Sleep Disorder Drug May Be Effective for Stimulant Abuse

The wakefulness-promoting drug modafinil may be effective in the management of stimulant use disorders, especially when used along with other nonpharmacological interventions, new research shows.

Overdoses from opioids and fentanyl are currently in the spotlight, but stimulant use disorders are also a growing concern with many experts sounding the alarm that it is the next wave of addiction.

“Stimulant use is a serious public health concern in the United States, and as an addiction psychiatrist, I found it frustrating that there are no Food and Drug Administration-approved medications for the treatment of cocaine, methamphetamine, or other stimulant use disorders,” Patricia Dickmann, MD, medical director of addiction services at the Minneapolis VA Medical Center, University of Minnesota Medical School, told Medscape Medical News.

“I have a large patient population struggling with treatment-refractory stimulant use disorders, where the combination of bupropion and naltrexone is not effective, residential treatments are not effective, and I had read some smaller studies suggesting modafinil could be a possible treatment option,” Dickmann said.

The findings were presented here at the American Academy of Addiction Psychiatry (AAAP) 29th Annual Meeting.

Lower Abuse Potential

Modafinil antagonizes dopamine transporters to increase dopamine availability in the brain, but to a lower extent than amphetamines. Therefore, it has a lower potential for abuse or misuse compared with traditional prescription stimulants such as Adderall and Ritalin, she said.

Between July 2017 and September 2018, Dickmann and colleague Erica Dimitropoulos, PharmD, also from the Minneapolis VA Medical Center, performed a prospective case series of 15 patients seen in the Addiction Recovery Services clinic who had a DSM-5 diagnosis of stimulant use disorder.

The patients were offered treatment with off-label modafinil, titrated based on efficacy and tolerability.

All care, including psychotherapy and other psychotropic medications, was continued as usual. Five patients were diagnosed with cocaine use disorder, 10 patients with methamphetamine use disorder, and one patient was diagnosed with both.

The majority of patients had comorbid mental health disorders, including mood disorders, post-traumatic stress disorder, and schizophrenia, as well as comorbid substance use disorders.

None of the patients were prescribed atomoxetine, bupropion, naltrexone, stimulants, or topiramate, although one patient was prescribed mirtazapine for insomnia.

At the time of data collection (November 2018), the average prescribed dose of modafinil was 300 mg/day (range, 200 to 400 mg/day).

Self-reported stimulant use was reduced or eliminated in 10 patients (67%). Six patients (40%) reported abstinence, four patients (27%) reported reduced use, and five patients (33%) reported no change in use pattern. These self-reports were confirmed by urine drug screens. Two patients (13%) overused their prescribed modafinil.

Modafinil was well-tolerated in all cases, with no reported side effects, Dickmann said.

“These results are encouraging, and will be used to support the addition of modafinil to our formulary for use in patients with stimulant use disorders,” she said.

Limited Treatment Options

Jonathan C. Fellers, MD

Commenting on the findings for Medscape Medical News, Jonathan C. Fellers, MD, Tufts University School of Medicine and Director, Integrated Medication-Assisted Treatment, Maine Medical Center, Portland, said there are very limited treatment options for stimulant use disorders.

“Unlike opioids or alcohol, there’s no medications that we have available, so whenever you have a study that has a positive result it’s always encouraging,” Fellers told Medscape Medical News.

“Modafinil is a stimulant but it’s a mild stimulant. Instead of Adderall or Ritalin, which are schedule II stimulants, and have more abuse potential, modafinil is a schedule IV, which is less abusable,” he added.

5 Ways Fitness Helped Me Recover From Addiction

In fitness, I found a new kind of high, and never looked back.

On June 30, 2000, I was 29 years old and found myself mentally, physically, and spiritually bankrupt; devoid of all emotion, lost, and terrified of myself.

I had stuffed every feeling I had down into the depths of my core while trying to look like I had it all together. Those around me knew that I didn’t, but I was in a state of denial until one day I hit my ultimate rock bottom.

That was almost 18 years ago and the last day I drank alcohol.

When I made the decision to get sober, I sought the help of a recovery program. It helped me to find a sober community of people who were living the life I wanted. The program was a springboard that helped me launch a new life, but when I really think about the success of my long-term sobriety, I credit it to fitness.

A year into my sobriety, I started running. I found a positive, healthy community where I began to feel accepted and confident. With every run, I left behind pieces of shame and believed in myself just a little bit more. I had found my new high.

It started with 5K races, then 10K, then half-marathons, and then I eventually left my full-time career to become a personal trainer because I had become so captivated by this new way of living. After being lost for so many years, I felt like I had finally found myself.

Fitness became my life, and it helped me bridge the gap from early recovery to long-term sobriety. Here’s how.

1. Fitness gave me a much-needed community of health-oriented people.

When I got sober, I didn’t have any friends who were healthy. Most of my friends were in the place I just left, and it was dangerous for me to be around them. Other than the new relationships I was building in recovery, I had no healthy friendships, and that was a really lonely and difficult place.

When I started running, I discovered a whole new community of people who were health-orientated. Finding this community solidified the types of friendships I wanted in my life, which left little room for turning back to old behaviors.

2. It helped me feel accomplished and begin to rebuild my self-esteem.

My rock bottom included rock bottom self-esteem. I had none. Zero. Zilch. I had to rebuild everything. Running really fast-tracked that process because with every run I was able to accomplish something challenging, and realizing what I could do made me feel better and better about myself. I started to build a new identity, no longer someone who was at rock bottom but someone who was rising up. Running allowed me to climb my way out of unsound, early recovery and onto more stable ground, with confidence.

