Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Drug users use a lot of drugs

astralcodexten.substack.com

Post reply on HN
Print view View original

191–198 of 198 posts

Re: Drug users use a lot of drugs

#191

Post by tannedNerd »

eurasiantiger wrote: post #163
tannedNerd wrote: post #141

Earlier quoted context omitted.

I’m not going to say you been in SF but you clearly haven’t walked through the tenderloin and probably not spent a lot of time around people that partake in harder drugs on regular basis. Yes it doesn’t match the clinical description, but that’s because the clinical description wasn’t written by someone who works in the heavily drug ridden areas. More likely by someone who probably only dealt with hard drug users onc…

Would you consider the people living in those areas to be living under constant survival stress? Asking because THAT fucks up people and makes them use drugs to escape their situation.

Possibly, but I've also seen white color workers with steady jobs and nice houses have a psychotic breaks because of heavy meth use. So perhaps it not all survival stress and the drugs have some affect as well.

Re: Drug users use a lot of drugs

#192

Post by eurasiantiger »

newbie789 wrote: post #188
eurasiantiger wrote: post #121

Earlier quoted context omitted.

No such thing as meth-induced psychosis. Yes, people might appear psychotic while under the influence, but that is not psychosis in the clinical sense. The few that do lose their rationality lose it because they don’t sleep for weeks. They likely also live in an unsafe environment which keeps them in a perpetual state of survival stress. Survival stress + not sleeping + stimulants —> psychosis. Very rarely any of the…

I don’t know exactly how to respond to this. You’ve clearly got some strong opinions on this and maybe for good reasons. I suppose I agree that environmental stress, survival stress, and PTSD are all common in the addict community. That’s true. In my experience though, meth-induced psychosis is a thing. For example, if you understand the following sentence you either have seen or done it! I once snapped/ghosted 3 poi…

We have differing definitions of ”meth-induced psychosis”. The clinical definition of psychosis excludes psychiatric symptoms of intoxication, so your experiences are simply psychiatric effects of meth overdose, not psychosis in the clinical sense.

Now, if those symptoms persist after you (would) pass a piss test, then we are talking about meth-induced psychosis.

Re: Drug users use a lot of drugs

#193

Post by eurasiantiger »

m-ee wrote: post #171
eurasiantiger wrote: post #121

Earlier quoted context omitted.

No such thing as meth-induced psychosis. Yes, people might appear psychotic while under the influence, but that is not psychosis in the clinical sense. The few that do lose their rationality lose it because they don’t sleep for weeks. They likely also live in an unsafe environment which keeps them in a perpetual state of survival stress. Survival stress + not sleeping + stimulants —> psychosis. Very rarely any of the…

I'm not a medical professional, maybe my terms are off but that's what I've seen it called in the media. In any case people are admitted with what appears to be schizophrenia only to end up perfectly lucid a bit later once the drugs have worn off.

The clinical diagnosis of psychosis can only be established if the symptoms REMAIN after the drugs have worn off.

Re: Drug users use a lot of drugs

#194

Post by [deleted] »

eurasiantiger wrote: post #121
m-ee wrote: post #117

Earlier quoted context omitted.

Unless this is a regional thing I wonder where the doctor even got that idea, I wasn't even aware people snort meth until now. Meanwhile I walked past two people lighting up after leaving a job interview in soma last week. Any doctor who's worked in the ER or psych ward in SF would be familiar with how its used, meth induced psychosis is very common around here.

No such thing as meth-induced psychosis. Yes, people might appear psychotic while under the influence, but that is not psychosis in the clinical sense. The few that do lose their rationality lose it because they don’t sleep for weeks. They likely also live in an unsafe environment which keeps them in a perpetual state of survival stress. Survival stress + not sleeping + stimulants —> psychosis. Very rarely any of the…

[deleted]

Re: Drug users use a lot of drugs

#195

Post by newbie789 »

painfulpox wrote: post #189
newbie789 wrote: post #32

Former meth addict here. > The average crystal meth addict uses about 500 mg a day. And they snort it, which probably produces about double the peak plasma level as taking it orally. So they're getting the equivalent of 1000 mg oral amphetamine daily... 500mg sounds about right, but from my experience the most common route of administration (in the western United States at least) is smoking, not snorting. Because so…

Methamphetamine HCl can be vaporized by itself. What is true for cocaine is not true for other drugs. Freebase methamphetamine is an oily liquid at normal temperatures. Almost all methamphetamine is the hydrochoride salt. It is what gives it the crystalline structure.

Holy shit, I think you’re right.

In my defense I haven’t really been involved with any of this in a decade and it’s entirely possible I mixed up cocaine and meth and their respective likelihoods of pyrolyzation in this case.

For some reason I remember a DEA Microgram bulletin showing crystalline dextromethamphetamine base in brick form, but it’s not available anymore and I can’t find it at the moment. I have had very few conversations with meth chemists over the years but I do distinctly remember the mention of the oily liquid in the latter stages when talking to them.

That being said, snorting meth (even HCl) is incredibly excruciating compared to other drugs and as a result most users that I’ve been around prefer to use it in a different manner.

