Why Ecstasy is more harmful than alcohol (whatever Professor Nutt says)

By  Professor Andy Parrott one of the world’s leading experts on MDMA, Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University.

Comparing alcohol with MDMA.

Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence (Professor Nutt, 21st May). Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising. Yours etc . . .

In the next few paragraphs, I have provided more information on this topic.

What is the basis for Professor Nutt claiming that MDMA is a safer drug than alcohol? This statement was based primarily on a survey he published in the Lancet (Nutt et al, 2007, vol 369; 1047). However this article contains some astounding errors. Indeed when I was first shown it, I contacted the Lancet stating that they needed to publish a detailed reply from me, since it was important to point out these errors. After some email exchanges with one of the Lancet editors, the journal decided not to publish my letter. However I presented some of my criticisms as a conference paper (Parrott, 2009. ‘How harmful is Ecstasy/MDMA: an empirical comparison using the Lancet scale for drug-related harm’. Journal of Psychopharmacology, vol 23, page 41).

I have listed below my main criticisms:

1. Nutt stated that ‘for drugs which have only recently become popular such as Ecstasy or MDMA, the longer term health consequences can only be estimated from animal toxicology at present’. This statement was grossly incorrect. Numerous articles (indeed several hundred) had been published before 2006 by various research groups worldwide, including many papers from my own group. These papers revealed a wide range of adverse health and related problems.

2. One of the Nutt harm scales was ‘intensity of pleasure’, since it is well documented that the most powerful mood enhancers also cause the most problems. Nutt’s article gave heroin and cocaine the maximum scores of 3.0, while nicotine was rated at 2.3, whereas MDMA was given the surprisingly low rating of 1.6. This made MDMA one of the least pleasurable of all their drugs (16th lowest out of their 20 drugs). This low pleasure score for MDMA is simply incomprehensible. How can anyone with even a rudimentary knowledge of human psychopharmacology state that Ecstasy/MDMA is less pleasurable than a cigarette? Yet this low rating was apparently given by Nutt’s group of experts! Recreational Ecstasy/MDMA users would certainly be very surprised at this low rating. It should be noted that this very low ‘pleasure’ score contributed directly to MDMA’s low ‘harm’ score.

3. Drug ‘injection potential’ was another scale, with heroin and cocaine again being given maximum scores of 3.0. In contrast MDMA was given a score of 0.0. This zero score was again bizarre, since MDMA is injected by some heavy users, and they suffer from the problems typically associated with drug injecting. This practice has been noted in various academic papers. Hence the injection score for MDMA should have been similar to that given for cocaine — namely 3.0. The zero score in Nutt et al may be difficult to comprehend, but again it was crucial for generating MDMA’s low overall harm score.

4. In my commentary paper (Parrott, 2009, see above), I provided harm estimates based on the empirical literature, and MDMA rose from 18th to 5th in the list of most damaging drugs. Hence the position of 18th given by Nutt et al in their Lancet paper is extremely misleading — and has no basis in science.

5. So what exactly are the problems caused by MDMA?

6. In 2011 I was asked by the USA Deputy Attorney General to be an expert witness in a court case, which debated the issue of the most appropriate sentences for Ecstasy/MDMA drug traffickers. I was asked to write a comprehensive report, based on all the available scientific research. This was later expanded into a comprehensive review (Parrott, 2013, Neuroscience and Biobehavioral Reviews 37: 1466-1484). The following brief summaries are based on that review, and many of my more recent papers.

7. MDMA is damaging when taken acutely, since it heats up the brain, impairs thermal control, increases neurotransmitter release, and generates extreme mood changes. It also leads to cognitive confusion, and a marked increase in neurohormonal activity. Death rates from acute abreactions are comparatively rare (around 60 per year in the UK), but have been increasing due probably to the increasing levels of MDMA in Ecstasy tablets (see reports by Professor Fabrizio Schifano for the UK, with similar increases reported within mainland Europe).

8. MDMA is also damaging when taken repeatedly. It leads to alterations and/or deficits in brain activity which may be permanent, with reductions in memory ability, reductions in problem-solving skills, deficits in complex visual abilities, impairments in some psychomotor skills, various health impairments, increased levels of depression, increased levels of aggression, and other deficits. Young women should certainly avoid MDMA if there is any possibility of pregnancy — since it can lead to impairments in subsequent child development (Professor Lynn Singer, et al, Neurotoxicology and Teratology, vol 54, pages 22-28).

9. I could go on describing more of the problems caused by MDMA — but will limit myself to one final point. MDMA has been medically tested for cancer therapy, since it can damage/kill human cells. The medical term for this is apoptosis, and it was first demonstrated in laboratory animals, but has subsequently been confirmed in human cells (the relevant medical papers were cited in Parrott, 2013, Human Psychopharmacology, vol 28, pages 289-307).

10. In summary, alcohol is certainly a damaging drug, and when misused it causes massive problems to individual drinkers, their families, and wider society. However the majority of alcohol drinkers are able to use it safely over their lifetimes. In contrast, MDMA is a far more powerful and damaging drug. Current evidence suggest that its regular usage is not only damaging to many young users, but that this damage may endure for several years following drug cessation (Taurah et al, 2013, Psychopharmacology vol 231, pages 737-751).