3. Fitness also let me form a new identity and discover a sense of purpose.

As I floundered through early sobriety, I also struggled to find a new identity and purpose. Being a part of a running community allowed me to fill that gap by identifying myself as a runner with goals and purpose. Before, in my drinking days, I really didn’t have any direction—so this was new and exciting. I started to take on an identity of someone who had ambition, which was all new to me. Running gave me something constructive to focus on.

4. It gave me a healthy outlet to cope with new challenges and difficult emotions.

For a very long time, I had been coping with the challenges of life in a very unhealthy way. Running and going to the gym gave me a tool that would help me cope with hardships. In exercise, I found a new strategy for dealing with stress, anxiety, and anger—and for once it was productive and satisfying on many levels.

5. And it taught me how to be accountable for my actions.

Through my drinking, I had become quite unreliable. I basically lived life on my terms and when I was hungover or “not into it” I would cancel on friends or appointments.

As part of a community of runners (and especially when I started leading others in that community), I needed to be accountable and do what I said I would do. This new way of living required me to not only show up for others but to learn why I needed to also show up for myself. Bailing on myself all the time weakened my confidence and trust in myself, but my new community encouraged me to show up and rise to each occasion. And my new responsibilities showed me exactly why and how to strive for accountability.

My experience was not unique—there’s a growing movement that champions the power of exercise for long-term recovery.

Eighteen years ago, I hadn’t heard of fitness being a tool to complement recovery, but today I am seeing it pop up on websites, in gyms, and at recovery centers. When people start the process of recovery, they’re often left dealing with the wreckage of their past, loss of friends and family, and the shame and societal stigma surrounding addiction. Fitness communities can be the places where people finally feel accepted, build confidence, and find hope.

One great example is the nonprofit organization The Phoenix, a sober active community that helps individuals recover and take back their lives through fitness. Scott Strode founded The Phoenix after experiencing firsthand the positive impact physical activity can have on recovery. While recovering from drug and alcohol addiction, Strode found self-confidence and a new identity in sports. “Every time I stood on top of a mountain or crossed a finish line, I was a little more a climber, and a little less an addict,” he says. Since 2006, The Phoenix has served over 24,000 individuals. The program, open to anyone with at least 48 hours of sobriety, offers activities that include CrossFit, yoga, boxing, rock climbing, cycling, hiking, and more—at no cost.

Kimberly Ready is the administrative director at Oaks Recovery Center in Greenwood, South Carolina, where in conjunction with their recovery program they offer a “Recover Strong” initiative in partnership with CrossFit Greenwood. Three times a week, residents have the option to attend the local CrossFit gym for a workout. Ready has observed that the residents who participate in the “Recover Strong” program often show increased confidence, a sense of community, and many demonstrate long-term recovery while continuing with their athletic pursuits post-treatment. One former resident at Oaks Recovery Center and a participant of the CrossFit program tells me that it made a big impact on her recovery. “I was looking for something and I couldn’t quite figure it out, so I started the CrossFit program. It was very hard at first, but the more I continued doing it, the better I started to feel both physically and mentally. On March 2, I celebrated two years clean and sober,” she says.

While endorphins alone are hardly enough to keep someone clean and sober for the long-term, fitness, and the community it provides, are proving to change the lives of many people struggling with addiction. It changed mine. Just know that you don’t have to go at this alone—there are people waiting to extend a hand at a meeting or in a gym where you can sweat, and thrive, together.

Study suggests a direct link between screen time and ADHD in teens

Image: Study suggests a direct link between screen time and ADHD in teens

Adding to the list of health concerns associated with excessive screen time, one study suggests that there could be a link between the length of time teenagers spend online and attention deficit hyperactivity disorder (ADHD).

The two-year study, which was published in the Journal of the American Medical Association (JAMA), observed more than 2,500 high school students from Los Angeles.

Digital media and the attention span of teenagers

A team of researchers analyzed data from the teenagers who had shorter attention spans the more they became involved in different digital media platforms for the duration of the experiment.

The JAMA study observed adolescents aged 15 and 16 years periodically for two years. The researchers asked the teenagers about the frequency of their online activities and if they had experienced any of the known symptoms of ADHD.

As the teenagers’ digital engagement rose, their reported ADHD symptoms also went up by 10 percent. The researchers noted that based on the results of the study, even if digital media usage does not definitively cause ADHD, it could cause symptoms that would result in the diagnosis of ADHD or require pharmaceutical treatment.

Experts believe that ADHD begins in the early stages of childhood development. However, the exact circumstances, regardless if they are biological or environmental, have yet to be determined.

Adam Leventhal, a University of Southern California psychologist and senior author of the study, shared that the research team is now analyzing the occurrence of new symptoms that were not present when the study began.

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Other studies about digital engagement have implied that there is an inverse relationship with happiness. The less people used digital media, the more they reported feeling an overall sense of happiness. (Related: The social media paradox: Teens who are always online feel more lonely.)

The researchers concluded that the teenagers might have exhibited ADHD symptoms from the outset due to other factors. However, it is possible that excessive digital media usage can still aggravate these symptoms.

Fast facts about ADHD

ADHD is a neurodevelopmental disorder that is commonly diagnosed in children. However, it can also be diagnosed in older individuals. ADHD can be difficult to diagnose. Since several symptoms of ADHD are similar to normal childhood behaviors, the disorder itself can be hard to detect.

The symptoms of ADHD may include forgetting completed tasks, having difficulty sitting still, having difficulty staying organized, and having trouble concentrating or focusing.

