With a nudge from AI, ketamine emerges as a potential rare disease treatment • Hacker News Board

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#31

Post by ihunter2839 » Sat, Aug 07, 2021, 6:41 PM UTC

dghughes wrote: post #27

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

>I’m glad we are moving away from the incredibly destructive drug policies that have been in place for so long The point of the polices was to counter the incredibly destructive result of the surge of cocaine, crack, heroin use in the mid 1970s and early to mid 1980s. And the deaths from the drug use and the gangs fighting over the spoils. It really was a war. Mexico didn't seem to make it, I think the drugs won. I k…

"The point of the polices was to counter the incredibly destructive result of the surge of cocaine, crack, heroin use in the mid 1970s and early to mid 1980s."

This would be plausible if the policies were focused on those drugs exclusively. However, I see the draconian policies targeted towards cannabis, hallucinogens, and amphetamines as pretty ample evidence that the "war on drugs" had much wider ambitions than curbing the usage of these hard narcotics.

Edit) To your point of folks speaking harshly of our current drug policies - look at where we are now, 50 years later. A nationwide opioid crisis created by pharma companies. A generation, if not two, of young men and fathers locked up in prison with little to no room for upwards mobility. Communities, already economically deprived, losing stability, obliteration of the nuclear family core, and enduring oppressive policing policies. So yes, I think its entirely fair for a new generation to shit on the war on drugs. Even if the policy was formed with good intentions (which is, frankly, debatable), it is still bad policy.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#32

Post by fsckboy » Sat, Aug 07, 2021, 6:42 PM UTC

tomato-sauce wrote: post #24

irthomasthomas wrote: post #21

Earlier quoted context omitted.

Sorry to burst your bubble but U.S. drug policy is not as progressive as you might think. Cannabis is still illegal under federal law. And right now America is petitioning the WHO for a GLOBAL ban on KRATOM, a herb which has been used in Asia for hundreds of years with no recorded deaths. It has been in use in Europe and America for a couple of decades and still there are no deaths recorded from pure Kratom use. Krat…

Thanks for pointing this out. I don’t know enough about kratom to have an opinion on how it should be regulated. I will add a comment though. Just because I am fundamentally opposed to America regulating drug use outside of its territory.

https://www.drugabuse.gov/publications/drugfacts/kratom

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#33

Post by pitaj » Sat, Aug 07, 2021, 6:44 PM UTC

nicoburns wrote: post #26

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

> The opioid epidemic was largely caused by the idea of them being non addictive being heavy pushed by the pharmaceuticals industry. I definitely think the pharmecuetical industry pushing drugs is a big problem. But that doesn't mean we should deny people treatments that work. Instead we should fix the actual problem: innapropruate presceiptions. Note that opiods are mostly not a problem here in the UK for example. W…

The US has been cracking down on opioid prescriptions to the point that a lot of people can't get opioids for when they really need them for chronic pain and even after surgeries!

In the meantime, opioid overdoses have continued to climb. Turns out that forcing people into the black market to deal with terrible pain is not a good policy.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#34

Post by sandworm101 » Sat, Aug 07, 2021, 6:46 PM UTC

wyre wrote: post #20

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

Cannabis, psilocybin, and LSD have been used recreationally for decades with death rates approaching zero and there have been 0 cases of overdose. I was under the impression that these drugs were made illegal because their use promotes an anti capitalism mindset (see Timothy Leary being called the most dangerous man because of his research on LSD) and the medical industrial complex isnt able to extract as much money…

Oxycodone was pitched as non-addicting. Opioids generally were pitched as non-addicting because they were by prescription, under control of doctors. That protection scheme obviously failed miserably.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#35

Post by Klinky » Sat, Aug 07, 2021, 6:47 PM UTC

dghughes wrote: post #27

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

>I’m glad we are moving away from the incredibly destructive drug policies that have been in place for so long The point of the polices was to counter the incredibly destructive result of the surge of cocaine, crack, heroin use in the mid 1970s and early to mid 1980s. And the deaths from the drug use and the gangs fighting over the spoils. It really was a war. Mexico didn't seem to make it, I think the drugs won. I k…

The "War on Drugs" did little to solve the social causes of drug addiction and dealing, and mainly focused on expensive law enforcement operations and penalizing impoverished people further. With the opioid epidemic, white-collar drug dealers were free to make huge profits getting people addicted, with little repercussions for decades. The "War" was targeted to a very specific demographic.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#36

Post by loeg » Sat, Aug 07, 2021, 6:47 PM UTC

irthomasthomas wrote: post #21

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

Sorry to burst your bubble but U.S. drug policy is not as progressive as you might think. Cannabis is still illegal under federal law. And right now America is petitioning the WHO for a GLOBAL ban on KRATOM, a herb which has been used in Asia for hundreds of years with no recorded deaths. It has been in use in Europe and America for a couple of decades and still there are no deaths recorded from pure Kratom use. Krat…

Kratom is fundamentally an opioid. It happens to be cheap and relatively safe (consumed by ingesting large quantities of plant matter, rather than injection or insufflation of some extremely potent compound). I think opioids are over-vilified in general, and I'm on the side of legalization, but kratom isn't magic.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#37

Post by jfk13 » Sat, Aug 07, 2021, 6:52 PM UTC

irthomasthomas wrote: post #21

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

Sorry to burst your bubble but U.S. drug policy is not as progressive as you might think. Cannabis is still illegal under federal law. And right now America is petitioning the WHO for a GLOBAL ban on KRATOM, a herb which has been used in Asia for hundreds of years with no recorded deaths. It has been in use in Europe and America for a couple of decades and still there are no deaths recorded from pure Kratom use. Krat…

I'm not familiar with that "awesome herb", so I wondered what other sources might have to say.