MDMA Madness

Can cannabis cure cancer?

Of course, it does! Haven’t you heard the rantings of the cannabis quacks! It is not only the cure for cancer, but THE panacea of all ills!

Well, there is no doubt that there is some therapeutic capacity in this complex 400 plus compound and 100 plus cannabinoid containing plant, but decades of trial and research have yielded only a very few symptoms managing potentials — and they too not without potential negative effects!  But hey, let’s not let facts get in the way of a good ‘hope’ generating story… Now that’s not all bad. Hope, not cannabis use maybe the reason why a few people have experienced some relief from use of this plant. It’s interesting to note that perceived benefits on some conditions in some settings, were statistically not better than placebo’s in double blind trials — so hope or ‘faith’ can influence the body as much as a plant compound! Hmmm, but that’s an existential question for another day, not a medical one now.

Just a couple of recent articles…

Eight people’s cancers showed some kind of response to the treatment, and one didn’t respond at all. All the patients died within a year, as might be expected for people with cancer this advanced.

The results from this study show that THC given in this way is safe and doesn’t seem to cause significant side effects. But because this was an early stage trial, without a control group, it’s impossible to say whether THC helped to extend their lives. And while it’s certainly not a cure,  the trial results suggest that cannabinoids are worth pursuing in clinical trials.

There is also a published case report of a 14-year old girl from Canada who was treated with cannabis extracts (also referred to as “hemp oil”), but there is limited information that can be obtained from a single case treated with a varied mixture of cannabinoids. More published examples with detailed data are needed in order to draw a fuller picture of what’s going on. [Updated 26/03/14, KA]

Unverified anecdotes about ‘cures’ do little to help progress towards more effective treatments for patients on a wider scale — even if they do get published in newspapers, they aren’t strong scientific evidence. In order to build a solid evidence base that might support future applications for funding or clinical trials it’s important to gather together detailed information about individual cases. Cannabis Cancer Cure?

Cannabis and Cannabinoids (PDQ®)—Health Professional Version (NIH — Cancer Institute)

Overview: This cancer information summary provides an overview of the use of Cannabis and its components as a treatment for people with cancer-related symptoms caused by the disease itself or its treatment.

This summary contains the following key information:

• Cannabis has been used for medicinal purposes for thousands of years.
• By federal law, the possession of Cannabis is illegal in the United States, except within approved research settings; however, a growing number of states, territories, and the District of Columbia have enacted laws to legalize its medical use.
• The U.S. Food and Drug Administration has not approved Cannabisas a treatment for cancer or any other medical condition.
• Chemical components of Cannabis, called cannabinoids, activate specific receptors throughout the body to produce pharmacologic effects, particularly in the central nervous system and the immune system.
• Commercially available cannabinoids, such as dronabinol and nabilone, are approved drugs for the treatment of cancer-related side effects.
• Cannabinoids may have benefits in the treatment of cancer-related side effects.

Many of the medical and scientific terms used in this summary are hypertext linked (at first use in each section) to the NCI Dictionary of Cancer Terms, which is oriented toward nonexperts. When a linked term is clicked, a definition will appear in a separate window.

Reference citations in some PDQ cancer information summaries may include links to external websites that are operated by individuals or organizations for the purpose of marketing or advocating the use of specific treatments or products. These reference citations are included for informational purposes only. Their inclusion should not be viewed as an endorsement of the content of the websites, or of any treatment or product, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board or the National Cancer Institute. Cannabis Cancer Cure?

Let’s start by asking what the medical efficacy might be. Contrary to what most people believe, medical uses of cannabis have been widely studied. A 2017 review by the National Academy of Science looked at over 10,000 studies. They found evidence for some applications of cannabis, including managing chronic pain and spasms associated with multiple sclerosis. There was also good evidence that tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis, can reduce the nausea caused by chemotherapy. Indeed, a synthetic form of THC, called dronabinol, has been prescribed for just this use for decades.

But, crucially, there is zero evidence that cannabis has any curative or even helpful impact on cancer, despite enthusiastic claims to the contrary. Cannabis Cancer Cure?

Medicinal cannabis should not be used ahead of approved drugs — German review:

The increasing number of German doctors prescribing cannabis is being fuelled in part by “hype,” concludes a review that contends that in most cases “tried and tested” drugs are better options.

The review says that research into the use of cannabis for medical treatment has been limited, in comparison with the intensive research process before traditional drugs receive regulatory approval. What limited research there is does not support the claims made by proponents medicinal cannabis, it says.

“Cannabis is not a miracle drug,” said the study coauthor Gerd Glaeske, an expert in healthcare economics and policy at the University of Bremen.

The 90 page cannabis report was commissioned by Techniker Krankenkasse (TK),1 one of Germany’s largest public sector health insurers Cannabis Cure Cancer?