  • Men are at least three times more likely to be diagnosed with ADHD than females.
  • During their lifetimes, at least 13 percent of men will be diagnosed with ADHD, as opposed to only 4.2 percent in women.
  • The average age of ADHD diagnosis is seven years old.
  • The symptoms of the condition will usually manifest when a child is aged three to six years old.
  • ADHD is not solely a childhood disorder. At least four percent of American adults older than 18 may have ADHD.

This disorder does not increase an individual’s risk for other conditions or diseases. However, some people with ADHD, mostly children, have a higher chance of experiencing different coexisting conditions. These can make social situations, like school, more difficult for kids with ADHD.

Some coexisting conditions of ADHD may include:

  • Anxiety disorder
  • Bed-wetting problems
  • Bipolar disorder
  • Conduct disorders and difficulties (e.g., antisocial behavior, fighting, and oppositional defiant disorder)
  • Depression
  • Learning disabilities
  • Sleep disorders
  • Substance abuse
  • Tourette syndrome

Minimize your child’s ADHD risk by reading more articles with tips on how to manage their internet use at

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Ask yourself: Why are there no prescription medications without horrific side effects?

Image: Ask yourself: Why are there no prescription medications without horrific side effects?

The reason there are no prescription medications available today where the side effects aren’t worse than the ailment being treated is because Big Pharma will not treat or heal anything without creating several new issues that keep their “customers for life” coming back for more. Most Americans do not want to stop eating junk food, fast food, corporate franchise restaurant food, microwaveable food, prepared food bar “stuff,” and “diet” food that’s mostly chock full of synthetic sweeteners, GMOs and MSG.

Due almost entirely to these nasty eating habits, about 200 million Americans seek medical doctors to prescribe them chemical-filled pills to kill the pain, quell the hypertension, reduce the inflammation, unclog the clots, numb the anxiety, and nullify the depression.

The FDA and CDC do not allow anything that cures disease or disorders to be labeled “medicine”

Most Americans think the FDA was created to protect us from dangerous chemicals that might wind up in food and medicine, but just the opposite is true. Over the past century, the FDA has tried to destroy all forms of holistic care in America that compete with “slash-and-burn” drug and vaccine treatments that are readily dished out by the allopathic Ponzi sick-care scheme that masquerades as ‘health’ care in this country.

The CDC is a actually a for-profit corporation listed on Dun and Bradstreet. As a health protection agency, the CDC is supposed to save lives and conduct critical science for responding to threats when they arise, but pharma corporations have lobbyists and their vice presidents now in positions of control in the bureaucracy, writing legislation that favors new, untested drug approvals, as they have for decades.

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Both the FDA and the CDC promote toxic chemicals as medicine, including prescription medications, chemotherapy, and vaccines. Meanwhile, any food, herb, tincture, plant, seed, or essential oil that treats, prevents or cures disease is banned as “medicine” while being manipulated in labs, weakened or deadened, patented, and then declared a failure.

Prescription drug deaths skyrocket while the Big Pharma world pretends to search for cures for cancer, dementia, and diabetes

Twenty years ago, only four in every 100,000 people died from taking prescription drugs “as recommended” by their medical doctors. Now, one in every ten Americans struggle with addiction to prescription drugs (think opioids and SSRIs). Right now, over three million Americans are abusing painkillers, two million are misusing tranquilizers, 1.7 million are abusing stimulants, and half a million are misusing sedatives.

More Americans use and abuse “controlled” prescription drugs than heroin, cocaine and methamphetamines combined. How many of them will die this year? About 50 people will die today from overdosing on opioids. And now heroin is the death drug of choice for most people who become addicted to opioid pain relievers. Most teenagers think it’s safer to take a friend’s prescription drugs than to dose some illegal street drugs, just because they were prescribed by a doctor, but that’s not true at all.

The side effects of most prescription drugs that treat depression and anxiety include worsened depression and thoughts of suicide. How ridiculous is that? Every prescription drug advertised on television for all American children and teens to see comes slathered with side effects you wouldn’t wish on your worst enemies. Then they all feature the same tag line, “Ask your doctor if (fill in complex chemical name here) is right for you.”

It would only make sense that natural cures would be banned if they caused side effects like all the prescription medications do, but they don’t. If organic foods caused the health problems conventional foods do, they too would be banned, recalled or stuck with warning labels.

It’s as if we are all living in total idiocy like the movie “Idiocracy.” More than 200 million Americans think it’s okay if their medical doctor prescribes them “medicine” that can cause internal bleeding, loss of vision, coma, feelings of suicide, and thoughts of committing homicide. Wake up America. You’re living inside a real-life nightmare, where the food is toxic, the medicine is more toxic, and the medical doctors have no nutrition education, yet go to school for eight years to learn how to juggle chemical medicines like some Bozo science clowns. Maybe all M.D.s should wear big red wigs with big red noses and big red shoes while scribbling out those toxic prescriptions.

Sources for this article include:

Technology and social media are feeding addictive behaviors and mental illness in society

Image: Technology and social media are feeding addictive behaviors and mental illness in society

Smart phones and tablets have become a cancerous growth in our lives – never leaving us, feeding off our essence, and sucking away our attention, life, and energy. Social media is like an aggressive form of brain cancer, attaching to our mind, addicting us to cheap dopamine rushes, replacing human interaction with a digital façade of living. Stealing away our time, technology has become a disease that infiltrates our mental and social health, leaving us depressed, anxious, worried, envious, arrogant, and socially isolated.

What we type and text to others causes over-thinking, rumination, and misunderstanding. The way we respond with type and text can be misinterpreted, leading to social strain in relationships. Digital communication lacks the natural flow of body language, eye contact, touch, voice inflection, tone, and real-life rapport. Accustomed to digital communication, people lose their ability to have adult conversations. This hurts everyone’s ability to work together, discuss ideas, solve problems, and overcome multi-faceted challenges.

