Substance Abuse and Rehabilitation
March 1, 2011
Jih-Heng Li, Vickna Kasinather, Cheung et al.
146 citations
Ketamine, an anesthetic developed in the 1960s, has hallucinogenic effects and a wide safety margin, but its therapeutic use is limited by mind-body dissociation, delirium, and hallucinations. Increasing recreational abuse, including to experience a "k-hole," has led to government restrictions. Long-term use can cause irreversible urinary tract damage, potentially leading to renal failure and dialysis. Assessments suggest ketamine may cause more harm than some UN-scheduled drugs, with dependence, lower urinary tract dysfunction, and sexual impulse or violence reported in Southeast and East Asia. The danger of ketamine may have been underestimated, and thorough surveys are needed to prevent an epidemic. However, recent findings indicate ketamine may be useful for treating major depressive disorder, prompting need for further research on risks and benefits.
Substance Abuse and Rehabilitation
November 1, 2013
Jerry Meyer
93 citations
Ecstasy, a recreational drug usually containing MDMA, produces euphoria, arousal, enhanced mood, sociability, and heightened perceptions, but also adverse effects like nausea, headache, tachycardia, bruxism, and trismus. Mood lowering can occur 2 to 5 days after use. Acute effects stem from increased release and inhibited reuptake of serotonin and norepinephrine, plus possible oxytocin release. Repeated or high-dose use is linked to tolerance, depressive symptoms, and cognitive deficits, especially in memory. Animal studies show high doses reduce forebrain serotonin markers, suggesting neurotoxicity or long-term downregulation.
Substance Abuse and Rehabilitation
April 1, 2011
Li-Tzy Wu, George E Woody, Chongming Yang et al.
40 citations
Between 2006 and 2008, past-year use of Salvia divinorum among US residents aged 12 or older rose from 0.7% to 1.3%, an 83% increase. Users were typically 18–25 years old, male, white or multiracial, and living in large metropolitan areas. Salvia use was especially common among people who also used other drugs: 53.7% of recent users had used LSD, 30.1% ecstasy, 24.2% heroin, 22.4% PCP, and 17.5% cocaine. Polydrug use was the strongest predictor of both recent and former salvia use. An estimated 43% of past-year salvia users had an illicit or nonmedical drug-use disorder, compared with 2.5% of nonusers. Even after adjusting for other drug use, salvia users had higher odds of depression and substance-use disorders.
Substance Abuse and Rehabilitation
January 1, 2026
Ethan Murphy, Chao Suo, Govinda Poudel et al.
Acute intoxication with delta-9-tetrahydrocannabinol (THC) is consistently associated with greater brain activity in fronto-striatal pathways. Regular cannabis users, compared to non-users, show lower hippocampal volume, reduced white matter microstructure in the superior longitudinal fasciculus, and altered fronto-striatal activity and connectivity during cue-reactivity tasks and at rest. Emerging evidence from Positron Emission Tomography studies indicates lower N-acetyl aspartate, reduced glucose metabolism in the frontal cortex, and lower density of cannabinoid receptors in fronto-striatal pathways, which may reverse with abstinence. Longitudinal multimodal neuroimaging studies are needed to determine whether these brain differences precede or follow cannabis use and whether they dissipate with abstinence.
Substance Abuse and Rehabilitation
January 1, 2016
Falk Mancke, Gintarė Kaklauskaitė, Jennifer Kollmer et al.
A 35-year-old man with MRI-confirmed subacute myelopathy from nitrous oxide (N2O) use also had cannabinoid and nicotine dependence and abused amphetamines, cocaine, LSD, and ketamine. A transient psychotic and depressive episode from synthetic cannabinoid abuse preceded these findings. The case highlights that N2O toxicity can cause irreversible neurological damage if untreated for months, making it essential to consider N2O in patients with substance use disorders who develop new neurological deficits.