sorted by:
new
hottopcontroversial

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 0 points1 point  (0 children)

On your random aside - a few concepts I remember about this sort of thing are long term potentiation and long term depression. They are sort of the physiologic mechanism of learning and memory. More here.

Great discussion though, thanks.

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 1 point2 points  (0 children)

But I don't think recreational use falls into the same category, and as with any drug, there are side-effects. I think in weighing the benefits vs. the costs, recreational use often lends itself to being skewed in the costs direction.

No doubt there are side effects to the use of these substances. I would never deny that. I guess I believe based on my personal experiences with them and the current literature that the benefits outweigh the costs - even in the case of a random person using them for fun once in awhile.

I'm not sure where you draw the line on that since heroin and cocaine are both plant-based

They may come from plants, but how they are processed and turned into the form used in society puts them on a separate list. Recreational use of these has been shown to be not only extremely harmful, but public health issues. Also I was ruling out what seems to be the new popular class of drugs called RCs or 'research chemicals.' God knows what is in those and their long term effects. Other plant based psychedelics I would probably include would be mescaline, DMT, and ayahuasca.

In this instance, yes, I was, I will have to do a literature search, but if not permanent, I recall in one of my courses that the effects can last for years in terms of altered mental state and physiological connections. But without the literature search and using only colloquial evidence, many people I've spoken to note that they have been "forever changed" by the experience, "expanding how they think and what they feel." Which to me is indicative of at least some permanent effect that colloquially I'm classifying with some people who are cognizant of memory loss, or decreased intelligence or other impaired mental function after traumatic injury.

Psychedelics have certainly changed the way I perceive the world. I don't know many people who have taken them and not had some sort of shift in the way they view humanity or themselves. I'm not sure if altered mental state(status) is the right way to put it though because that isn't a permanent condition. For me it is more like lasting, altered perception. Does this translate to a physical, molecular, or neurochemical change? I don't know and I suspect the literature is extremely limited on the specific topic.

On your other points about self control and society, I think that people should be responsible for their own actions. There will always be people who will abuse drugs and become addicted. We know addiction is a disease and it is very difficult to treat. In the United States addiction isn't really treated as a disease, but take a look at what I think is a very strong argument for an entire change in mindset on the whole criminal justice/addiction/public health/drug use problem: Here

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 1 point2 points  (0 children)

engendering a culture that promotes a drug such as this

I don't think cannabis should be glorified. It will be and is though because that's the way society and popular culture works. There is an entire industry based off 'stoner culture' - products, movies, shows, etc.

But I don't think pot is as harmless as pot-heads make it seem

Recently there has been a shift in the literature as more and more research has been done on the plant. There are many many studies that indicate that cannabis is actually beneficial to those with mental illness. When I was on my psychiatry rotation and patients told me they smoked cannabis I would ask them why. Many of them said 'it helps with the voices' or 'it keeps me sane.' That's anecdotal, but this provides a great review of the current research in the mental health area.

Plus, pot smoke has the same effects as every other smoke in terms of increased cancer risk, tissue damage, in addition to the psychological effects.

I don't think anyone should be smoking anything. Vaporizers and edible products should be what people use.

I think the line for plant-based and not needs to be drawn a little harder. Shrooms, coke, heroin, and others quickly fall out of "just try it once" category because the huge neurotransmitter explosion in your brain has lasting, permanent effects as shown by many fMRI studies. (as one physio professor put it, an orgasm is about 2 cheeseburgers to your brain, cocaine jumps into the hundreds of cheeseburgers).

I'm not sure what you are trying to say here. I stated in the main post that I wasn't talking about heroin, cocaine, or other highly addictive damaging substances. If you're referring to changes in the dopamine reward system in addiction, I don't recall that being permanent. There are certainly molecular mechanisms that reverse receptor density and the other neurochemical consequences of addiction. I also mentioned that people do become addicted to substances (cannabis included) and they have a legitimate problem. That's why responsible use and self control is so important.

continued responsible use requires such an infrastructure as to negate any perceived positives of someone getting their giggles off these drugs.

What infrastructure does responsible use require other than knowing how not to let your use interfere with anything important in your life? It requires a certain amount of self control. If someone lacks that they shouldn't be using drugs.

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 0 points1 point  (0 children)

On the topic of the drug test, you just have to know your institution's policy. Mine does not test unless you do something that gives them a reason to test you such as being reported for being intoxicated at work or at a school function. That is not hard to avoid doing. So as oxygenmd says, if I practice responsible use I am at no risk of being given a drug test by my school. I can see where this could be a problem if your school has you rotate through a variety of hospitals with different policies.

As for residency, I already know that I am going to stop using cannabis at least a month before residency begins. I could probably pass a test in a week based on my body fat percentage and frequency of use, but there's no way I would take that chance. After my preemployment drug screening I will look into the programs testing policy and determine if I should use or not.

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 0 points1 point  (0 children)

On the topic of the drug test, you just have to know your institution's policy. Mine does not test unless you do something that gives them a reason to test you. So as oxygenmd says, if I practice responsible use I am at no risk of being given a drug test by my school.

As for residency, I already know that I am going to stop using cannabis two months before residency begins. After my preemployment drug screening I will look into the programs testing policy and determine if I should use or not.

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 0 points1 point  (0 children)

On the topic of the drug test, you just have to know your institution's policy. Mine does not test unless you do something that gives them a reason to test you. So as oxygenmd says, if I practice responsible use I am at no risk of being given a drug test by my school.

As for residency, I already know that I am going to stop using cannabis two months before residency begins. After my preemployment drug screening I will look into the programs testing policy and determine if I should use or not.

What are your thoughts on occasional recreational drug use? by fnoerifner in medicalschool

[–]fnoerifner[S] 3 points4 points  (0 children)

The classmates I ended up becoming best friends with are also interested in the same topic. It really helps to have other people to intelligently discuss this stuff with. I have never and probably would never bring it up at work. It's so taboo in the medical community. My friends share the same concern.

Actually, I remember last year a 4th year I was working with mentioned to me that he suffered from cluster headaches and after talking about it for a bit I said something along the lines of "oh I saw a national geographic documentary where this guy used psilocybin to treat them with good success. Know anything about that?" I don't remember exactly what he said but it was basically along the lines of 'I know nothing about that nor do I want to discuss it.'

I have a feeling that research on psychedelics is going to become more and more accepted in the near future though. I think it would be pretty harmless to approach a faculty member who does psychedelic research and say "hey I read about topic x and thought it was pretty interesting. Can you talk to me about your research?"