Popular social media platforms prey on human weaknesses

On Facebook, the pursuit of likes and comments can become an addicting sensation. When the attention fails to come in, the Facebook user may feel unheard or undesirable. When the user sees their friends getting more likes, they may perceive other people having a better life than they do, leading to depressed feelings. (Related: Former Facebook exec: “Social media is ripping society apart.“)

On Twitter, communication is limited to short bursts. These bursts encourage people to engage in divisive language that is used in inflammatory ways and is easily misunderstood. Twitter is used to build a “following” which becomes a high-school-esque popularity contest that easily inflates egos and gives a platform to the most annoying ones in the bunch.

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Instagram and Snapchat have become more popular as well, making users anxious to show off their lives online 24-7. This infatuation with documenting every moment is an anxious, self-absorbed way to live and it does the person no good, because these technology gimmicks interrupt the actual moment and disturb the flow of real life. Do we really think that everyone cares about every picture, every meal, and everything that we do? As the digital world continues to bloat up with information, pictures, and voices, all of it loses its value and sacredness. Over time, no one genuinely cares. The louder a person gets on social media, the more annoying they are perceived.

Technology addiction destroys sleep, leads teenagers to other addictive substances

As parents pacify their children with screens, the children are exposed to constant light stimulation which excites brain chemicals. The colorful games and videos over-stimulate the child’s mind, making them addicted to the sensation. Consequentially the child becomes more restless and behavioral distress increases over the long term.

Technology has made our lives more selfish, isolated, and interrupted. Social media has preyed on our weaknesses, trapping us in its mesmerizing facade of happiness. According to SurvivoPedia, teenagers who spend more than five hours a day on their devices are at a 72 percent higher risk for suicide risk factors. In order to alleviate the mental health issues associated with social media, teenagers may turn to other addictive substances to take the edge off.

Additionally, these devices interfere with healthy sleep patterns — which are essential for proper brain development. The onslaught of blue light and electromagnetic frequency interferes with healthy melatonin levels in the brain. The things that we post online can keep us up at night as well. The addiction to check the phone for responses and likes can keep a person up, too. All this brain excitement and depression throws off the body’s circadian rhythm, leading to poor sleep and mental fatigue during the daytime.

Check out more on mental health at Mind.News.

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Addictive Behavior Related to Low Levels of Oxytocin, the “Love/Bonding Hormone”

The more we understand how nature works, the more we realize just how complex, intricately balanced and ingenious its systems are. One aspect that we are currently gaining more insight into is the human body’s ability to produce natural chemicals and their effects on our general wellbeing.

Addictive Behaviour Related to Low Levels of the ''Love-Bonding Hormone'' Oxytocin 1

Oxytocin is a hormone secreted by the posterior lobe of the pituitary gland, a pea-sized structure located at the base of the brain. It is often referred to as a natural love chemical because it is pumped into our bodies when we experience love. It promotes bonding, trust and attachment. It enhances the connection between mother and baby when it is released in high doses during childbirth, and is responsible for the magical seeming way a mother’s breast instantly releases milk at the sight or sound of her infant. It also deepens the sense of union between couples at orgasm.

Oxytocin levels are naturally increased when we feel connected. Actions such as physical touch, cuddling, massage, physical activity, sexual contact, and activities like singing and reading all encourage our bodies to produce oxytocin. When this hormone is whizzing around our bodies it instills a sense of wellbeing and our natural mechanism for healing is promoted.

Conversely levels of this chemical are diminished by isolation or loneliness, anxiety, depression, and chronic stress. When we are deficient in oxytocin, we are likely to have raised levels of the damaging stress hormone cortisol which, as well as negatively affecting our health, adds to the feeling of anxiety, disconnection and despondence.

“Sometimes we spend less quality time with our partner — especially when other demands on us are pressing. However, neuroscience findings suggest that we should change our priorities. By forgoing closeness with our partners, we are also missing our oxytocin boost — making us less agreeable to the world around us and more vulnerable to conflict.” ~ Paul J. Zak

It would seem that nature, in its innate brilliance, actually favors loving supportive social interactions by rewarding them with a natural feel-good, healing elixir. But this raises the question: If we crave oxytocin when our levels (and loving interactions) are low, how might we try to compensate?

Addiction is Not Necessarily an Addiction for Life - fb

Oxytocin and Addiction

A recent article in the international journal Pharmacology, Biochemistry and Behavior explored the current state of research linking oxytocin and addiction. The article, guest edited by Dr. Femke Buisman-Pijlman from the University of Adelaide’s School of Medical Sciences, suggests that addictive behaviour such as drug and alcohol abuse could be associated with low levels of this love hormone.

For a long time it was assumed that addiction was the result of bad life decisions. The fact that as a society we still imprison people for personal drug use suggests that this view is likely still coloring our perception of addiction. However, Buisman-Pijlman’s article puts forward the theory that substances like drugs and alcohol may in fact be a means to compensate for inadequate levels of oxytocin; that when we don’t have the natural feel-good hormone circulating in our bodies, we are more inclined to seek out reward through our external environment.

Addressing the long-held association between addiction and childhood neglect, Dr. Buisman-Pijlman, whose background encompasses both addiction studies and family studies, continues that some individuals’ lack of resistance to addictive substances may be specifically associated with poorly developed oxytocin systems. She believes that when a child feels loved and safe they are more likely to develop a healthy oxytocin system, while harsh conditions (such as neglect and abuse) during early childhood may be responsible for the impaired development of the oxytocin system.

