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Chronic use of e-cigarettes, commonly known as vaping, can result in progressive small airway obstruction and asthma-like symptoms such as shortness of breath and chest pains, according to researchers at Massachusetts General Hospital (MGH). In the first study to microscopically evaluate the pulmonary tissue of e-cigarette users for chronic disease, the team found in a small sample of patients fibrosis and damage in the small airways, similar to the chemical inhalation damage to the lungs typically seen in soldiers returning from overseas conflicts who had inhaled mustard or similar types of noxious gases.
In addition, three of the four patients had evidence of mild emphysema consistent with their former combustible cigarette smoking history, though researchers concluded this was distinct from the findings of constrictive bronchiolitis seen in the patient cohort.
Because the same type of lung damage was observed in all patients, as well as partial improvement in symptoms after e-cigarette usage was stopped, researchers concluded that vaping was the most likely cause after thorough evaluation and exclusion of other possible causes. "Our investigation shows that chronic pathological abnormalities can occur in vaping exposure," says senior author David Christiani, MD, a physician investigator at Mass General Research Institute. "Physicians need to be informed by scientific evidence when advising patients about the potential harm of long-term vaping, and this work adds to a growing body of toxicological evidence that nicotine vaping exposures can harm the lung."
The study was published in New England Journal of Medicine Evidence.
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A flagrant black market is selling vapes and e-cigarettes containing nicotine to young people in plain sight of authorities and in contravention of the law, exposing a new generation to the highly addictive substance.
Nearly all store-bought vapes contain the chemical nicotine, despite not stating so on the packaging, threatening to undo decades of public health campaigning on the dangers of smoking.
Health experts said the true toll of vaping may not be known for years as convenience stores and tobacconists continue to sell vapes with near impunity.
Tobacconists in inner Sydney sold The Oz vapes without asking for proof-of-age identification or a valid prescription for nicotine e-cigarettes, which is a requirement by law.
None of the vapes said they contained nicotine on the packaging and only one tobacconist said that the vape they sold The Oz contained nicotine, an IGET Shion Pod. They did not ask for a prescription.
Independent testing by the University of Wollongong (UOW) confirmed all but one of the four store-bought vapes – a strawberry lychee flavoured One Vape – contained the highly addictive chemical.
Dr Celine Kelso said the UOW’s School of Chemistry has tested hundreds of vapes. She said all contained nicotine except for the one supplied by The Oz For more go to Almost all vapes contain nicotine: health effects still unclear
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A new paper argues that excitement has veered into misinformation—and scientists should be the ones to set things straight.
CONCLUSIONS: On the basis of the change in depression scores on the QIDS-SR-16 at week 6, this trial did not show a significant difference in antidepressant effects between psilocybin and escitalopram in a selected group of patients. Secondary outcomes generally favored psilocybin over escitalopram, but the analyses of these outcomes lacked correction for multiple comparisons. Trial of Psilocybin versus Escitalopram for Depression | NEJM
IN APRIL 2021, a widely anticipated paper in the field of psychedelics dropped. The study, a small trial run at Imperial College London and published in The New England Journal of Medicine, investigated the use of psilocybin, the active ingredient in magic mushrooms, to treat depression. Led by Robin Carhart-Harris, who now directs the Neuroscape Psychedelics Division at the University of California, San Francisco, the research compared psilocybin with a standard antidepressant. The findings were somewhat lackluster: it found that the psychedelic was only marginally better than traditional treatments at relieving depression.
Back in 2017, Rosalind Watts, an author on that paper and a former clinical lead for the trial at Imperial, had given a TEDx talk on the power of psilocybin to treat depression, prompted by the time she had spent working on the study. In the talk, she shared her belief that psilocybin could “revolutionize mental health care.” But in February of this year, Watts published a Medium piece in which she expressed regret at her initial unbridled enthusiasm. “I can’t help but feel as if I unknowingly contributed to a simplistic and potentially dangerous narrative around psychedelics; a narrative I’m trying to correct,” she wrote.
“I just reflected on how I myself had got caught up in the black and white of like, ‘This is wonderful,’” she says today. “Now having been through that trial … I’m much more neutral and agnostic.”
Scientists’ unwillingness to accept criticism makes Corlett pessimistic about the future of psychedelic research. “Science is meant to be somewhat adversarial. It’s not meant to be presided over by a single group of people,” he says. “I’m still open and excited about the possibilities, but I think this kind of breathless rush to translation and to a conclusion is really dangerous.”