While the numbers are small (unsurprisingly, if it's not nearly as widely known and used as some other substances), it may not be quite as innocuous as you seem to imply:

> "A 2019 paper analyzing data from the National Poison Data System found that between 2011-2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances."

> "In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom."

(https://www.drugabuse.gov/publications/drugfacts/kratom)

Actually, even the study you linked has some disturbing statements:

> Deaths attributed to the use of Kratom have been reported in Europe and the United States but not in Southeast Asia.

> The increasing trend in Kratom consumption in the West has corresponded with an increase in reports of Kratom-related exposures to Poison Control Centers in the United States, care received at a health care facility due to Kratom consumption, and association with overdose fatalities.

> Kratom was identified as the cause of death by a medical examiner in 91 of the 152 Kratom-positive deaths, but was the only identified substance in just seven of these cases.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#38

Post by scythe » Sat, Aug 07, 2021, 6:56 PM UTC

tomato-sauce wrote: post #12

It feels like in the last few years I have been constantly hearing about new research showing “fun” drugs as cures to a wide array of medical conditions. There’s marijuana for chronic pain, mushrooms for depression, mdma for ptsd, and now ketamine. They are often talked about as if they have little or no harmful side effects. I’m glad we are moving away from the incredibly destructive drug policies that have been in…

>marijuana for chronic pain, mushrooms for depression, mdma for ptsd

Is it that much of a surprise that psychoactive drugs treat psychogenic symptoms? In the particular case of pain, the two major available drug classes -- opioids and benzodiazepines -- mimic the activity of addictive recreational drugs opium and alcohol. THC is used per se instead of derivatives because of its price and safety record (contrast opium/alcohol).

For depression/PTSD, psychiatry has thrown the kitchen sink at these conditions. It's more "newsworthy" when MDMA is used for PTSD than propanolol even though both serve essentially the same purpose: allowing the patient to discuss the traumatic experience without experiencing the emotional effects of that trauma, by blocking them physiologically. In this case, "blocking negative emotions" is a naturally desirable effect of a recreational drug (propanolol also blocks many positive emotions, rendering it less fun). Modifying emotions in depression doesn't seem like a surprise either, although psychedelics can be unreliable here (and this is well-documented). I expect some negative side-effects to appear, but I disagree that this is much of a change from the norm, except insofar as it upends a taboo. Methaqualone got its start treating insomnia, and the medical history of amphetamine is too long to fit in this comment.

In fact, during the early history of psychedelics, there were developed "less recreational" analogues of the major drugs, such as diethyl-psilocin ("ethocin") and 5'-methoxy-MDA ("MMDA") which were considered as possibly safer adjuvants to psychotherapy. The rediscovery of these agents might benefit more from attention on their history of bona fide therapeutic use, rather than on their recreational past. Perhaps we shouldn't be so surprised when some psychiatric medications turn out to be recreational, and mitigate the consequences pragmatically, rather than reflexively recoiling from anything resembling euphoria. One thing you learn from Infinite Jest is that the mere materialism of emotion is especially unnerving insofar as it applies to happiness, but reality isn't going away anytime soon.

What happened in this article with ketamine is quite different: test-tube evidence uncovered an effect that modifies a rare hereditary condition. I think the story here is really more about data-mining, and ketamine just happens to be interesting.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#39

Post by lumost » Sat, Aug 07, 2021, 7:00 PM UTC

pitaj wrote: post #33

nicoburns wrote: post #26

Earlier quoted context omitted.

> The opioid epidemic was largely caused by the idea of them being non addictive being heavy pushed by the pharmaceuticals industry. I definitely think the pharmecuetical industry pushing drugs is a big problem. But that doesn't mean we should deny people treatments that work. Instead we should fix the actual problem: innapropruate presceiptions. Note that opiods are mostly not a problem here in the UK for example. W…

The US has been cracking down on opioid prescriptions to the point that a lot of people can't get opioids for when they really need them for chronic pain and even after surgeries! In the meantime, opioid overdoses have continued to climb. Turns out that forcing people into the black market to deal with terrible pain is not a good policy.

No one has had a good approach for opioid addiction since the first cases of morphine addiction a century ago.

Banning opiate use results in deaths, restricting prescriptions moves addicts to the black market, the status quo results in more addicts.

Re: With a nudge from AI, ketamine emerges as a potential rare disease treatment

#40

Post by stouset » Sat, Aug 07, 2021, 7:01 PM UTC

narag wrote: post #17

nickthemagicman wrote: post #13

Earlier quoted context omitted.

What there a really are no or very few side effects?

Ketamine seems to be a commonly used drug in emergencies because it's a safer anesthetic than propofol when you don't know specifics about the patient and can't determine dosage.

Ketamine is the world’s most commonly used anaesthetic, or at least it was as of some years ago. It’s on the WHO’s list of 100 essential medicines because it’s one of the very rare anaesthetics that doesn’t depress the respiratory system, making it extremely safe by comparison with many others.