“Previous research has shown that there is a high degree of variability in people’s oxytocin levels. We’re interested in how and why people have such differences in oxytocin, and what we can do about it to have a beneficial impact on people’s health and wellbeing,” she says.

“We know that newborn babies already have levels of oxytocin in their bodies, and this helps to create the all-important bond between a mother and her child. But our oxytocin systems aren’t fully developed when we’re born — they don’t finish developing until the age of three, which means our systems are potentially subject to a range of influences both external and internal,” Dr. Buisman-Pijlman explained. “And because the hardware of the oxytocin system finishes developing in our bodies at around age three, this could be a critical window to study.”

Attachment Parenting - Learning From The Other Side

Oxytocin and Parenting 

“Oxytocin connects us to other people; oxytocin makes us feel what other people feel. And it’s easy to cause people’s brains to release oxytocin. Let me show you. Come here. Give me a hug.” ~ Paul J. Zak

In the past, the feeling of love was not seen as necessary for successful physical development. The focus of childrearing was on obedience and basic physiological needs like food and housing. Some experts even warned parents that providing too much love and affection could lead to ‘problem children’.

More recently, harsher practices like letting babies ‘cry it out’ and strictly controlled feeding times have declined in popularity as more parents began to choose to listen to their inner knowing, rather than voices of ‘authority’. Today this inclination to respond to our children from a space of love and connection is supported by most experts in the field of child development. Movements like attachment parenting, which encourages feeding on demand and co-sleeping, are becoming increasingly popular. And, now that we understand that there is a physiological motive as well as an emotional one for giving our children lots of love and affection in early childhood, there is even more reason to engage our natural inclinations.

For those who may have lacked the necessary love and attention during the formative stage of the oxytocin producing system, or for those who just want to maximise their feel good experience, the awesome news is that encouraging the body to produce more of this ‘love drug’ is not hard work. All the activities that increase oxytocin production are pleasurable and easily accessible. Activities like sex, cuddling, hugging, all raise levels naturally. Pleasurable activities like long baths, eating chocolate, listening to soothing music, singing in the shower, and showing our pets affection are also recognized as effective ways to increase the amount of oxytocin circulating in the body.


The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think.

It is now one hundred years since drugs were first banned — and all through this long century of waging war on drugs, we have been told a story about addiction by our teachers and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my new book, Chasing The Scream: The First And Last Days of the War on Drugs, to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong — and there is a very different story waiting for us, if only we are ready to hear it.

If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I learned it from an extraordinary mixture of people I met on my travels. From the surviving friends of Billie Holiday, who helped me to learn how the founder of the war on drugs stalked and helped to kill her. From a Jewish doctor who was smuggled out of the Budapest ghetto as a baby, only to unlock the secrets of addiction as a grown man. From a transsexual crack dealer in Brooklyn who was conceived when his mother, a crack-addict, was raped by his father, an NYPD officer. From a man who was kept at the bottom of a well for two years by a torturing dictatorship, only to emerge to be elected President of Uruguay and to begin the last days of the war on drugs.

I had a quite personal reason to set out for these answers. One of my earliest memories as a kid is trying to wake up one of my relatives, and not being able to. Ever since then, I have been turning over the essential mystery of addiction in my mind — what causes some people to become fixated on a drug or a behavior until they can’t stop? How do we help those people to come back to us? As I got older, another of my close relatives developed a cocaine addiction, and I fell into a relationship with a heroin addict. I guess addiction felt like home to me.

If you had asked me what causes drug addiction at the start, I would have looked at you as if you were an idiot, and said: “Drugs. Duh.” It’s not difficult to grasp. I thought I had seen it in my own life. We can all explain it. Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That’s what addiction means.

One of the ways this theory was first established is through rat experiments — ones that were injected into the American psyche in the 1980s, in a famous advert by the Partnership for a Drug-Free America. You may remember it. The experiment is simple. Put a rat in a cage, alone, with two water bottles. One is just water. The other is water laced with heroin or cocaine. Almost every time you run this experiment, the rat will become obsessed with the drugged water, and keep coming back for more and more, until it kills itself.

The advert explains: “Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It’s called cocaine. And it can do the same thing to you.”

But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander noticed something odd about this experiment. The rat is put in the cage all alone. It has nothing to do but take the drugs. What would happen, he wondered, if we tried this differently? So Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat-food and tunnels to scamper down and plenty of friends: everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn’t know what was in them. But what happened next was startling.

The rats with good lives didn’t like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

At first, I thought this was merely a quirk of rats, until I discovered that there was — at the same time as the Rat Park experiment — a helpful human equivalent taking place. It was called the Vietnam War. Time magazine reported using heroin was “as common as chewing gum” among U.S. soldiers, and there is solid evidence to back this up: some 20 percent of U.S. soldiers had become addicted to heroin there, according to a study published in the Archives of General Psychiatry. Many people were understandably terrified; they believed a huge number of addicts were about to head home when the war ended.

But in fact some 95 percent of the addicted soldiers — according to the same study — simply stopped. Very few had rehab. They shifted from a terrifying cage back to a pleasant one, so didn’t want the drug any more.

Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It’s not you. It’s your cage.

After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days — if anything can hook you, it’s that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can’t recover? Do the drugs take you over? What happened is — again — striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)

When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don’t seem to make sense — unless you take account of this new approach.

Here’s one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right — it’s the drugs that cause it; they make your body need them — then it’s obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit.

But here’s the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected.

If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander’s theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.

