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Heroin dependence

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Heroin dependence

My sister suffers a heroin dependence .. how do i make her stop using these fucking opiates??

Originally posted in SR 2.0 22/10/2013. Reviewed 26/03/23

Some people quit opiates by themselves. Other need medical and/or psychological help. There are some drugs that make the process of detoxification easier or long-term treatments to avoid relapse.

But quitting opiates or any other drug is always a personal decision. And there is no way that you can make her quitting opiates. It does not mean that you can’t help her. She will not change until she feels opiate use is a problem for her.

It is common that opiate addicts do not realize this. So, in a first step you can try to help her to realize of the real and particular problems that opiates have in her concrete case. Then, once she is conscious of this, changes will be much easier.

Continue to offer your sister emotional support, even if she is resistant to seeking professional help. Let her know that you are there for her and that you believe in her ability to overcome her addiction.

Talk to selected family members, friends, or a therapist about your sister’s addiction. It can be helpful to have a support system in place for yourself and to get advice on how to best approach the situation.

If your sister is not ready to quit using drugs, consider harm reduction strategies to help reduce the risks associated with drug use. For example, providing clean needles and syringes can help to prevent the spread of diseases like HIV and hepatitis.

Remember that addiction is a complex issue, and there is no one-size-fits-all solution. So, it’s important to continue to offer support and to keep the lines of communication open with your sister. Also, taking care of yourself and seeking help when needed.

 

 

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MDMA post-loading with 5-HTP

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MDMA post-loading with 5-HTP

I have read about using foods rich in triptophan (MDMA post-loading with 5-HTP). According to my sources, this diminish negative MDMA effects and reduce neurotoxicity. Do you have any food supplement recommendation to reduce the bad effect of MDMA?

Originally posted in SR 2.0 6/5/14 . Reviewed 20/2/22

Pre-loading/post-loading via herbal and/or pharmacological products in relation to the effects of MDMA is a relatively common practice (up to 40-70% of users, according to some studies) .

5-HTP (hydroxytryptophan) or tryptophan are the most commonly used substances. 5-HTP is the precursor of serotonin, the neurotransmitter allegedly responsible of MDMA  psychological effects . MDMA produces a rapid release of a large amount of serotonin in neurons.

However, this release is also believed to be the cause of the acute adverse effects that occur 24-48 hours after consumption This includes depressed mood and fatigue, as well as the potential neurotoxic effects.

To combat these adverse effects, some users turn to herbal supplements or tryptophan-rich foods: chocolate, peanuts, or bananas. Typical «post-load formulas» contain Vitamin C, magnesium, alpha-lipoic acid or green tea extract.These guidelines are based on recommendations in Internet forums or some books on MDMA.

  • Pre-loading (taking supplements before consuming MDMA) seeks to enhance the effects of the substance by theoretically increasing the amount of serotonin available.
  • Post-loading (taking supplements after consuming MDMA) aims to help the body recover from the potential adverse effects of MDMA. Neurotoxicity, oxidative stress, and depletion of certain neurotransmitters , linked to depression and other negative effects.

Interestingly, the «midweek blues» have only been reported in recreational users, while therapeutic use has been associated with  an «afterglow» in which residual empathogenic effects remain 24-48 hours longer. So this implies that the «crash» of MDMA has more to do with contextual aspects (lack of sleep, physical exercise, mixing with other substances…) than with its pharmacology.

Thus, users who use moderate doses and frequencies, occasionally, programmed and without too many excesses should not suffer very accentuated acute psychological adverse effects. There is also no evidence that, in the usual patterns of consumption in humans, MDMA produces irreversible neurotoxic damage. On the contrary, heavy users are more prone to such effects.

So,  data to support the use of post-load supplements are based on the subjective experience of users. There are no clinical trials that have evaluated this type of strategy. And there is also no consensus on appropriate dosages. Some authors recommend «50 mg of 5-HTP for 3 days 24 hours after the last intake». Others use doses of 100-300 mg for 5-7 days.

Post-MDMA intake of bananas, peanuts, or chocolate is unlikely to have any consequence (unless overindulged)

With the available data it is not possible to recommend a guideline or to consider its efficacy. Then.  a diet rich in bananas, peanuts and chocolate is unlikely to have any negative impact after taking MDMA. But it has not been shown to have any effect on either moderate users (in whom it is probably unnecessary) or intensive users (in whom it is probably ineffective for its intended purposes).

 

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How to Detect LSD in Blotters

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I would like to know how to detect LSD in blotters. Is this possible? I am concerned about adulterations with NBOMEs. My country does not allow Drug Checking Services. Thank yoh

Originally posted in Evolution 17/6/15 . Reviewed 27/3/23

Over the past few years, there have been reports of the adulteration of blotting papers allegedly containing LSD. While LSD is a relatively safe psychedelic, other substances such as 25-i-NBOMe and BromoDragonfly are much more dangerous on an organic level.

It’s worth noting that LSD is a highly sensitive chemical compound that can easily decompose under adverse conditions. Exposure to light, heat, humidity, and air can accelerate the degradation process. This results in most LSD blotters degrading within 5-10 years.

To ensure the safety of the substance, it’s ideal to have samples analyzed in a Drug Checking Service. However, this option may not always be available. Nevertheless, there is a simple way to detect the presence of LSD in a blotter or liquid.

LSD has a unique characteristic of fluorescing under UV light. A black light,(known as UV-A light, Wood’s lamp, or ultraviolet light), emits long-wave ultraviolet light (UV-A). It’s the type of bulb used to produce fluorescent effects on clothing or paint . You can find it in any lighting shop for a few dollars or euros.

