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Does A Medical Setting Affect Psychedelic Treatment?

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As psychedelics gain acceptance quickly, laws in different states are changing to accommodate their possession and use. So far though, the only states to legalize have done so with an allowance for use in a medical/supervised setting. How useful is this medical setting to psychedelic treatment, and can it get in the way?

What is a medical setting?

When it comes to using psychedelics, there are no specific rules for what will lead to a good trip, and what will bring on a bad one. Though this can do with individual reaction to the drug, it also has to do with outside factors that can impact our individual reaction. We’re often told ‘set and setting’ play a big role in a trip going smoothly, and this can encompass different factors.

‘Set and setting’ refers to the place you’re having the experience, and the environment around. You could be in the woods, or on the beach, or at a dance club, or alone with your partner. The environment around might include the other people you’re interacting with, how crowded it is, if other people are also having the same experience, if you’re doing something organized or on your own, lighting and sound, and even the weather around you.

A medical setting is another type of setting, but until recently, it wasn’t associated with taking a psychedelic drug, or hallucinogen of any kind. However, as research amps up, and legalizations roll in, that idea of a medical, or supervised setting, becomes that much more important, as it’s the only setting legally available to use the compounds in question.


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A medical setting is not one specific thing. Also referred to as a ‘healthcare setting,’ and expanding into ‘supervised setting’, this term encompasses: “acute care hospitals, urgent care centers, rehabilitation centers, nursing homes and other long-term care facilities, specialized outpatient services (e.g., hemodialysis, dentistry, podiatry, chemotherapy, endoscopy, and pain management clinics), and outpatient surgery centers. In addition, some healthcare services are provided in private offices or homes.”

The last one is important, because it reminds us that our own home can be a medical setting under the right conditions; which is the medical setting most people should automatically be the most comfortable with. And when it comes to ketamine, it is offered by many clinics as an at-home treatment which both cuts costs, as well as gets away from the medical setting that not everyone is comfortable with.

In reality, both current psychedelics legalizations aren’t for medical use, and the legislation uses the term ‘service center’ instead. Considering it’s a formal setting, with a person watching over, it represents essentially the same thing. Perhaps its not so much about a ‘medical setting’ as a ‘controlled setting’, but the same idea of how it can affect a trip, applies. It seems Colorado might understand this a bit better, allowing for treatment outside of authorized service centers, but what this actually entails is not entirely clear.

Does being in a medical setting affect a psychedelic trip?

There isn’t one specific answer to this, and not everyone has the same requirements. For some people, the experience won’t differ greatly depending on set and setting, and for some people it will make all the difference. For everyone in between, well its hard to say. Plenty of trials for psychedelic medications have gone on at this point, and for those, we only get the results of the medical setting. Is it possible that results might have differed if the trials were run in a more familiar, or chosen, surrounding?

I came across an interesting statement when researching the Salvia divinorum plant, and the different ways that users describe the experience. Found in a Wired magazine article, and written by Daniel Oberhaus in 2020, the article details the writer’s own experience as a part of a research study into how the compound salvinorin A affects the brain during use. The trial took place at Johns Hopkins University in Baltimore, a research hospital, and involved being hooked up to an fMRI machine.

Per Oberhaus, “I had just inhaled an unspecified dose of the pure crystalline substance from a hose attached to what one of the researchers characterized as an ‘FDA-approved crack pipe.’” He continued, “My psychedelic experience in the fMRI machine was markedly less otherworldly. On the second round, I saw some colorful pinwheels and felt as though my body had merged with the machine. But I didn’t enter another dimension or dissolve into pure being”.

How much does set and setting affect psychedelic experience
How much does set and setting affect psychedelic experience

What are his thoughts as to why his experience in the trial differed from his experience using salvia illicitly, outside of a hospital setting? “This may have been because I received a lower dose. Or it may have been because it’s harder to give in to the experience when you’re inside a giant machine making a racket while it soaks your head in a powerful magnetic field.”