When I learned all this, I found it slowly persuading me, but I still couldn’t shake off a nagging doubt. Are these scientists saying chemical hooks make no difference? It was explained to me — you can become addicted to gambling, and nobody thinks you inject a pack of cards into your veins. You can have all the addiction, and none of the chemical hooks. I went to a Gamblers’ Anonymous meeting in Las Vegas (with the permission of everyone present, who knew I was there to observe) and they were as plainly addicted as the cocaine and heroin addicts I have known in my life. Yet there are no chemical hooks on a craps table.

But still, surely, I asked, there is some role for the chemicals? It turns out there is an experiment which gives us the answer to this in quite precise terms, which I learned about in Richard DeGrandpre’s book The Cult of Pharmacology.

Everyone agrees cigarette smoking is one of the most addictive processes around. The chemical hooks in tobacco come from a drug inside it called nicotine. So when nicotine patches were developed in the early 1990s, there was a huge surge of optimism — cigarette smokers could get all of their chemical hooks, without the other filthy (and deadly) effects of cigarette smoking. They would be freed.

But the Office of the Surgeon General has found that just 17.7 percent of cigarette smokers are able to stop using nicotine patches. That’s not nothing. If the chemicals drive 17.7 percent of addiction, as this shows, that’s still millions of lives ruined globally. But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture.

This has huge implications for the one-hundred-year-old war on drugs. This massive war — which, as I saw, kills people from the malls of Mexico to the streets of Liverpool — is based on the claim that we need to physically eradicate a whole array of chemicals because they hijack people’s brains and cause addiction. But if drugs aren’t the driver of addiction — if, in fact, it is disconnection that drives addiction — then this makes no sense.

Ironically, the war on drugs actually increases all those larger drivers of addiction. For example, I went to a prison in Arizona — ‘Tent City’ — where inmates are detained in tiny stone isolation cages (‘The Hole’) for weeks and weeks on end to punish them for drug use. It is as close to a human recreation of the cages that guaranteed deadly addiction in rats as I can imagine. And when those prisoners get out, they will be unemployable because of their criminal record — guaranteeing they with be cut off even more. I watched this playing out in the human stories I met across the world.

There is an alternative. You can build a system that is designed to help drug addicts to reconnect with the world — and so leave behind their addictions.

This isn’t theoretical. It is happening. I have seen it. Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them — to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings, after years of trauma and stunning them into silence with drugs.

One example I learned about was a group of addicts who were given a loan to set up a removals firm. Suddenly, they were a group, all bonded to each other, and to the society, and responsible for each other’s care.

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I’ll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country’s top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass — and he now hopes the whole world will follow Portugal’s example.

This isn’t only relevant to the addicts I love. It is relevant to all of us, because it forces us to think differently about ourselves. Human beings are bonding animals. We need to connect and love. The wisest sentence of the twentieth century was E.M. Forster’s — “only connect.” But we have created an environment and a culture that cut us off from connection, or offer only the parody of it offered by the Internet. The rise of addiction is a symptom of a deeper sickness in the way we live — constantly directing our gaze towards the next shiny object we should buy, rather than the human beings all around us.

The writer George Monbiot has called this “the age of loneliness.” We have created human societies where it is easier for people to become cut off from all human connections than ever before. Bruce Alexander — the creator of Rat Park — told me that for too long, we have talked exclusively about individual recovery from addiction. We need now to talk about social recovery — how we all recover, together, from the sickness of isolation that is sinking on us like a thick fog.

But this new evidence isn’t just a challenge to us politically. It doesn’t just force us to change our minds. It forces us to change our hearts.

Loving an addict is really hard. When I looked at the addicts I love, it was always tempting to follow the tough love advice doled out by reality shows like Intervention — tell the addict to shape up, or cut them off. Their message is that an addict who won’t stop should be shunned. It’s the logic of the drug war, imported into our private lives. But in fact, I learned, that will only deepen their addiction — and you may lose them altogether. I came home determined to tie the addicts in my life closer to me than ever — to let them know I love them unconditionally, whether they stop, or whether they can’t.

When I returned from my long journey, I looked at my ex-boyfriend, in withdrawal, trembling on my spare bed, and I thought about him differently. For a century now, we have been singing war songs about addicts. It occurred to me as I wiped his brow, we should have been singing love songs to them all along.

Scientists Link Selfies To Narcissism, Addiction & Mental Illness

Scientists Link Selfies To Narcissism, Addiction & Mental Illness
The growing trend of taking smartphone selfies is linked to mental health conditions that focus on a person’s obsession with looks.

According to psychiatrist Dr David Veal: “Two out of three of all the patients who come to see me with Body Dysmorphic Disorder since the rise of camera phones have a compulsion to repeatedly take and post selfies on social media sites.”

“Cognitive behavioural therapy is used to help a patient to recognise the reasons for his or her compulsive behaviour and then to learn how to moderate it,” he told the Sunday Mirror.

A British male teenager tried to commit suicide after he failed to take the perfect selfie. Danny Bowman became so obsessed with capturing the perfect shot that he spent 10 hours a day taking up to 200 selfies. The 19-year-old lost nearly 30 pounds, dropped out of school and did not leave the house for six months in his quest to get the right picture. He would take 10 pictures immediately after waking up. Frustrated at his attempts to take the one image he wanted, Bowman eventually tried to take his own life by overdosing, but was saved by his mom.

“I was constantly in search of taking the perfect selfie and when I realized I couldn’t, I wanted to die. I lost my friends, my education, my health and almost my life,” he told The Mirror.

The teenager is believed to be the UK’s first selfie addict and has had therapy to treat his technology addiction as well as OCD and Body Dysmorphic Disorder.
Part of his treatment at the Maudsley Hospital in London included taking away his iPhone for intervals of 10 minutes, which increased to 30 minutes and then an hour.

