Listening to Ketamine
knowablemagazine.org
knowablemagazine.org
This might surprise everybody, but if it's possible to "abuse" it, somebody will (turns out some humans will do that). I wish we'd stop restricting access to things that could help and improve people's lives because we're worried that somebody might do something with their body that we find morally objectionable.
Source: I spend two years doing Ketamine and analogs on a regular basis.
Which isn’t to say that I didn’t know people who abused it way beyond “normal” recreational use, but those people were abusing every drug they could find.
Much like any other potential side-effect, addiction is a risk that must be heavily weighed and mitigated against. Addiction causes harm, and even death. It isn't a question of personal morals, it's a question of ethics.
This is the same country that has experienced a decade-long opioid epidemic because addiction risks of prescription drugs were intentionally covered up, and in many cases, the drugs themselves were overprescribed.
That's mostly because the drug they're addicted to can't readily be purchased. So they're stuck buying stuff illegally. Stuff that's expensive. And with unknown potency. Or even, for that matter, identity.
This is because they're taking very large quantities of opioids and suffering the side effects, and they've developed a tolerance so they need larger more risky doses, and because it's probably not treating the problem they started taking opioids for.
And yes, by idiot thrill seekers, and people carelessly combining their opioids with other drugs (e.g., zolpidem) or alcohol. But that's a minor issue, in the context of the pain relief that they get.
I do admit, though, that US doctors have tended in recent years to over-prescribe. Partly because it's faster and less hassle to prescribe opioids than physical therapy. And because physical therapy tends to cost more for patients and insurance companies. And also because the compliance rate for physical therapy tends to be low. People are busy, and want quick results.
But still, focusing on addiction as the main problem is, in my opinion, misguided. It's better to focus on people being well, and able to enjoy their lives. And if, for whatever reason, that means taking opioids until they die, that's just how it is.
Narcan is saving a lot of lives (although it does little or nothing for addiction itself), and kratom looks like a potentially promising way to help addicts stop/reduce their use of harder stuff (if misguided crusaders don't go and ban that everywhere), but everything's a tradeoff and nuance is important. We've got a ton to work on in this area for a long time.
Nothing whatsoever, and from a bigger picture hurts.
"Ideal" treatment for opiate overdose? Manage respiratory depression/arrest, slowly titrate IM (not nasal) Narcan to keep level of consciousness lower, get to hospital, offer patient treatment options/longer term help.
Blast IN naloxone into someone and they'll almost always AMA (against medical advice) on scene.
-- paramedic
I said... “we’re not going to do this again.” She said it was barely any heroin at all, that she wasn’t going to get addicted again, and that she just needed it so she could sleep. Just to show me that it wasn’t much she prepared a second shot and injected that too. I don’t think she realized that her tolerance had changed and that benzodiazepines increase the potency of opiates.
Then she fell forward, said “I meant to do that”, then her face turned blue and she went non-responsive. I called EMS. They revived her with 2x2mg naloxone.
After a few minutes the firefighters decided she was okay. The police officers also decided they didn’t need to intervene. She did very well for about 2 weeks: drinking under control, benzodiazepine withdrawal mostly completed, etc.
Narcan/naloxone has much broader effects than just kicking out the opiates from the opioid receptors. The related drug Naltrexone is FDA-approved to help people get their alcohol use under control. I’m not entirely clear on how the anti-opiates help with alcohol use, but I think it has to do with fixing the metabolic problem that is associated with most cases of alcoholism.
You’re correct that narcan isn’t much of a treatment by itself. But naltrexone is almost the same drug, keeps people sober long enough to get them stabilized, and partially addresses the long-term emotional pain they’re actually self-medicating for.
If addicts are helped out of their “cage”, narcan/naloxone and naltrexone are very useful tools to support them while they recover.
In 2019, you are more likely to die in the US of an opiate overdose than you are to die in a car accident. That staggers me.
A diet of pure fat would literally be healthier than the diets of a majority of Americans. At least satiety is activated much sooner.
If we examined it, we'd probably find a number of preventable deaths per year far exceeding that from any drug use. Hell, the side effects of our dietary metabolic wreckage probably impel the search for comfort/escape in intoxicated states.
Of course simultaneously we're dealing with a breakdown of a post WWII script, in mainstream American society, where the dream is available if you work hard and your purchasing power will only get better as society "progresses". But for the average Joe, the price of everyday consumables (Food, gas, water) and shelter has outpaced inflation. At least electronic soma is cheaper!
For me, it's hard to extract our drug problem from the pervasive shitstorm of other factors.
PS: MXE was/is the shit. It's a damn shame such a relatively mild dissociative with a promising profile will probably never be allowed for public use until the current generation of puritan drug cop-regulators die off.
nah, K is terribly moreish.