Being in an fMRI machine is much more extreme than simply sitting in a doctor’s office. But consider that most people who do ketamine illicitly, do it by snorting the drug; and one of the more common medical techniques is hooking someone up to an IV. The idea still resonates. Neither being stuck in a tube, or hooked up to an IV in a doctor’s office will likely be the chosen set and setting for many people. And no matter how comfortable you try to make a doctor’s office, it might still have the ability to change the experience.

Tack onto that the cost of the treatments, and this could make patients apprehensive about the outcome of their treatment, which could also affect experience. When getting a service is so expensive, you can’t mess around with it, and for people scraping to make this happen, there’s increased pressure to ‘get it right’. A less controlled environment could pose cost reduction ability, and make users more comfortable about what they’re spending.

My own experience in a medical setting for psychedelic treatment

On this particular topic, I can throw in my own opinion, as I did receive ketamine treatments in a doctor’s office, as well as having previously used the drug on my own illicitly. I’ll take a second to remind that ketamine is a dissociative hallucinogen, not a psychedelic. It is used for therapy in a similar way to psychedelics, and is currently the only legal way to get such treatment, as neither state thus far that legalized any form of a hallucinogen, started services yet.

I ended up in the office of a psychiatrist in Guadalajara, Mexico, which is one of the only places in Mexico that provides ketamine treatments. Most of the doctor’s business is for pain. I went because of sleep issues, which falls under psychiatric. There are very few people who do this there. As such, the procedure isn’t established like it is in American facilities; and from the beginning I was left to feel like not everything was being covered. I made the most of the experience, but looking back I can see how badly it went.

I was hooked up to an IV, and I sat in a comfortable enough place, but was it really? It was a kind of cold office, with no blanket offered, dim lighting, and no window. I was on a couch facing a desk, with very little around me. Sure, it was okay, but I wasn’t super comfortable. Nor did I like having an IV hooked up to me, or seeing the blood squirt out when they had a hard time getting my vein (both times!) I left with blood stains on my pants the second time. I didn’t enjoy the actual drug experience at all; it left me feeling queasy, shaky, and incredibly anxious. And while this could represent my own personal reaction to ketamine, there’s a problem here…

IV ketamine treatment in medical setting
IV ketamine treatment in medical setting

I did ketamine plenty illicitly. I used to do lines with an ex-boyfriend frequently enough to have a great idea how the drug affects me. I liked it back then. Not my favorite of all drug experiences, but very interesting. I used to feel like I was floating, disconnected, like my brain was pulling in different directions. But not bad. And at no point with the anxiety and discomfort I suffered in the doctor’s office. An anxiety so bad the doctor did not push me for another appointment (or even contact me again for follow-up…I would never got back to that provider).

The experiences were so wildly different, that it makes me wonder how much of my negative experience in the medical setting with the psychedelic-like drug, was related to being in that setting, rather than a place I am more comfortable with. My experience gives a huge amount of credence to the idea of at-home ketamine therapy, and the ability to do the treatment in the comfort and privacy of your chosen location. Perhaps under other circumstances, I would not have been a non-responder.

Conclusion

It’s not for me to say what works for other people. But when it comes to expensive treatments, or ‘services’, how many people want to pay out for something that isn’t what they’re looking for? And how much do we damage our own understanding of the usefulness of something, when the controls for use are so extreme? It’s not like these drugs are used illicitly in a medical setting; and people turn out just fine when using a psychedelic on their own, or in a less restrictive way. Maybe that’s something that should be remembered.

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How Cannabis Can Help With Dysmenorrhea

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Millions suffer, but relief could be here thanks to science and a simple plant.  Here is how cannabis can help with dysmenorrhea.

It is an uncomfortable topic to discuss, but the painful truth is a majority of women will suffer it at some point and finding relief is invaluable. Around 80% of women experience period pain at some stage in their lifetime. Dysmenorrhea is the medical term for pain or discomfort during menstruation. It is a common gynecologic problem, but the pain can range from dull cramps to indescribable agony. Here is how cannabis can help with dysmenorrhea.