“It was excruciating to begin with but I knew I had to do it if I wanted to go on living,” he told the Sunday Mirror.

Public health officials in the UK announced that addiction to social media such as Facebook and Twitter is an illness and more than 100 patients sought treatment every year.

“Selfies frequently trigger perceptions of self-indulgence or attention-seeking social dependence that raises the damned-if-you-do and damned-if-you-don’t spectre of either narcissism or very low self-esteem,” said Pamela Rutledge in Psychology Today.

The big problem with the rise of digital narcissism is that it puts enormous pressure on people to achieve unfeasible goals, without making them hungrier. Wanting to be Beyoncé, Jay Z or a model is hard enough already, but when you are not prepared to work hard to achieve it, you are better off just lowering your aspirations. Few things are more self-destructive than a combination of high entitlement and a lazy work ethic. Ultimately, online manifestations of narcissism may be little more than a self-presentational strategy to compensate for a very low and fragile self-esteem. Yet when these efforts are reinforced and rewarded by others, they perpetuate the distortion of reality and consolidate narcissistic delusions.

The addiction to selfies has also alarmed health professionals in Thailand. “To pay close attention to published photos, controlling who sees or who likes or comments them, hoping to reach the greatest number of likes is a symptom that ‘selfies’ are causing problems,” said Panpimol Wipulakorn, of the Thai Mental Health Department.

The doctor believed that behaviours could generate brain problems in the future, especially those related to lack of confidence.

The word “selfie” was elected “Word of the Year 2013″ by the Oxford English Dictionary. It is defined as “a photograph that one has taken of oneself, typically with a smartphone or webcam and uploaded to a social media website”.

1. The Gym Selfie (Because the checkin isn’t enough.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Gym Selfie (Because the checkin isn’t enough.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Gym Selfie (Because the checkin isn’t enough.)

2. The Pet Selfie (If you want to post a picture of your pet, post a picture of your pet.)
Unless this happens, then it’s ok:
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Pet Selfie (If you want to post a picture of your pet, post a picture of your pet.)

3. The Car Selfie AKA The Seatbelt Selfie (You LITERALLY got in the car and thought, “I look so good today, I better let everyone know before I put this thing in drive and head to my shift at the Olive Garden.”)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Car Selfie AKA The Seatbelt Selfie (You LITERALLY got in the car and thought, “I look so good today, I better let everyone know before I put this thing in drive and head to my shift at the Olive Garden
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Car Selfie AKA The Seatbelt Selfie (You LITERALLY got in the car and thought, “I look so good today, I better let everyone know before I put this thing in drive and head to my shift at the Olive Garden

If you can combine the Seatbelt Selfie with the beloved Shirtless Selfie like this unattractive fella below, you..are…GOLD.
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - If you can combine the Seatbelt Selfie with the beloved Shirtless Selfie like this unattractive fella below, you..are…GOLD.

4. The Blurry Selfie (Why?)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Blurry Selfie (Why?)

5. The Just Woke Up Selfie
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Just Woke Up Selfie
Yeah right you just woke up.

6. Or even worse, the Pretending to Be Asleep Selfie. (We know you’re not asleep, asshole. You took the damn picture.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - Or even worse, the Pretending to Be Asleep Selfie. (We know you’re not asleep, asshole. You took the damn picture.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness

7. The Add a Kid Selfie (Extra points for a C-section scar.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Add a Kid Selfie (Extra points for a C-section scar.)

8. The Hospital Selfie (A rare gem. The more tubes you have hooked up to you, the better.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Hospital Selfie (A rare gem. The more tubes you have hooked up to you, the better.)

9. The “I’m On Drugs” Selfie (This looker below also qualifies as theLook At My New Haircut Selfie.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The “I’m On Drugs” Selfie (This looker below also qualifies as theLook At My New Haircut Selfie.)

10. The Duck Face Selfie (Hey girls. This doesn’t make you prettier. It makes you look stupid and desperate. If that’s what you’re going for, carry on.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Duck Face Selfie (Hey girls. This doesn’t make you prettier. It makes you look stupid and desperate. If that’s what you’re going for, carry on.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Duck Face Selfie (Hey girls. This doesn’t make you prettier. It makes you look stupid and desperate. If that’s what you’re going for, carry on.)

11. The Pregnant Belly Selfie (Send this to your family and friends, not the entire Internet.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Pregnant Belly Selfie (Send this to your family and friends, not the entire Internet.)
And yes, that’s a pregnant belly duck face selfie. It’s the unicorn of awful selfies.

12. The “I’m a Gigantic Whore” Selfie
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The “I’m a Gigantic Whore” Selfie
Nice phone case, by the way.

13. The “I Have Enough Money to Fly On an Airplane” Selfie (AND I own earbuds.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The “I Have Enough Money to Fly On an Airplane” Selfie (AND I own earbuds.)

14. The 3D Selfie. (It takes talent…along with class.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The 3D Selfie. (It takes talent…along with class.)

15. The Say Something That Has Nothing To Do With Anything Selfie(You had a great night? Oh.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The Say Something That Has Nothing To Do With Anything Selfie(You had a great night? Oh.)

16. The “I Live In Filth” Selfie (We all make messes, but if you’re going to post your living quarters on the World Wide Web, pick up your damn room.)
Scientists Link Selfies To Narcissism, Addiction & Mental Illness - The “I Live In Filth” Selfie (We all make messes, but if you’re going to post your living quarters on the World Wide Web, pick up your damn room.)
Source: via Why Don’t You Try This

Mental health campaigner who created Project Semicolon dies at 31.

