Results from a small pilot study were recently published in the journal of Alcoholism Clinical and Experimental Research,[1] the essay sheds light on the direction that clinicians might turn with the use of medicine to reduce alcohol cravings amongst abstinent and non-abstinent alcoholics. Animal studies have clearly established that the alpha-1 adrenergic receptor plays a prominent role in cravings and consumption reinforcement for many people who abuse and/or who are dependent on alcohol. The alpha-1 adrenergic receptor antagonist Prazosin was the subject of this Journal article. This drug is widely known by its brand name of Minipress. Prior editions of this newsletter have evaluated the use and efficacy of Campral (acamprosate), another drug that has been utilized to reduce alcohol cravings amongst abstinent alcoholics. Prazosin works differently than Campral; early results tend to indicate that Prazosin may be more effective and more profound in its effects.

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MEDTOX Newsletters have posted several recent articles relating to bad outcomes for those who are chronic or frequent smokers of marijuana. There is no end to the bad news for marijuana. All of this negative scientific news flies in the face of an ever-growing movement to expand the presence, utilization and legal immunity of medical marijuana cooperatives in America. It seems like those who are leading this movement recognize that the smoking of marijuana will never be “cleared” by the FDA, so they’ve decided to push medical legalization through a smoke and mirror process of community activism. Can you imagine the FDA ever clearing a drug that has direct effects of brain volume shrinkage, serious depression and pulmonary disease? Well that’s what marijuana does. Now add to the list of known marijuana side effects: testicular cancer.

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In the world of adolescent drug abuse, being in vogue means being an aficionado of Salvia Divinorum (aka: Diviner Sage). A drug that’s widely available in marijuana head shops and on the Internet (and grown in home gardens), Salvia has turned out to be a new age alternative to old guard hallucinogens such as LSD. A member of the sage family of herbs, Salvia can be prepared or cooked up to render a “high” that’s best characterized as being “out of body,” or dissociated from a surrounding environment. The Internet now features videos of teenagers under the influence of this drug; most of these vignettes oddly enough depict kids who appear to be in angst or discomfort. Anecdotes abound though of users who experience profoundly hallucinogenic yet calm effects, distortions of sound, color and sense of touch. It seems that like LSD, Salvia tends to elicit feelings and moods that reflect the basic nature of a person who has consumed it. In other words, someone who is a sort of bubbly and effusive personality will end up experiencing a Salvia “high” that’s manageable and pleasant, someone who is dour, downbeat and moody, might experience a very uncomfortable set of effects that may even border on being terrifying. In any event, Salvia “experts” strongly recommend that users arrange for a sober coach or monitor to be present with them. When a Salvia user is intoxicated, coaches are supposed to supervise and steer the experience towards a safe and sane conclusion. A Salvia high is relatively short lived, oftentimes no more than 20-30 minutes long. Salvia’s leaves can be tinctured into a tea, chewed and digested orally or crimped up and smoked. Salvia seeds are less potent than the plant leaves are, but they too contain traces of the prime hallucinogen that causes its unique effects.

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There seems to be some general misunderstandings as to which opiates are detected by the classic opiate assay. This is based on numerous calls from doctors, nurses, pharmacists, pain clinics, and rehab care givers that were unclear or unaware of which ‘opiates’ the classic ‘opiate screen’ will detect. Many were under the false impression that the opiate screen will pick up ‘ANY’ opiate-this is NOT the case!

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Have you gone to your corner drug store looking for an instant cold pack to treat a sport or exercise injury recently? Was the counter depleted? Were there any packs at all that were available for purchase? Well, this is a situation that’s occurring in drug stores throughout the country, especially stores located in areas where methamphetamine abuse is already rampant. In the last few years, state and local law enforcement agencies have successfully cracked down on the availability of chemicals that methamphetamine “cookers” need to make the drug. A cat and mouse game has ensued and has forced “cookers” to use some imagination as to how and what they can use to make methamphetamine.

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