The article explores the origins of the ritual drink soma/haoma, known as the 'nectar of immortality' in ancient Asian literature. It assesses shortcomings of previous botanical candidates and identifies plants that contain dimethyl tryptamine, monoamine oxidase inhibitors, and other psychedelic substances. The author suggests that complex formulas similar to ayahuasca were developed in Central Asia through trial and error, and knowledge of psychoactive plants spread via migrants to Persia and India. The article summarizes arguments from the author's book, without elaborating on topics like Greek mystery rites, cannabis, or criteria for non-ordinary states of consciousness.
A postoperative cancer patient who was taking buprenorphine–naloxone for chronic noncancer pain and then switched to methadone for uncontrolled cancer-related pain successfully transitioned back to buprenorphine–naloxone using a microdosing strategy over one week in an inpatient setting. This approach avoided the need to reduce total opioid intake before starting buprenorphine, which is typically required to prevent precipitated withdrawal. The case suggests that microdosing may be a feasible method for transitioning from methadone to buprenorphine in patients who require higher opioid doses, such as those with cancer pain, though more research on its tolerability is needed.