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Tag: Stimulants

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

    Can Cannabinoids Help People Wean Off Opioids? | High Times

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    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.

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    Benjamin M. Adams

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  • Study: Cannabis May Be Effective Harm Reduction Tool To Ease Stimulant Cravings | High Times

    Study: Cannabis May Be Effective Harm Reduction Tool To Ease Stimulant Cravings | High Times

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    Despite the skewed messaging of the past suggesting that cannabis is a gateway drug or will lead to the use and abuse of more addictive and harmful substances, many today understand that cannabis may be utilized as a harm reduction tool. 

    Whether its individuals looking to reduce or eliminate their use of opioids for medical reasons or people who use drugs seeking relief from withdrawal symptoms and cravings, research is increasingly finding that cannabis may help.

    In one of the more recent studies on the topic, researchers at the University of British Columbia (UBC) took a closer look at cannabis use and managing cravings to stimulant drugs. Ultimately their findings, published in the journal Addictive Behaviors, indicated that cannabis is not only widely used to manage stimulant cravings but that it may be an effective strategy to reduce stimulant use.

    Cannabis as Harm Reduction for Other Drug Use

    Researchers note how medical and recreational cannabis reform has opened the door for other conversations, namely how cannabis use interacts with other higher risk substances and that cannabis substitution is a commonly utilized method of harm reduction. 

    Given today’s ongoing drug toxicity crisis and the prevalence of fentanyl contamination in a number of substances, researchers say that investigating cannabis as a substitute for stimulant use could have “important public health and harm reduction appliances among people who use drugs at a heightened risk of overdose and other drug-related harms.”

    To further analyze how cannabis use may affect people using stimulant drugs, researchers collected data from three cohorts in Vancouver, Canada: the At-Risk Youth Study (ARYS), the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS).

    Researchers used a cross-sectional questionnaire alongside logistic regression models to analyze the relationship between cannabis use to manage stimulant cravings as well as self-reported changes in the frequency of stimulant use. A total of 297 participants reported cannabis and stimulant use over the past six months and were included in the study. 

    Cannabis a Common Strategy to Reduce Stimulant Use

    Of the participants, 45.1% reported that they used cannabis to manage stimulant cravings and 77.6% of those participants said that cannabis use indeed decreased their use of stimulants, including powder cocaine, crack cocaine and methamphetamines. 

    Researchers noted that cannabis use to manage cravings was significantly associated with reduced stimulant use specifically among those who used crystal meth daily, though it was not significantly associated with reduced stimulant use among crack cocaine users.

    While the study doesn’t provide all the answers, lead author Dr. Hudson Reddon noted the importance of the results.

    “Our findings are not conclusive but do add to the growing scientific evidence that cannabis might be a beneficial tool for some people who want to better control their unregulated stimulant use, particularly for people who use crystal meth,” Dr. Reddon said. “This suggests a new direction for harm reduction strategies among people who use drugs.”

    Adjacent Research and the Push for Further Investigation

    While it’s surely an adjacent but far different issue, myriad research has explored the topic of cannabis as means to limit or replace opioids for medicinal use. 

    Recent studies have found that cannabis may be comparable to opioids in treating pain while providing more holistic relief and that patients largely reduce or fully replace opioid use after beginning a medicinal cannabis regimen. Another recent study also found that CBD curbed opioid cravings in rats.

    There is far less research available regarding the relationship between cannabis and recreational drug use and abuse, though the UBC study’s findings are still echoed in past studies. 

    A 2021 study similarly found that cannabis is commonly used as a harm reduction strategy to substitute for stimulants and opioids. Another 2023 study found that cannabis was often utilized as a harm reduction strategy for those who had difficulty accessing addiction treatment or those using substances where effective treatments are limited.

    Dr. Zach Walsh, a clinical psychologist and professor at the University of British Columbia Okanagan, called the findings of the UBC study “promising” while emphasizing the need for further research on the topic.

    “[The findings] underscore the need for more comprehensive studies to understand the full potential of cannabis in the context of the overdose crisis,” Dr. Walsh said.

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    Keegan Williams

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  • Drug Makers Struggle to Replace Stimulants with Non-Addictive Alternatives | High Times

    Drug Makers Struggle to Replace Stimulants with Non-Addictive Alternatives | High Times

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    Unfortunately, the same drugs with high potential for abuse are also the ones that work best for certain individuals with neurobehavioral conditions. According to GlobalData, penetrating the stimulant-dominated pharmaceutical market remains challenging without comparable efficacy from non-stimulants. 

    The attention deficit hyperactivity disorder (ADHD) market is a lucrative business: Stimulants, amphetamines, and methylphenidates continue to dominate the ADHD drug market across the seven major markets, Express Pharma reports. (The seven major markets are in France, Germany, Italy, Spain, the UK, the US, and Japan.)

    Non-addictive drugs demonstrate a “crippling lower” efficacy in treating ADHD.

