It's also worth noting that ketamine does appear to increase neural plasticity and can promote the formation of new synaptic connections (synaptogenesis), particularly in areas of the brain involved in mood regulation.
That being said, I too have experienced tolerance with ketamine infusions- even with a month between doses. Always found it a bit troubling and I'd rather not have to continue to increase the dose.
Find providers who don’t seem too eager to give you as many treatments as possible. I’m getting ketamine infusions for pain through a pain specialist but he also treats depressed patients. A pain specialist may be able to help you as much as someone focused on psychiatry as they still know the drug well and often know how to treat depression
I used to love it so much but I stopped when the feed became more algorithm based (looks like they reversed much of that though). There's just a whole lot of noise to sift through now regardless. 80% of products seem end their description with "with AI". I just think the maker spirit that was previously present is hard to find now.
Yes this sort of logic always maddens me. And it has extended to medicine for sure. Simplifying "screen time" as if what type of screen, the size of the screen, brightness, and what you are doing on it are insignificant. Anecdotally I had a "sleep specialist" actually give "no screens before bed" as medical advice. So what am I supposed to do- stare at the wall and think about if I'll be able to sleep? Reading a book will require more illumination which will disrupt circadian rhythm
What's more important is being conscious of what we are doing with screens at what times. I stop using my computer after 7pm typically, no social media before bed or upon waking
Two things work for me, either reading on my phone (I have a support thing) with the eye shield to avoid the blue light or listening to music until I feel sleepy enough to stop.
When it comes to bedtime reading, I found that nothing beats an OLED smartphone so long as you can fully control the brightness and the colors; e.g. a reading app that lets you set whatever you want - i.e. not Kindle - or else things like "color calibration" in GrapheneOS. That way, you can set the text to dull orange or red and dial the brightness very low. With OLED, the blacks are basically non-emissive, so the whole thing can be made extremely little light. This works even better if you gradually dial it down as your eyes get accommodated.
no this happens both in and out of cities. Just moved out of the American south where something called "rolling coal" is common practice in suburbs, cities, rural areas- a term heard fairly often. A bizarre amount of pickup owners modify diesel engines to produce thick, black smoke as a means of showing off or as a nuisance to others. I know I had a lot of lifted trucks cut me off and roll coal
Hear me out, but childhood trauma and neglect is common in rural areas. This was especially the case 30-40 years ago when family violence prevention programs were just lip service and practically non-existent.
I assume those children grew up to become maladapted adults with Cluster B traits. This manifests as antisocial nuisance behaviours such as rolling coal.
Second. Had to get a spam blocker because I was getting like 5-10 calls/day from “debt consolidation” companies which is a significant distraction
The spam blocker is pretty powerful though, you aren’t getting past it unless you are in my contacts or have a # flagged as affiliated with a reputable business
Yeah and I think I believed in aspects of this line of logic when my state legalized sportsbooks. I believe in harm reduction in most regards. What happened though, in my opinion, is an increase in access wound up creating an increase in net harm. Just my assessment. Timing is worth noting, this was rolled out to users initially during quarantine times.
the bane of my existence. I have some older family dealing with serious cognitive decline and when it comes to my parents or in-laws I'm "the guy" so they will ask for my help navigating the TV because they are still understandably clinging onto satellite/cable while being forced to learn streaming.
I'm more than happy to help as this is an area of interest but man, what I would do to be able to set my father-in-law up with a TV, streamer, remote he can use consistently. When I bought an Apple TV I thought that would solve his problems when they housesat for us but his motor issues get in the way and he always forgets Siri. I raised this question of how do we better serve older adults a few times at an assistive tech conference and no one seems to have cracked the code yet.
FYI you can use a universal infrared remote with Apple TV, which might have larger buttons or a more familiar interface. I have mixed feelings myself about the "touchpad" in the apple remote.
I understand your position in theory but feel the comparison to cannabis is a bit unfair. Most physicians will agree that cannabis is fairly harmless in adults.
Gambling, however has previously in the U.S. shown to be the leading cause of suicide attempts (20% in total) among all forms of addiction [1]. A body of evidence has also demonstrated it leads to divorce, bankruptcy, poor health and sometimes incarceration. Worth noting many of these studies centered around machine gambling and all forms of gambling are unique in terms of tendency for compulsion. Considering the landscape it is quite difficult for me to see a way of regulating out of this, not in the U.S. at least.
> Most physicians will agree that cannabis is fairly harmless.