Thank you!

Re: Drug users use a lot of drugs

#196

Post by stuntkite »

cosmicglee wrote: post #183
lazerpants wrote: post #182

Earlier quoted context omitted.

By and large I think wealthier people have more incentives to limit their drug use. They have hobbies, jobs, etc, that they probably enjoy and don't want to ruin via drug use. On the other hand when everything in your life sucks because you're completely broke there's very little reason to not use more drugs, if they are the only thing you get to enjoy. So the mental image of meth as a poor person drug exists possibl…

I take the opposite view. I think it's more that when wealthy people use/abuse drugs, they have a way bigger financial, social, and medical safety net, so that their drug use ends up having a far smaller (and less publicly noticeable) impact on their lives and future opportunities. Yes, people with less access to financial security have more statistical drug use, but the statistics might also be skewed by 1. the fact…

This is a good breakdown and I agree 100%. No one ever reports using meth or heroin for 5 years with no legal consequence and then just moving on. There are a couple studies that show that there is a type of drug user that may be massively uncounted for. They take a turn into substance abuse/dependance after a trauma. Loss of a loved one, a breakup, loss of a job, serious injury, etc. The main study I read on the issue said the average arc of the people they could find to self report was about 5 years.

Almost all of our drug statistics are based on interactions with police which produce legal consequences for a medical issue. All that said, I'm not saying "drugs are more safe than previously thought!" just that most of our public knowledge and legislation is about incarceration and leaves out an invisible population. The study was a few years old, I believe it was done just as the opiate epidemic came into view and well before anyone knew what carfentanyl was. Opiates affected rich white people's children has widened out the understanding a bit and migrogram opiates put a lot more people in front of police and medical. Also microgram opiates pop up in a lot of drugs that aren't supposed to contain them so I think that changes some things too.

A quick google has not produced this study or related, but if I find it, I'll tag it back in an edit.

Re: Drug users use a lot of drugs

#197

Post by stuntkite »

austhrow743 wrote: post #98
golergka wrote: post #37

There's recreational drug users, and then there's recreational drug users. Turns out some people I know who microdosed amphetamine took doses exactly in the ballpark of what doctor would prescribe them.

If they're microdosing amphetamine at medicinal dosage levels are their intentions even recreation?

That's an interesting question. Sometimes I experiment with my meds into micro dosage levels if I have a long weekend. Sometimes I'll even keep a journal and sometimes I'll mix with other agents like microdosed psilocybe or LSD and run tests on neuroplacticity.

Some times on the weekends I'll take 2mg or less of my ADHD meds just to clear the noise out of my head so I can get a nap. It works a treat, I wake up feeling refreshed and I can tackle some chores or do nothing at all with only muted versions of my normal symptoms.

I wouldn't say this is not recreational. It's my body and am curious about how it works and also I think it's always good to experiment with making very low doses or even medication fasts (in relation to stims specifically THIS IS NOT MEDICAL ADVICE) part of any regimen. Testing out strategies on my free time and not at work is just responsible. My ADHD medication makes me employable and has helped tremendously with my ability to maintain valuable relationships, it's crucial for me to make my way in a world designed around shit that is nearly torture for me, but I really hope to not be on the stims one day and I think it's going to take some work to figure that out. I'm a long time psychonaut so what is recreation to you might not be the same thing it is to me but I consider the observations and experiments to be recreational.

Re: Drug users use a lot of drugs

#198

Post by ultimape »

eurasiantiger wrote: post #165
ultimape wrote: post #154

Earlier quoted context omitted.

Because it seems to cause cortical thinning https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135731/ which is correlated with psychosis https://www.medscape.com/viewarticle/952628 and so has been associated as partly causal?

These studies are meaningless, as they cannot distinguish between the effects of the drug and the effects of the illegality of the drug: constant survival stress, negative outlook on self imposed by others, social exclusion, paranoia. Survival stress, as in PTSD, causes cortical thinning, and explains everything in the scenario without the need to arbitrarily assign blame to methamphetamine.

Survival stress also impacts liver function leading to poor lipid metabolism which in turn can impact cholesterol absorption and lead to cortical thinning. Which is also an effect that we see from methamphetamine use in various animal models, which by it's nature of being controlled trail seems to exclude the stress factor. https://pubmed.ncbi.nlm.nih.gov/28689763/

I would agree with you in general, but there are situations where prescribed methamphetamines also lead to cortical thinning when not used as recreationally. This seems to suggest that stress may not be the entire player here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870784/

It was likely decided because of the dose of meth found in the persons systems that correlates with various findings on dose-dependence https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

If you would like to read more about PTSD findings as it relates to stress and liver function, I would be happy to expound upon the way that corticosteroids impact gut bacteria that directly affect FXR metabolism and bile acids and further lead to cortical thinning. https://academic.oup.com/cercor/article/30/2/575/5521088

Its really fascinating how a drug like methamphetamine impact neuroactive steroids that impact the same pathways tha stress does. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862925/ We've been able to reverse it in rats https://www.sciencedaily.com/releases/2013/10/131007093739.h...

Post reply on HN