Commons doctors rally to false cause over cannabis

By  Kathy Gyngell May 26, 2018

It is a pity the doctors of the House of Commons don’t find time for research. Before rallying to the cause of Alfie Dingley and campaigning ‘to change the law banning the medicinal use of cannabis’ they should have checked the facts. So should the Guardian.

So too should Cathy Newman of Channel 4 News, who also assumes that cannabis-based meds are illegal in the UK.

It simply is not true. The medicinal use of cannabis is not illegal in the UK. Licensed medicines, extracted and purified substances from the cannabis plant have been available for many years.

One of its active ingredients, tetrahydrocannabinol or THC, under the name of Nabilone and now made synthetically, has been around for about 30 years and is used for the relief of nausea resulting from chemotherapy. There are caveats. It is not uniformly well-tolerated and can exacerbate rather than reduce vomiting. Since safer and more efficient medications exist, THC-derived clinical compounds tend to be used only when other interventions have failed.

Sativex, a combination of THC and another ingredient, cannabidiol or CBD, is licensed for the relief of muscle stiffness (spasticity) in patients with multiple sclerosis. Warnings on its use are similarly extensive. Finally CBD is being clinically tested for some types of epilepsy. In the US Epidiolex, a pharmaceutical-grade form of CBD developed by GW Pharmaceuticals, has been approved by the Federal Drug Administration. In the UK the work to clear it is not complete.

For anyone who hasn’t been in Holland and Barrett recently, cannabis oil which contains CBD is available to buy in the UK, subject to the Medicines & Healthcare products
Regulatory Agency (MHRA) statement on products containing CBD. It is not illegal if it contains less than 0.05 per cent THC.

The trouble is that the term ‘cannabis oil’ is dangerously imprecise. The make-up of the cannabis oil Alfie Dingley’s mother says her child needs and which is available to her in the Netherlands has never been specified despite the extensive news coverage of the case. Such misleading and inaccurate reportage raises the question as to its purpose — to lobby for the legalisation of the Class B drug, perhaps?

The bottom line is that even in the upside-down and parallel truths world we live in, there is still such a thing as objective fact. We are, too, still a first world nation with a first world pharmaceutical approval system. It is not foolproof, as the terrible thalidomide tragedy showed us, but such a tragedy is exactly what it is designed to protect us from — and it does.

For complete article https://www.conservativewoman.co.uk/commons-doctors-rally-to-false-cause-over-cannabis/?utm_source=TCW+Daily+Email&utm_campaign=fc81c3811a-RSS_DAILY_EMAIL&utm_medium=email&utm_term=0_a63cca1cc5-fc81c3811a-556077329

Marijuana Accountability Coalition Takes Action to Defend Babies from the Marijuana Industry

EMCDDA releases its first analysis on monitoring drug-related homicide in Europe

• Drug-related homicide in Europe: a first review of the data and literature

• New EMCDDA report sheds light on drug-related hospital emergencies

An EMCDDA Paper released today provides an overview of the information available on drug-related homicide (DRH) in Europe. This first snapshot provides practitioners and policymakers with the current state of the art on this topic. It is part of the EMCDDA’s efforts to expand its monitoring in the drug-related crime area in order to fully comprehend the broader ramifications of the drugs phenomenon.

Since 2013, the EMCDDA has been working on improving its framework for monitoring the supply side of the drugs problem to reflect the changing nature of drug markets and their wider harms and impact (¹). The effects of drugs and drug markets reach beyond those who are directly exposed to drugs in terms of health or social problems. The issue is of serious concern in relation to the overall security situation in Europe and deeply affects communities at large, as drug use and drug markets can act as cross-cutting facilitators of acts of violence.

Literature on the relationship between psychoactive substance use and violence is increasing, although most of this is devoted to the use of alcohol. However, a smaller, but growing, number of studies focus on the drug—violence relationship.

To help bridge the gap, today’s report:

• maps existing data sources on homicide in European countries;
• estimates the extent of drug involvement in national homicides by country;
• assesses and discusses the obstacles where a drug-homicide relationship cannot be readily established; and
• considers the practical implications for monitoring drug-related homicide at the EU level.

There are clearly inconsistencies in the data available on drug-related homicide in Europe. While 10 countries systematically prepare data on this topic, there is variation, between and within countries, on the role drugs play in homicide events. Homicides are internationally well-recorded, but as the report states: ‘Research and monitoring activity internationally has rarely looked beyond the link between homicide and the involvement of organised crime in the supply and distribution of illicit drugs’.

According to the report, Europe currently faces four key obstacles to monitoring drug-related homicide:

• missing data;
• fragmented data;
• comparability issues; and
• data quality reservations.

To overcome these obstacles there is a need to define and operationalise concepts based on common definitions and integrate them into the EMCDDA monitoring system.

Drug-related homicide is one of the most serious manifestations of drug markets and has a high social cost. It can also be an indicator of wider drug-related violent crime. Comparing these statistics between countries can help identify trends and new threats in order to plan and implement proportionate responses.

For complete article http://www.emcdda.europa.eu/news/2018/emcdda-releases-analysis-monitoring-drug-related-homicide-europe_en