To conduct the test, prepare a small sample of the substance you want to test, such as a small piece of blotting paper or a small amount of liquid. The undecorated back of the LSD blotters is the most suitable.

Turn off the lights in the room and turn on the UV lamp. Ensure that the UV lamp emits light at a wavelength of about 365 nm.

Bring the sample close to the UV lamp and observe if it emits a bright bluish-white fluorescence. LSD typically emits a bright blue-white fluorescence under UV light.

It’s important to note that this method can only confirm or rule out the presence of LSD and cannot detect adulterants or degraded samples. In cases where Drug Checking Services are unavailable, this test can provide an initial indication of the substance’s identity.

 

uv lamp for lsd test
lsd blotters back
lsd blotters uv lamp
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Benzodiacepine tapering plan

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Benzodiacepine Tapering Plan

I have been taking benzodiazepines on a daily basis for many years. I want to get off alprazolam tapering down. I take 5-6 2 mg pills every day for years and don’t know how to do it. I am afraid of withdrawal.

Originally posted in Evolution Marketplace 4/5/14 . Reviewed 24/3/23

To safely stop using BDZs, it’s important to keep track of how much you’re taking each day. This includes the number of hours you’re taking them and the amount of doses you’re taking in a typical day. Then, you can calculate the daily equivalent dose of diazepam (a long-acting BDZ). Diazepam can be administered two or three times a day. This is a good option for a gradual tapering plan.

These are the equivalences for common prescription BDZ:

  • Diazepam 10 mg
    Clonazepam 0.5 mg
    Alprazolam 1 mg
    Lorazepam 1 mg
    Lormetazepam 1-2 mg
    Midazolam 5 mg
    Bromazepam 6 mg
    Clorazepate 15

So, for example, someone using 6 mg of alprazolam daily would need 60 mg of diazepam, that can be divided in three 20-20-20 dosages

Tapering means taking progressively lower doses of the medication over time. And once you reach low doses (around 5-10 mg of diazepam), you can safely stop taking the medication altogether. This process is more comfortable with a reduction of 5 mg/week

Additionally, diazepam comes in many different dosages and formats: There are tablets of 2 mg, 2.5 mg, 5 mg, 10 mg, 25 mg and syrup with 2.5 mg/ml). So this makes it easier to adjust the dose precisely for each patient.

Most clinical guidelines recommend using diazepam for tapering, but direct reduction of the BDZ being used by the patient is also possible. Probably, in practise it is more difficult to taper down alprazolam or short action BDZ as triazolam.

So, with these guidelines it is possible to diminish abstinence symptoms (anxiety, insomnia, nightmares, tremor, physical symptoms…). But, many times, instead of «abstinence» there is a «rebound». Rebound phenomenon  refers to the return of symptoms that were originally being treated by the drug after the drug is discontinued or reduced.

In cases in which sleep disturbance is a significant problem, the drugs with which there is most experience are SSRIs with a sedative profile (paroxetine, mirtazapine) and trazodone. Long-term treatment of anxiety disorders achieve better results using SSRI than BDZ.

There are another options to achieve BDZ detoxification but are less safer. Carbamazepine (200 mg twice a day), may be useful in patients with a history of seizures (drug withdrawal or epilepsy). Short regimen of 7-14 days can be considered reasonably safe for outpatient administration. Medical advice is particularly suggested in this case.

Other alternatives with a lesser degree of evidence are anxiolytic agents that act on GABA receptors such as pregabalin and gabapentin. The progressive decrease in BZD doses together with gabapentin has shown better results in opioid-dependent patients. in opiate-dependent patients seeking detoxification from BZDs.

 

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Nasal problems after high cocaine dosage

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Nasal problems after high dosage cocaine

A while ago I insufflated about 500 mg cocaine in the coarse of an evening, it was the first time I used coke. So nearing the end of the evening I had an constant runny nose which was pretty annoying. I cleaned my nose with saline, but nevertheless by the time I went to bed my nose was totally clogged up.

The next morning when I blew my nose, all of the mucus was red coloured. For about a week afterwards there I had blood in my mucus, it became less and less till finally no blood at all after a week and the mucus was colourless again.

Clearly this is a sign that my nose didn’t like what I put up there, but I’m not sure how harmfull it is. Is such a reaction ‘normal’ for coke use? Could another coke experiment be conducted without a risk on permanent damage, or is coke a nono for my nose?

Originally posted in SR 2.0 15/10/2013. Reviewed 20/2/22

Intranasal damage is a common problem with drugs used by this route of administration.

Dosage, frequency and technique of use are important factors that influence the frequency, severity and likelihood of problems.

Cocaine itself (and associated impurities) can irritate nasal tissues and cause them to bleed. Cocaine has a vasoconstrictor effect (reduces blood flow to the area).In your case the problem seems to have solved itself spontaneously. But an acute sinusitis (nasal congestion, pressure pain in the face, headache, green and smelly mucus) is a possible complication that should be treated with antibiotics.

Half a gram seems like a fairly high dose for an inexperienced person. If that amount of any substance is administered intranasally over a short period of time, it is easy for problems to occur.

Some tips for intranasal administration are:

  • It is advisable to pulverize the substance to a very fine powder before snorting it.
  • Do not always use the same nostril for snorting, but alternate between the two.
  • The sniffing straw should not be pointed at the nasal septum, but at the nasal turbinates (lateral), where vascularization is greater and absorption is better.
  • It is recommended to clean the nostrils well a few hours after the last dose of cocaine. Physiological saline (or slightly salty clean water) can be used. Saline irrigation can be used for several days (best with a syringe).

If you experiment with cocaine again I suggest you follow these tips. Also decrease the total dose.

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