Search

Introduction Psychedelics show promise in treating unipolar depression, though patients with bipolar disorder have been excluded from recent psychedelic trials. There is limited information on the use of classic psychedelics (e. g., LSD or psilocybin) in individuals using mood stabilizers to treat bipolar disorder. This is important to know, as individuals with bipolar depression may attempt to treat themselves with psychedelics while on a mood stabilizer, particularly given enthusiastic media reports of the efficacy of psilocybin for depression. Methods This study analyzed reports of classic psychedelics administered with mood stabilizers from 3 websites (Erowid.org, Shroomery.org, and Reddit.com). Results Strikingly, 47% of 62 lithium plus psychedelic reports involved seizures, and an additional 18% resulted in bad trips while none of 34 lamotrigine reports did. Further, 39% of lithium reports involved medical attention. Most of the lamotrigine reports (65%) but few (8%) of the lithium reports were judged to not affect the psychedelic experience. Discussion Although further research is needed, we provisionally conclude that psychedelic use may pose a significant seizure risk for patients on lithium.

Background Despite effective, evidence-based medications for opioid use disorder (MOUD), these treatments remain underutilized. This may be due to multiple reasons. Family members may impact patient decision-making when choosing an opioid use disorder (OUD) treatment. While there has been work on patient preferences and attitudes towards opioid use disorder (OUD) treatment, to date, there has been minimal work assessing the attitudes of family member towards OUD treatment and recovery. Methods Participants were ≥ 18 years of age and endorsed having a first-degree family member with past-year treatment for OUD. Participants were recruited via online crowdsourcing and were asked a number of questions regarding their desired outcomes for OUD treatment, and their familiarity, approval, and perceived effectiveness of various OUD treatment options. Results The most commonly reported desired treatment outcome (50 %) was for family members to never use any kind of opioid, including maintenance therapies or opioid analgesics. Mean familiarity ratings for MOUD (rated 0–100) were relatively low, with naltrexone being the least familiar (32.3). Among those who endorsed a familiarity rating of at least 30 for a given treatment, mean approval and effectiveness ratings were relatively low—buprenorphine (approve 55.1; effective 54.1), methadone (approve 51.9; effective 49.3), naltrexone (approve 61.6; effective 55.9). These were lower than approval and effectiveness ratings for all non-MOUD treatments queried. Conclusions These findings highlight a need for clinicians and researchers to engage with family members’ regarding their preferences and understanding of treatment, and to better understand how this might impact patient engagement with treatment.

Access to sterile syringes for injection drug users (IDUs) is a critical part of a comprehensive strategy to combat the transmission of HIV, hepatitis C virus, and other bloodborne pathogens. Understanding IDUs' experiences and attitudes about syringe acquisition is crucial to ensuring adequate syringe supply and access for this population. This study sought to assess and compare IDUs' syringe acquisition experiences and attitudes and HIV risk behavior in two neighboring states, Massachusetts (MA) and Rhode Island (RI). From March 2008 to May 2009, we surveyed 150 opioid IDUs at detoxification facilities in MA and RI, stratified the sample based on where respondents spent most of their time, and generated descriptive statistics to compare responses among the two groups. A large proportion of our participants (83%) reported pharmacies as a source of syringe in the last 6 months, while only 13% reported syringe exchange programs (SEPs) as a syringe source. Although 91% of our sample reported being able to obtain all of the syringes they needed in the past 6 months, 49% had used syringes or injection equipment previously used by someone else in that same time period. In comparison to syringe acquisition behaviors reported by patients of the same detoxification centers in 2001-2003 (data reported in previous publication), we found notable changes among MA participants. Our results reveal that some IDUs in our sample are still practicing high-risk injection behaviors, indicating a need for expanded and renewed efforts to promote safer injection behavior among IDUs. Our findings also indicate that pharmacies have become an important syringe source for IDUs and may represent a new and important setting in which IDUs can be engaged in a wide array of health services. Efforts should be made to involve pharmacists in providing harm reduction and HIV prevention services to IDUs. Finally, despite limited SEP access (especially in MA), SEPs are still used by approximately one of the three IDUs in our overall sample.