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Author Topic: Ask a Drug Expert Physician about Drugs & Health  (Read 36439 times)

DoctorX

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Ask a Drug Expert Physician about Drugs & Health
« on: April 14, 2013, 12:16 am »
Hello,
I am a Spanish Family Physician working in fields like risk reduction associated to drug use, club drugs, new synthetic drugs, cannabis therapeutic and steroids since 1999. I would like to contribute to this forum offering professional advice in topics related to drug use and health: pharmacological interactions, risks of drug use in particular conditions (specific diseases, problems of health…), contraindications, adverse effects and toxicity, risk reduction measures… 
This advice cannot replace a complete face-to-face medical evaluation, but I know how difficult can be to talk frankly about these things. You can see my CV in my personal web-page http://www.doctorcaudevilla.com/
You can also use PM for personal questions or video-conference in my web.
I will try to answer all your questions (if I know the answers) but I have limited time
DoctorX

(03/05/13) Please use only PM and PGP for personal questions. Most of the questions can be answered in general forum and can be useful to other people

(05/07/13) Thanks to user cleansober, who is helping me editing my awful English
« Last Edit: July 08, 2013, 11:38 am by DoctorX »
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b3tterliving

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #1 on: April 14, 2013, 01:30 am »
Hey doctor thanks so much for offering your advice! I have type 1 diabetes and i am wondering if there is any information connected to MDMA and its effect on blood sugar? I have never done MDMA but am interested in exploring it. Would i have enough control over myself to realize "i need to test" or should a trip sitter be there to remind me? Secondly, I have tripped in the past on LSD and mushrooms but that was before my diagnosis...now that i know i have to monitor my sugar levels to avoid issues im afraid i might become afraid or paranoid of my glucometer or my insulin injections under the influence..any recommendations on how to deal with this?

DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #2 on: April 14, 2013, 09:54 am »
In non-diabetic persons MDMA does not have a significant effect on glucose blood levels. There are no specific studies on diabetic persons but, according to MDMA pharmacology, dramatic changes in glucose are not expected.
In fact, alcohol is the most altering glucose drug in diabetics. For the rest of substances, it is more important “what are you doing” that “what substance did you take”. If you are dancing, doing exhausting exercise or you forget to eat are important aspects that can affect glycaemia. Some drugs make you hungry (cannabis), other diminish appetite (stimulants).
Most people feel like, on MDMA, it is easy to keep control on what you feel, what you think and what you do (or at least easier than other drugs). But the positive mood could make you feel forgetful and carefree. As MDMA effects last for 4-6 hours, one possible strategy is to set an alarm clock in hour 2-4 to remind you of test your sugar. I think with that it should be enough. If you are with some friends that know what you are doing it should be great. You should use moderate doses first times (60-80 mg) and be cautious with dosage in general (not over 120 mg) as diabetes can affect cardiovascular health. One important thing to remember is that MDMA decreases appetite: you should keep with you sweat soft food as milkshakes or fruit.
Some diabetic MDMA users have told me that MDMA makes them feel more conscious about their own body, so they can notice better if there is hyper or hypoglycaemias. On the other hand, ketamine is a drug not recommendable for diabetics, as it alters self-perception of body.
I don´t know how long have you been diagnosed of diabetes, but if it is a recent diagnosis you should wait to know well how to use insulin and “get used” to your condition and then after experiment with substances. I think worries and paranoias are less probable with MDMA than psychedelics. But as you learn to live a normal life with diabetes worries will disappear.
DoctorX
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zvp1014

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #3 on: April 14, 2013, 10:01 am »
Do you have any information on the Dissociative Fugue experienced by those on prescription Lithium or Tricyclics with LSD? Is it unpleasant, and should it be avoided?
This is my last fucking post on this shit forum. I hope all you assholes OD and get what's coming to you, fucking pricks.

onezero32

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #4 on: April 14, 2013, 11:01 am »
dar la bienvenida Dr Caudevilla!

It's fantastic that you've joined us and are offering your knowledge towards harm reduction, thank you! +1

I noticed on your page that you accept bitcoin donations, so I hope anybody that's financially able and who also takes benefit from your information to donate as a token of thanks.

estoy agredecido

DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #5 on: April 14, 2013, 11:32 am »
A dissociative fugue is a kind of amnesia in which, the person who suffers it, experiments an "escape" of his own personality, and so he is not able to remember a part or the whole of his previous life. He is not able to remember who he or she is and, in some times, it produces the creation of a new identity. In most cases it is a temporal state, lasting hours to days or months.
In relation to LSD, lithium and tricyclics I only know some reports in Internet forums, but, as far as I know there are no scientific data about it. I think very high doses of LSD or other psychedelics could rarely trigger dissociative states in predisposed individuals. I don´t know if lithium or triciclycs raise this probability. From a medical point of view, dissociative fugue is considered a psychiatric condition and, in my personal opinion, is an unpleasant and non-adaptative state. Some psychonauts like to explore these mind-states but I would not personally recommend that.
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b3tterliving

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #6 on: April 14, 2013, 01:04 pm »
Thank you! If i could it would definitely be +1!

flyinghigh1660

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #7 on: April 14, 2013, 02:17 pm »
Hi Doc,

Great that you are giving out advice.