    Drug makers are in a race to develop safer alternatives. Three out of the four late-stage pipeline drug candidates in Phase III development within those markets have non-stimulant properties: Axsome Therapeutics Inc’s solriamfetol, Otsuka Pharmaceutical Co Ltd’s centanafadine and Neurocentria Inc’s L-Threonate Magnesium Salt. 

    The lower abuse potential of solriamfetol and centanafadine is a major selling point created by developers, but without displaying efficacy comparable to stimulants, they will struggle to penetrate the market—even if they are approved.

    The use of stimulants for ADHD treatment is increasing.

    The key opinion leaders (KOLs) in the treatment of ADHD say that patients and parents have been hesitant to use stimulants for the treatment of ADHD in children and adolescents, but this is changing with time, and the use of stimulants for ADHD treatment is increasing.

    “Marketing emphasis on abuse potential is common in non-stimulates both marketed and pipeline; this is despite KOLs viewing the abuse potential of ADHD stimulants as overstated,” said Lorraine Palmer, Pharma Analyst at GlobalData. “The KOLs interviewed by GlobalData were not concerned about whether a treatment is a stimulant or a non-stimulant, rather they are focused on the pharmaceuticals efficacy and side-effect profile.”

    Four non-stimulants are commonly marketed: guanfacine, clonidine, atomoxetine and viloxazine. Sleep disturbances and a decreased appetite have been reported from both clonidine and atomoxetine. 

    “All four display cripplingly lower efficacy in the treatment of ADHD than stimulants,” Express Pharma reports.

    “Rather than an emphasis on abuse potential, a better alternative strategy to penetrate the saturated ADHD market would be to target key unmet needs in ADHD treatment such as improving compliance or providing coverage into the evening without affecting sleep.”

    Part of this challenge likely includes the impact of addiction itself.  Regarding the popular ADHD drug Adderall, adults and children 6 years of age and older are eligible to take Adderall, beginning at 5 milligrams, while children 3 to 5 years of age are able to start at 2.5 mg per day. Only children under the age of 3 are prohibited from being prescribed the drug in all cases.

    Adderall’s active ingredients are dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate. Columbia University psychiatry professor Carl Hart famously wrote for Vice in 2016 that meth is “almost identical to Adderall” in terms of chemistry and its effects on the brain.

    A 2016 study published in the Journal of Clinical Psychiatry indicates that an increasing number of young adults have been checking into emergency rooms over the past few years due to accidental overdoses on Adderall and similar drugs.

    Other Reasons for Stimulant Alternatives

    High Times reported last September that leading drug makers and pharmaceutical companies are having little luck addressing nationwide shortages of stimulant-based ADHD medications like Adderall, Vyvanse, and Ritalin.

    The Adderall shortage began in Fall of 2022, marked by an FDA notice acknowledging the shortages with an estimate that things would be resolved in a month or two. That is not the case, however, as issued a joint notice on August 1 acknowledging that the shortage had been “understandably frustrating” for patients and providers.

    “The current shortage of stimulant medications is the result of many factors. It began last fall due to a manufacturing delay experienced by one drug maker,” the joint notice said. “While this delay has since resolved, we are continuing to experience its effects in combination with record-high prescription rates of stimulant medications. Data show that, from 2012 to 2021, overall dispensing of stimulants (including amphetamine products and other stimulants) increased by 45.5 percent in the United States.” 

    Teva Pharmaceuticals, Adderall’s biggest manufacturer, reported shortfalls. Teva CEO Richard Francis told Bloomberg that the company is operating at “full capacity” at the moment and blamed their decreased output in previous years to COVID-induced work shortages which they have only just barely recovered from. Should they wish to increase the amount of Adderall they produce, they would have to buy or build more factories as their current infrastructure cannot handle bigger output. The company has declined to comment on whether or not they plan to invest in such infrastructure.

    This adds to the multiple reasons less addictive non-stimulant drugs are needed to treat ADHD.

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    Benjamin M. Adams

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  • Cocaine Found At White House

    Cocaine Found At White House

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    The Secret Service confirmed that testing showed an unidentified white substance found in the White House during a routine search is cocaine, with the investigation into how it got there still ongoing. What do you think?

    “The fair thing to do now is distribute it equally to all Americans.”

    Colton Kemper, Number Deducer

    This Week’s Most Viral News: June 30, 2023

    “To be fair, cocaine was a prescription medicine when Biden was young.”

    Dakota Gilbert, Amateur Clairvoyant

    “If it doesn’t send a Black person to jail, does it even count as drugs?”

    Miguel Badillo, Cheese Ager

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  • FDA Announces Adderall Shortage

    FDA Announces Adderall Shortage

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    The FDA has confirmed a nationwide shortage of the attention-deficit/hyperactivity disorder medication Adderall due to manufacturing issues, with the shortage expected to last through the end of the year. What do you think?

    “Pretty sure meth’s still in stock.”

    Miles Seelbach, Crypto Banker

    “Between this and the formula shortage, what am I supposed to feed my baby?”

    Anita Santana, Cannoneer

    “I guess I have to go back to bribing teachers.”

    Hank Schilsky, Content Aggregator

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