And in an ethically murky turn, for those in the field who have begun to dabble in the corporate side of psychedelics, hyping up findings has become of obvious interest. Declaring conflicts of interest is standard practice in academia, and for good reason: Would you trust a paper that declared that spending more time on Instagram makes you happy if the lead author was receiving money from Meta? But that happens on a regular basis in psychedelic research; many in the field have accepted board positions or consulting fees for the ever-expanding number of psychedelic companies. That means “it’s literally a financial incentive to hype the results,” says Yaden. Watts agrees: “I think for research to be truly solid and not hyping things, it needs to be separated out from the interests of the companies who have stuff to gain.” (For complete article go to WIRED )
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Expectation, Excitation, Subjectivity, Idiosyncrasy, Placebo, and the Psychedelic Micro-dosing Experiment
A systematic study of microdosing psychedelics: Taken together these findings paint an intriguing picture. We found clear changes in a small set of psychological variables: decreased depression and stress; decreased mind wandering; increased absorption; and increased neuroticism. Notably, these variables were not those that participants most expected to change. If the current findings were entirely due to expectation, then we should have seen changes in those variables that are most commonly discussed in media and online accounts of microdosing, and in those variables rated highest in Study Two. In fact several of the most commonly discussed effects of microdosing and the effects most expected to change (creativity, wellbeing, mindfulness) showed no evidence of alteration whatsoever. This suggests that the longer term changes we identified were unlikely to be due to expectation.
On the other hand, although we did identify clear short term changes following each microdose in the daily analyses, the longer term changes identified in Study One were unrelated to the total number of doses participants ingested during the study period and also unrelated to participants’ prior microdosing experiences. This surprising lack of a relationship between the overall quantity of microdoses and the degree of subjective effects is a reason to interpret these findings cautiously. At face value this suggests that any engagement with microdosing, whether a single dose or relatively frequent dosing, can impact the variables we identified. This may be the case, but it is also possible that participants’ self reports of dosage and frequency in this study were not precise enough to accurately characterise dose related effects.
Overall, these findings suggest several disconnects between the popular narrative around microdosing and the experience of microdosers in this sample. Participants in Study One microdosed less often than is recommended in most online protocols and did not report that many of the immediate effects of microdosing lasted beyond the day of dosing. Although popular accounts of microdosing describe sustained boosts in productivity and creativity [16–18], the longer term effects we identified mainly involved reduced mental distress and changes in constructs such as absorption and mind wandering that are not as commonly discussed. This suggests that microdosing may lead to more subtle changes characterised by improvements in mental stability, the capacity to sustain attention and increased ability to become engaged in intense imaginative experiences.
The most surprising finding was that neuroticism also appeared to increase following microdosing. This is not something that is discussed in popular accounts of microdosing and was not what participants expected in Study Two. This highlights an important and under discussed aspect of microdosing: not everyone has a positive experience. Although the majority of participants’ comments were positive (and even glowing), there were a subset of comments that reflected unease about microdosing (see Table 5). In a context of considerable hype around the practice of microdosing, particularly with regards to it’s potential as a business tool, it important to acknowledge that microdosing may not be universally beneficial. These findings highlight the need for further research into the full range of microdosing effects (positive and negative) and also for investigations into subtypes of individuals who may particularly benefit from or be adverse to the practice.
Strengths, limitations and future directions
This was very much a preliminary and exploratory study of microdosing, and there are clear limitations to the study design. This was a self reported observational study and as such, we relied on participants’ accuracy and honesty in their reports of doses and effects, and also on their continued responsiveness throughout the study period. Recruitment for this study occurred through online forums that were mainly very positive about the effects of microdosing. As such, these results may be affected by sampling bias, and may under represent individuals with negative or ambivalent experiences of microdosing. Furthermore, as might be expected in an observational study of individuals who are interested in psychedelics, there was some concurrent use of higher dose psychoactive substances and non psychedelic substances that may have had some influence on these results. A better design would certainly be to conduct an experimental study with controlled doses of known substances and a placebo comparison condition. The legal and bureaucratic limitations around psychedelic research make the approval process for such a study prohibitive. As an alternative, in implementing the current design we aimed to demonstrate that it is possible to investigate the effects of psychedelic substances in a systematic observational paradigm, using an automated and anonymous communication system.
It is clear from this research that there is a high level of popular interest in microdosing, that many people are engaged in this practice, and that there are strong expectations about the various effects that microdosing can have. The current findings suggest that popular accounts of the effects of microdosing may not match the experience of long term microdosers, and that promising avenues for future investigation are the impacts of microdosing on improved mental health, attentional capabilities, and neuroticism.
Further Reading
Psychedelics: The New Panacea – Just Like Cannabis, it will Fix Everything, Won’t it?
- Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents…
- Vaping cannabinoid acetate leads to formation of deadly gas – New Study
- Vaping and GERD – Further Harms Inflicted!
- Challenges in Identifying Novel Psychoactive Substances and a Stronger Path Forward