Comment by dmos62
8 months ago
Some countries (Germany, Holland) have (or had ~5 years ago when I was interested in this) legal analogues of LSD that are produced and sold in a fully regulated, safe, precise manner.
8 months ago
Some countries (Germany, Holland) have (or had ~5 years ago when I was interested in this) legal analogues of LSD that are produced and sold in a fully regulated, safe, precise manner.
Well, cocaine and heroin are still used for certain medical applications, too, ain't they?
Cocaine is still legal for medical use, but in twenty years of anesthesia I've never seen it used (though we are not an ENT-heavy practice). Too much concern about diversion. It's a great drug for ENT use but the way little bits of excess disappear means that most hospital pharmacies don't want to touch it (and surgery centers that don't have 24/7-staffed pharmacies want it even less due to risk of break-ins and theft).
Heroin is not legal in the US, although it is in the UK at least as a hospice med (under the generic name diamorphine).
Being significantly older than you (I retired from the practice of anesthesiology at age 67 in 2015) I am able to recount my experience with cocaine use to prepare patients for nasal intubation.
When I began my residency at the UCLA Department of Anesthesiology in the fall of 1977, I was instructed on how to use cocaine.
First, one requested a 2cc glass vial of cocaine hydrochloride solution (4-10% strength, prepared from cocaine powder).
The patient in the O.R. was then sedated heavily to both eliminate fear and anxiety and decrease the stinging and discomfort resulting from the imminent application of the cocaine solution against the nasal mucosa.
Cotton pledgets on thin wooden sticks about 6 inches long were submerged in the cocaine solution until saturated, then very slowly and delicately introduced into both nostrils simultaneously and rotated while being advanced deep into the nasal cavity: usually they went in about half their length.
A nice aid to successful intubation: As a rule, we chose to intubate via the nostril which most easily and deeply accommodated the pledget.
We then waited for 15-20 minutes for maximum local anesthesia and vasoconstriction, then removed the pledgets and proceeded with nasal intubation.
I continued to use cocaine for nasal intubation until I moved to the University of Virginia in 1983; for whatever reasons, the drug wasn't part of our therapeutic armamentarium there, rather lidocaine with epinephrine was employed in the same manner as cocaine solution and produced equivalent results.
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It's not just used in palliative care (though it is certainly used widely for that). As I understand it, in the UK diamorphine is prescribed for lots of types of acute, severe pain, including pain from surgery, heart attack and childbirth.
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My wife, a PhD student at the time, was tasked with delivering cocaine to another university's research lab. I believe they were administering it to mice, I don't know much else. Anyway, my wife agrees and proceeds to take a public bus with an illicit substance and no accompanying permit or documentation. Wild.
Like what? What was a legal analogue 5 years ago?
There were multiple, I think they were called 1p-LSD, 1cp-LSD, 1d-LSD, 1v-LSD and currently you can still legally buy 1S-LSD. Its a bit of whack-a-mole with the lawmakers because there isnt a blanket ban, only ever the specific chemical gets banned. Although stuff got quite a lot more expensive with every iteration.
Prior to those there were LSZ (lysergic acid dimethylazetidide) and AL-LAD doing the rounds in the UK. Very briefly PARGY-LAD too.
1P-LSD was something of a breakthrough IIRC (never tried it but I was still following the scene at that point) because unlike the others it is a pro-drug for LSD, being quickly metabolised to the parent compound, rather than a different but closely related compound as the others were.
Never heard of the rest of those though! I stopped paying attention sometime around then.
Not quite the specific chemicals anymore. As I understood it, when they outlawed 1v, the legislation was changed to also consider the weight of the molecule. Ok fine, still whack-a-mole, it just took the clandestine chemists slightly longer to figure out what mostly inert structures they could add to the LSD (though not actually add, since that would mean they were at some point making LSD, which is illegal) that would be cleaved off metabolically so you end up with LSD in your system