But! If you use either of those two for no more than two days in a row every ~2 weeks, and no more, you'll never get addicted.
Probably true with ketamine. I've used it a few times, but never abused it. Occasional recreational use is possible.
I can't be bothered finding a source for this as I'm on my phone but I'm fairly sure it's somewhere in my comment history from the last time this came up
You would need to be dedicating your life to obtaining and consuming ketamine, at which point you already have serious problems
I’ve also never really drank much alcohol, I don’t smoke, and don’t regularly use caffeine (coffee / tea).
I’m willing to believe my drug use patterns make me an outlier.
A quick search suggests something like 25% of people who try Heroin will become addicted. That is quite a frightening statistic!
The thing with drugs is that it's always different for everybody. Your circumstances, physical (anatomically speaking) and psychological have an impact on the experience of a drug and the potential for abuse.
My point being: your experience will almost always differ from someone else's.
I’m willing to believe my drug use patterns make me an outlier.
Even more ironic, the very country they founded would now imprison them and label them junkies.
But yeah. The state has become a monster.
The state has indeed become a monster.
He did mention, though, that every time you get a dose you basically hallucinate for an hour. But maybe that's fine, if you're into it.
There are better highs IMO.
https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescr...
Really wish they'd have gone for Arketamine. To quote in part from above:
"Another possibility is that everyone made a huge mistake in using left-handed ketamine, and it’s right-handed ketamine that holds the magic. Most previous research was done on a racemic mixture (an equal mix of left-handed and right-handed molecules), and at least one study suggests it was the right-handed ketamine that was driving the results. Pharma decided to pursue left-handed ketamine because it was known to have a stronger effect on NMDA receptors, but – surprise! – ketamine probably doesn’t work through NMDA after all. So there’s a chance that this is just the wrong kind of ketamine – though usually I expect big pharma to be smarter than that, and I would be surprised if this turned out to be it. I don’t know if anybody has a right-handed ketamine patent yet."
I don't think that quite covers it, tho. Personally, I suspect Esketamine, as the part of racemic Ketamine that causes hallucinations exhibits an 'antidepressant' effect similar to the one weakly associated with psychedelics, i.e. more by granting new high level psychological insight than via some low level neurological effect - whereas I'd speculate Arketamine causes the documented 'magic' and RAPID next-day antidepressive effect of racemic Ketamine.
Which makes me suspect we'd probably do well doing the same thing done with some other stereoisomeric medications such as for example in the case of Adderall, which has a ratio of Dexamphetamine to Levo Amphetamine of 3:1(viz., 75% Dex, 25% Levo):
Figure out the optimal ratio of the two stereoisomers (to each other) for depression treatment.
My doctor prescribes me sublingual ketamine for use at home. What we have now is good enough.
We need doctors like mine that have the courage to prescribe off label.
Meditation and yoga offer plenty of support for managing stress and in fact depression. But most people want a quick antidote, something that 'burns' the edge off and not fixes it for good.
I tried meditation and yoga for years to treat depression, and I suffered unnecessarily for years (including periods of being suicidal). Getting on pharmaceuticals vastly improved my life and I can't imagine going back.
I'm really glad you found something that works for you, but I believe you actively harm others by suggesting that it will work for everyone else too.
Few seem to understand how debilitating treatment-resistant depression can be. Source: wife's cousin, who when s(he)'s ok, is super smart, capable, and lives a good life. When s(he)'s in the depression hole, s(he)'s nearly comatose. Ketamine has helped greatly in his/her case.
It's just that the ghost of my 5th grade English teacher would have emerged from the mists to point out that "they" is plural, whereas I was referring to an individual. Can't win.
Words mean what people who use them intend them to mean.
But if you want something more authoritative than random-internet-comment, definition three from dictionary.com has you covered:
https://www.dictionary.com/browse/they
they
pronoun, possessive their or theirs, objective them.
1 nominative plural of he, she, and it.
2 people in general: They say he's rich.
3 (used with a singular indefinite pronoun or singular noun antecedent in place of the definite masculine he or the definite feminine she ): Whoever is of voting age, whether they are interested in politics or not, should vote. A person may apply only if they are over 21. They have been an actor since childhood.
It makes no sense to me to exclude agents that affect biochemistry ('drugs') from consideration as having therapeutic benefit.
They have the ability to do absolutely nothing in some folks and the ability to make mental problems worse for other folks. This is why some retreats won't take people that have a history of mental health issued.
You could simply stick with what works for you and let others do what works for them without judging them harshly for doing something you believe won't help (even when the research and their personal experience says otherwise).
I sure hope so, you obviously have no idea what you talk about. If you can postulate that meditation and offer plenty of support for depressed people. Can some depressed people be helped by meditation and yoga? Sure!
But saying that it offers plenty of support, is like saying that people with cancer just need to eat healthy.