Medicinal cannabis has emerged as a potential treatment option for dysmenorrhea, offering hope for the tens of millions of women who suffer from menstrual pain. Current medical management options primarily consisting of over-the-counter pain relievers and hormonal contraceptives. The effectiveness of these treatments vary greatly.

The endocannabinoid system plays a role in uterine function and pain perception. Cannabinoid receptors CB1R and CB2R, as well as TRPV receptors, have been identified in human myometrial tissue. Tetrahydrocannabinol (THC), a primary component of cannabis, can act as a cannabinoid agonist, potentially triggering myometrial relaxation and easing menstrual pain.

Photo by Esther Kelleter/Getty

The potential benefits of cannabis for dysmenorrhea includes pain relief, improved sleep quality, and reduced reliance on pharmaceutical pain relievers. While research specifically on cannabis for dysmenorrhea is growing, studies on chronic pain provide some insights:

  • A systematic review of 18 randomized controlled trials found that synthetic cannabis products with high THC-to-CBD ratios may offer moderate improvement in pain severity.
  • A meta-analysis of 32 trials showed that medical cannabis or cannabinoids resulted in small to very small improvements in pain relief, physical functioning, and sleep quality among chronic pain patients.

There is significant interest in using cannabis for gynecologic pain management:

  • A survey found that 61.2% of women who had never used cannabis and 90.0% of those who had were willing to try it for gynecologic pain.
  • After cannabis legalization in Canada, current cannabis use increased from 13.3% to 21.5% among women with self-reported moderate-to-severe pelvic pain.

With th American Medical Association, American College of Physicians and even AARP recognizing the medical benefits of cannabis, it is critical more research is funded.  Millions of women may be in pain needlessly due to untreated dysmenorrhea.



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Science Says Cannabis Can Be Making Us Healthier

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As it it becomes available to more people, there is a positive health change going on according to data.

Cannabis is becoming more mainstream and and the side effects are doing even better than expected.  It seems the availability of legal marijuana is helping with the health of the general population. Studies in California, Canada and the now New Zealand have shown the upside of legalization. While cannabis has been used for health benefits for millions of years, reduction in more harmful intoxication products is another important wellness trend.

RELATED: Can CBD Oils Help With Anxiety & Depression

Alcohol consumption is associated with significant health risks, including liver damage, cardiovascular issues, and certain cancers. In contrast, marijuana has not been linked to the same level of severe physical health consequences. The Centers for Disease Control and Prevention (CDC) reports that over 36,000 annual U.S. deaths are attributed to chronic alcohol use, while there is no comparable category for marijuana-related deaths. Alcohol is also much more addictive than marijuana, causing long term physical and mental issues.

A study from New Zealand has found some interesting trends regarding the relationship between marijuana legalization and the consumption of alcohol and opioids.

heart cannabis
Photo by megaflopp/Getty Images

Following the legalization of marijuana in New Zealand, researchers observed a notable decline in alcohol consumption:

This suggests for adults, marijuana may be serving as a substitute for alcohol in some cases, particularly when it comes to heavy drinking episodes.

The relationship between marijuana legalization and opioid use appears more complex:

  • There was no clear evidence of marijuana legalization directly reducing opioid use or abuse.
  • However, some research indicates that people who use cannabis are more likely to initiate opioid use, with an odds ratio of 2.76 compared to non-cannabis users.
  • The likelihood of transitioning from opioid use to opioid use disorders among cannabis users was found to be 2.52 times higher than non-cannabis users.

The study also revealed some additional findings regarding substance use patterns:

  • Marijuana use increased by 16% among adults aged 21 and older following legalization.
  • There was a 5-6% increase in marijuana use initiation among adolescents and young adults aged 12-20. This would be go with the greater North American trend of California sober and Gen Z drifting away from alcohol and more into marijuana.
  • No significant changes were observed in the use of hard drugs like cocaine or heroin in any age group.