Mental health campaigner who created Project Semicolon dies at 31
Amy Bleuel, 31, from Wisconsin, founded Project Semicolon in 2013 with one goal in mind – to help people struggling with mental illness, suicide and addiction. 

The woman behind a powerful mental health campaign which aims to lower suicide rates around the world has died. 


Amy Bleuel, 31, from Wisconsin, founded Project Semicolon in 2013 with one goal in mind – to help people struggling with mental illness, suicide and addiction.

She encouraged people to draw or tattoo semicolons on themselves as a message of hope – a sign that their story isn’t finished – and to fight the stigma of mental health.

Jeff Strommen, the chairman of the Brown County Coalition for Suicide Prevention who had previously worked with Amy, told Fox 11: ‘Her loss is felt tremendously both by myself and our community here.’

The most recent post on her Facebook fan page was written on March 20 and reads: ‘Depression takes root when the picture of the past is more powerful than the picture of the future.’

Amy struggled with mental illness for more than 20 years and experienced many stigmas associated with it.


After overcoming some of her struggles, she began sharing stories and giving hope to others struggling with mental illness.

On the Project Semicolon website, Amy, who lost her own father to suicide in 2003, wrote: ‘Despite the wounds of a dark past I was able to rise from the ashes, proving that the best is yet to come.

‘When my life was filled with the pain of rejection, bullying, suicide, self-injury, addiction, abuse and even rape, I kept on fighting.

‘I didn’t have a lot of people in my corner, but the ones I did have kept me going. In my 20 years of personally struggling with mental health I experienced many stigmas associated with it.

‘Through the pain came inspiration and a deeper love for others. Please remember there is hope for a better tomorrow.’

Amy Bleuel death
She passed away last Thursday 

Since the news of her passing was released, there has been an outpouring of support on the Facebook page.

One person wrote: ‘Just being real, being who you are, not being ashamed, or afraid to talk about things that are difficult to talk about, she did that well.’


Could Psychedelics Be The Future Of Children’s Medicine?

Since their discovery, MDMA, LSD and psilocybin (which makes certain mushrooms so magical) have collected tons of cultural baggage. Decades of recreational use obscure their pharmacological origin stories and potential medical applications. But today, many researchers are optimistic that the compounds could treat mental health issues ranging from depression to autistic spectrum disorder without the side effects or addictive nature of today’s prescription drugs.

magic mushrooms

While drug prohibition made research into psychedelics impossible for most of the 20thcentury, restrictions were lifted in the 1990s. Promising results already surfaced, including a pair of studies published in late 2016 showing that psilocybin use eased depression and anxiety for terminal cancer patients.

As the medical director of the Heffter Institute, George Greer explores medical possibilities for psilocybin and other psychedelics. He believes the future of psychedelic research holds vast potential. And while he cautioned extreme care with regards to dispensing it to the developing mind of a child, he predicted possible pediatric applications for psychedelics within the 21stcentury.

Solving The Mystery of Mushrooms

While there’s been increased research into psychedelics in recent years, researchers don’t know exactly how psilocybin works in the brain. The compound interacts with receptors for serotonin, a brain chemical that regulates mood and affects functions including sleep, appetite, memory and sexual desire. But, according to Greer, the details of that relationship are unknown. In fact, psilocybin may adjust or change the way serotonin receptors work in a lasting way. “How that leads to symptom reduction is a major question,” Greer says. “We don’t know for sure. But with most psychiatric drugs, the mechanism of action is not well known at all.”

Wikimedia Commons

The Psychedelic Shutdown

Thanks to brain regions that create what’s called the default mode network, your thought-organ is always busy. Repetitive thoughts cycle constantly in the background of our minds. It’s part of our identity, for good and bad — it can reinforce patterns of behavior our conscious mind knows are unhealthy. Psychedelics temporarily shut down that network, and the pause allows for a different perspective on your own behavior. “Those thoughts are silent, so new perspectives can come into the mind,” Greer said.

Tripping Away Addiction

Paradoxical though it may sound, psychedelic compounds may be a boon for parents of teens struggling with addiction. Before it was criminalized, researchers and addiction experts including Alcoholics Anonymous founder Bill Wilson, believed psychedelics had great potential to combat addiction. “With addictions, they would ask why am I doing this? Why am I doing this self-destructive thing?” Greer says. “It’s an emotionally painful realization.”

mdma pills


Researchers haven’t explored whether psychedelics could help treat attention deficit disorders, but, per Greer, anecdotal evidence suggests it could. Because even though psychedelics travel a different neurochemical circuit than that associated with ADHD they still seem to calm some symptoms. “ADHD is linked to dopamine and norepinephrine receptors, which psilocybin has no effect on,” Greer says. “There are reports from people on their own that micro-dosing LSD, meaning a dose so small they don’t feel the effects of LSD directly, helps with attention and focus.”

The Autism And Psychedelic Connection

In the 1950s, LSD was given to autistic children and it showed benefits in their behavior. “Right now another study is in process of using MDMA for adults with autistic spectrum disorder,” Greer says. The research follows anecdotal reports of MDMA helping people on the autism spectrum relate more socially. MDMA appears to activate parts of the brain that help people read expressions and ease anxieties related to social communications.

psychedelic tunnel

Will Kids Be Tripping Anytime Soon?

Your pediatrician isn’t going to prescribe your kid LSD anytime soon. Greer says that while there are promising indicators, research is still in very early stages. Ethical rules governing testing drugs on children — and common sense — keep researchers with psychedelics away from kids. “Children’s brains are developing and you don’t want to risk disturbing that development in an unhealthy way,” says Greer. “So there has to be a very clear and good reason to believe it will help the children and not cause problems before doing the research.”

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