners as integral members of a multidisciplinary advisory body. 

    Seasoned practitioners—i.e. trip sitters—would serve as a guiding authority, offering essential insights to regulators and healthcare practitioners regarding optimal practices as the field expands and changes. This effort comes from the European Psychedelic Access Research and European Alliance (PAREA), as reported by Politico, as per a briefing document slated for submission to the European Medicines Agency (EMA).

    The document reads that people with actual experience with psychedelics should have say-so over the dos and don’ts of psychedelic trips. This aligns with the idea that those with an actual relationship with the substance, rather than simply a desire to profit from it, makes for better business, as seen in the cannabis industry as well. 

    If psychedelics are taken with better care, often with a trip-sitter involved, bad trips would be less common and people would be less reliant on so-called trip-killers.

    Benjamin M. Adams

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