RELATED: Marijuana Use And Guy’s Member

These findings suggest while marijuana legalization may lead to decreased alcohol consumption among adults, it does not necessarily translate to reduced use of other substances, particularly opioids. The relationship between cannabis use and other substance use behaviors is complex and multifaceted. Time and more research should yield more benefits.



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Try These Delicious Autumn Cream Drinks

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Want something delicious with an “oomph” – these yummy creamy concoctions will make your mouth happy!

Fall is a time of coziness, cuffing and nights in front of the fire. Want better way to accent it with a nice tasty cocktail? Try these delicious autumn cream drinks and enjoy the pre-holiday season. Bailey’s was the commercial first cream liquor and made available to the public in 1971. But Irish monks have blended whiskey with fresh dairy cream since the 14th century.  These new and classic connections will bring a smile on crisp nights.

RELATED: Beer Sales Flatten Thanks To Marijuana

Important note, using cream instead of milk in alcoholic cocktails can significantly enhance the drink’s texture, flavor, and overall experience. Cream provides a richer and smoother texture compared to milk. The higher fat content in cream (typically around 36% or more) creates a luxurious mouthfeel that can elevate the drinking experience.

White Russian

The White Russian’s development took about 30 years. The first mention of the drink is in a newspaper was in 1965 in the Oakland Tribune. The 1961 edition of the Diner’s Club Drink Book included a recipe for a Black Russian, with a note suggesting adding cream to make a White Russian. The White Russian’s popularity increased after the 1998 movie The Big Lebowski, where the main character, Jeffrey “The Dude” Lebowski, drinks it throughout the film.

Ingredients

  • 2 ounces vodka
  • 1 ounce Kahlúa
  • 1 ounce heavy cream

Create

  1. Add the vodka and Kahlúa to a rocks glass filled with ice
  2. Top with the heavy cream and stir
White Russian cocktail

Churro Cocktails

A churro is a fried dough pastry originated in Spain and Portugal. They are a fast-growing dessert and breakfast item on menus, and are a popular treat at theme parks and sporting events in Europe and North and South America.  Somrus, who makes cream liquors, made a cocktail from the flavor.

Ingredients

  • 1 1/2 parts Somrus Coffee
  • 1/2 part cinnamon whiskey

Create

  1. In an ice-filled shaker, add ingredients and shake
  2. Strain and pour

Brandy Alexander

This is was a classic “go to drink” for X. It was rumored to have been created at the Paris Ritz in 1922. Or it could have been made in 1915 by celebrate pitcher Grover Cleveland Alexander during a World Series. It was considered a posh way to end the evening, especially after other cocktails.It’s creamy and boozy or a delicious replacement for dessert for those who like to drink their sweets. In the 2000s, it has moved to the back of the line, but is still a great way to cap off a night drinking.

  • 1 1/2 ounces cognac
  • 1 ounce dark creme de cacao
  • 1 ounce cream
  • Grated nutmeg for garnish

Create

  1. Add cognac, dark creme de cacao and cream into a shaker with ice and shake until well-chilled
  2. Strain into a chilled cocktail glass or a coupe glass
  3. Garnish with freshly grated nutmeg

RELATED: Rainy Weather Cocktails

Mango Fizz

For those who are holding on to every last bit of summer, this mango cocktail can add a a little sunshine. The fruit is considered the world’s most popular fruit with over 20 million tons consumed each year. Mangoes are a symbol of friendship and love, which can add to special evening.

Ingredients

  • 2 parts Somrus Mango
  • 1 part citrus vodka
  • ½ part simple syrup
  • Club soda

Create

  1. Combine Mango liqueur, vodka and simple syrup in an ice-filled shaker
  2. Shake vigorously
  3. Strain into ice-filled glass
  4. Top with club soda

 



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