What are your thoughts on the neuro toxicity of 2C-B and other 2C drugs?

Cheers

FH

Not all drugs are good, some are fucking great.

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b3tterliving

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #8 on: April 14, 2013, 06:40 pm »
Hey doc after tapering my lexapro down to zero how long should i wait before taking MDMA to feel its full effects?

zipstyle

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #9 on: April 14, 2013, 07:03 pm »
Hi Doc,

Great that you are giving out advice.

What are your thoughts on the neuro toxicity of 2C-B and other 2C drugs?

Cheers

FH



Bumping this question. ^

Also: What suggestions would you have for stimulant users (never more than 25 mg meth or 30 mg dextroamphetamine used at a time) that want to avoid weight loss or want to re-gain the weight that was lost during routine stimulant use? I am prescribed an extended-release form of dextroamphetamine and sometimes take low doses of methamphetamine on days that I wake up too late to take the meds and need to keep up productivity. The doctor hasn't wanted to prescribe an instant release form in addition to my extended-release. I have lost some notable body mass and I'm already slim/athletic build to begin with. What are your suggestions for re-gaining weight while still on the medication?

Thank you for providing this to the community!
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DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #10 on: April 14, 2013, 07:08 pm »
2C-B and 2C-X
Amphetamines and ring substituted methylenedioxyamphetamines are known to be neurotoxic in animals in high doses. This is a problem with MDMA, MDA or meth and has been studied and described for decades. 2C-B is structurally related to mescaline, not to MDMA or amphetamines. And mescaline is a molecule known since a century and there are no studies showing neurotoxicity in animals or humans. So it is not likely that 2C-B has significant neurotoxic potential.
Our working team published last year the first study on subjective effects of 2C-B users. The sample was small but we did not find any adverse effects or toxicity ( motor problems, memory complains) suggestive of neurotoxicity.
http://www.slideshare.net/fernandocaudevilla/2cb
On the other hand, and in terms of general toxicity, 2C-B is known since the 70s and has been widely used. Adverse effects seem well known and not important. It is a well known molecule. But there are some other derivatives with atoms that are not typical in human pharmacology (2C-F, 2C-C...). Maybe any of these lesser-known drugs are potentially more dangerous
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DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #11 on: April 14, 2013, 07:27 pm »
MDMA and Lexapro

In theory, two or three weeks after finishing escitalopram, your neurorreceptors would be in a state similar to how you felt before Lexapro. But life is much more complex than neurochemistry. It depends also on your expectations, feelings, mood, personal experiences...I suppose that you have been taking Lexapro for a  mental health or psychological condition. The best way to have a positive experience with any drug is to be in good state of mind before taking it. Until you are feeling 100% and able to abandon your medication it will be difficult for you to feel the full effects of MDMA.
« Last Edit: July 02, 2013, 09:15 pm by DoctorX »
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DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #12 on: April 14, 2013, 07:36 pm »
Stimulants and weight loss
Like therapeutic effects, some adverse effects of  drugs are inherent to them and difficult to avoid. Loss of appetite is a well-known effect of amphetamines, in fact some people take them to lose weight , the opposite as you wish. The only way I think you could win or re-win some weight is increasing protein and carbohydrates intake. I think many formula used in bodybuilding (50% protein + 50% carbohydrate, for example) could make you gain some weight if you get used to use it daily.
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valakki

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #13 on: April 14, 2013, 08:17 pm »
I love this thread! Thank you!

So my question is..... Whats your favorite drug and why? Which one do you consider the most harmless and why?
Which one do you consider the most dangerous?
Which one causes the most problems?
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DoctorX

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Re: Ask a Drug Expert Physician about Drugs & Health
« Reply #14 on: April 14, 2013, 09:04 pm »
Dangers of drugs.

All drugs are absolutely harmless. If you leave cocaine, MDMA, meth or 4-AcO-DMT on a table, they won´t try to assault you, rape you or hit your balls.
To consider potential of harm of psychoactives you should keep in mind factors as individual, doses, patterns of use, frequency, motivation and context of use. This seems obvious but it is very important, it is no sense talking about harms of drugs in abstract.
From an objective point of view and in a Public Health perspective, legal drugs (alcohol and tobacco) causes much more problems (health, familiar, social...) than all the other illegal together.
Scientific studies trying to answer this question point that alcohol, heroin and crack cocaine are the most harmful substances
http://www.fcaglp.unlp.edu.ar/~mmiller/espanol/Variedades,%20politica/drogas_Journal.pdf
 
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