Great-Gran’s elixir

May 13, 2010

I have been waiting and waiting for this post.

This is a page from my great-grandmother’s cookery notebook. She was a cook in England in the late nineteenth century (yes, we have long generation times in my family). Elsewhere in the notebook she seems to be planning a menu for a visit by Lord Roberts of Kandahar, so her employers were clearly very, very posh. And, whenever they got a cold, very, very high.

Go Read.

As a bit of a followup to the poll we ran on whether or not cigarettes make you high, I offer context and my thoughts. As of this writing, btw, the votes are running 44% “Yes”, 47% “No”, the balance “other” with a fair bit of commentary to the effect that “high” is not exactly the right description for nicotine.
For the background, we might as well start with the comment from SurgPA:

This started with an email from PalMD asking why doctors react much more negatively to narcotics abusers than alcohol or nicotine abusers. I hypothesized that most people view acute use of the various drugs differently. Specifically I suspected that most doctors’ gut reactions when seeing someone light a cigarette are qualitatively (and vastly) different from seeing someone shoot heroin (or snort crushed oxycontin). In short that we don’t see the act of smoking as an acute intoxication by a neuroactive substance, even if we understand it intellectually.

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I last broached the topic of immunization against drug use some time ago and I concentrated more on the ethical implications of vaccinating. I was being ever so slightly disingenuous because the current state of progress is not such that we need to consider such questions as:

Would you recommend it broad-spectrum for all children much like MMR?
Would you recommend parents be permitted to subject their drug abusing teen against his or her will?
Allow the courts to mandate inoculation?
Suppose it were made a condition of employment?

ResearchBlogging.org This post was chosen as an Editor's Selection for ResearchBlogging.orgA recent paper by Martell and colleagues provides a nice opportunity to review the promise and limitations of immunopharmacotherapy for drugs of abuse. The rationale for such studies is pretty easy to grasp, although at present the results fall short of the lasting immunity you associate with childhood vaccines and even the seasonal flu shot. Drugs of abuse are molecules that do not generate any immune response because they are too small. The starting rationale is that if you create a drug mimic and attach it to something that will attract the attention of the immune system you might be able to generate antibodies that recognize the target drug.

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The initial news reporting from Baltimore led with “Post-Doctoral Fellow Charged After Girlfriend’s Death”. Oh Christ.

A post-doctoral fellow at the University of Maryland School of Medicine has been charged with illegal drug possession after his live-in girlfriend, also a fellow, died.

Not. Good. Not good in the least.


According to investigators, Dr. Carrie Elisabeth John injected herself Monday with a drug known as “bupe” in the house she and McCracken shared.
Bupe is intended to help addicts break their dependency on heroin.
Court documents said John stopped breathing and was pronounced dead in the university hospital emergency room.

“Bupe” or buprenorphine [Wikipedia] is an mu opioid receptor partial-agonist used as agonist therapy for opiate dependency under trade names such as Subutex® and Suboxone®.

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Another Poppy Tea Death

July 22, 2009

Damn. A Twitt from @abelpharmboy alerted me to this article in the Denver Post.

A 19-year-old man was found dead in Boulder on Tuesday morning, and authorities suspect poppy tea as the cause.
If so, it would be the second death in five months of a young person in Boulder who drank opium tea, police said.
Jeffrey Joseph Bohan, a 2008 graduate of Fairview High School in Boulder, drank the powerful psychoactive brew with his older brother about midnight, authorities said.
His brother found him unresponsive at 6 a.m. in a home

Abel Pharmboy had written some comments about that first death of a young man in Boulder. In the first post, Able overviewed a bit of the history of the medicinal (and recreational) preparation of products from the opium poppy.

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Another Poppy Tea Death

July 22, 2009

Damn. A Twitt from @abelpharmboy alerted me to this article in the Denver Post.

A 19-year-old man was found dead in Boulder on Tuesday morning, and authorities suspect poppy tea as the cause.

If so, it would be the second death in five months of a young person in Boulder who drank opium tea, police said.

Jeffrey Joseph Bohan, a 2008 graduate of Fairview High School in Boulder, drank the powerful psychoactive brew with his older brother about midnight, authorities said.

His brother found him unresponsive at 6 a.m. in a home

Abel Pharmboy had written some comments about that first death of a young man in Boulder. In the first post, Able overviewed a bit of the history of the medicinal  (and recreational) preparation of products from the opium poppy.

The sad fact is that we’ve known for over 200 years that this is a bad idea: based upon growing conditions, harvest time, and extraction method, the resulting concoction can provide an extremely variable dose of these compounds. Used medicinally as one of the strongest analgesics (“painkillers”) we know, in higher doses the opiates can impart a warming sense of euphoria but, at even higher doses, suppresses the respiratory control center of the brain stem, resulting in death.

Abel also mentioned a website created by a father of yet another kid who overdosed on poppy tea. The point of Poppy Seed Tea Can Kill is, quite obviously, to educate people on the risks of home-brewed poppy tea. It includes a redacted version of the drug panels run on his son postmortem which is a great thing. I wish all the parents / closest relative of the folks who die from “Ecstasy” would do similar- this kind of information goes a long way toward addressing controversy over what did and did not kill the individual.

At any rate, it is very sad that this seeming fad in recreational drug use is resulting in fatalities. It seems that it is doing so almost entirely because the dose is so hard to control / appreciate under the typical use circumstances. Perhaps publicizing this hypothesis widely would go a long way toward harm reduction by inducing a bit of caution in the user population. I can hope, anyway.

The National Institute on Drug Abuse has issued a notice requesting help in developing a new research strategy (NOT-DA-09-006). They are after:

Public Comment on Development of a Funding Opportunity Announcement on Translational Research on Minimizing Risks of Managing Pain with Opioids in General and Specialty Medical Settings

Post done, right? No, no, that’s just the title. What they are working up to is issuing a “funding opportunity announcement”. Although a Program Announcement qualifies, we are probably talking about an eventual Request For Applications. RFAs are the things we are looking for because they come with set aside money, a limited application window and an assurance that at least one or three projects will be funded. For anyone who thinks that IC research priorities are detached from real world interests or are developed a little to self-referentially (say by calling up a couple of already-funded investigators and asking them what is important to fund), well, this RFI is a cool thing. They want feedback from you.
So, why is NIDA interested in this topic?

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