If you read some papers on the subject it should be plenty apparent that it has adverse effects on the development of young adults, as well as long term use by anyone, particularly of recent high-potency strains.
It's not as bad as other drugs (heroine), and it's worse than others (coffee), but it's not harmless. I'm far from being a prohibitionist, and live somewhere that has (I think) sensible policies (The Netherlands), but to simply put that it's "fairly harmless" as something most physicians agree with is not true. I'd say it's similar to alcohol in terms of its moderate use being possible in a working society - albeit with some negative outcomes for people that overdo it, or do it too early in life.
Edit: there's lots of discussion below about if the studies that exist are trustworthy or not, but since anyone can google for studies, I'll leave a different recommendation to check out the r/Leaves subreddit, and read some first hand accounts of long term and heavy users. It's at least a different type of source and you can make up your own mind about what real users say about it, in case you never encountered it before.
I have a graduate degree in neuroscience, worked with colleagues who focused on psychopharmacology for their research, and many of my friends and neighbors are biologists of various stripes, including still-active neuroscientists, as well as epidemiologists, and clinicians. They all agree cannabis is fairly harmless, and would outright laugh you out of the room if you compared its negative effects (either in the individual or to society) to alcohol.
Clinicians aren’t the ones to go to for harms anyways, they’re largely not doing the research at any level.
What is the harmless dose? One join per year? Per month? Per week? Per day? Several per day, as I often saw in my youth? My father was addicted to cannabis, I can tell you that it reduces a lot ones' life outcomes and has consequences on your family.
"Stan, the truth is marijuana probably isn't gonna make you kill people, and it most likely isn't gonna fund terrorism, but… well, son, pot makes you feel fine with being bored. And it's when you're bored that you should be learning some new skill or discovering some new science or being creative. If you smoke pot you may grow up to find out that you aren't good at anything." - Randy Marsh, South Park (https://en.wikipedia.org/wiki/My_Future_Self_'n'_Me)
that's the part they leave out. the cannabis they test in the labs is probably 5mg. The flower sold in the streets is over 20mg.
I have seen people go into psychosis from weed. & no it wasn't laced. I have seen my gf's dad go from a non-smoker to rolling a blunt every hour. I have had friends drop out of college due to weed.
If you are alcoholic enough, alcohol withdrawal can literally kill you. Likewise, consequences on family and your own outcomes are massive even before that stage.
Unfortunately, people with predispositions like that are even more drawn to marijuana (and other drugs). It's a form of self-medication-- that sometimes goes wrong.
For a while it was unclear if the link between cannabis and psychosis was correlation or causation, but causation was ultimately established. It seems to be a relatively small percentage of the population that experience such things, but that's largely the same part of the population prone to heavy, chronic cannabis consumption in the first place.
So I just wanted to add that for a subset of the population, the risks are several orders of magnitude more serious than "lost a few IQ points", as many people are not able to resume normal life (nor indeed, a normal experience of reality) after a psychotic experience.
That being said, I do support legalization, since the alternatives are worse. I just also support people being well informed, and aware that while they're probably not in that 2%, there's only one way to find out, and you really, really don't want to find out.
edited to specify that I was addressing adult use. Agreed use in adolescence or even younger can be problematic. I also think that there isn't enough discussion around the impact of cannabis on cognition. Here in the U.S., though, as far as medical consensus there truly is not very much concern around cannabis use. A report found that there is limited evidence of the harms of cannabis, and ample evidence of medical use-cases- published by the National Academies of Sciences, Engineering, and Medicine (NASEM) in 2017
Worth noting our current overdose crisis and general lack of health care in many parts of the country, now the under-prescription of controlled medications- which all helps shift a lot of these dynamics in a direction that might not be seen in other parts of the world.
I'd challenge you to read those results again. They admit to the evidence for health effects being elusive (due to limited or no robust studies), yet there is still enough evidence to summarize the following:
"
There is substantial evidence of a statistical association between cannabis use and:
The development of schizophrenia or other psychoses, with the highest risk among the most frequent users (12-1)
There is moderate evidence of a statistical association between cannabis use and:
Better cognitive performance among individuals with psychotic disorders and a history of cannabis use (12-2a)
Increased symptoms of mania and hypomania in individuals diagnosed with bipolar disorders (regular cannabis use) (12-4)
A small increased risk for the development of depressive disorders (12-5)
Increased incidence of suicidal ideation and suicide attempts with a higher incidence among heavier users (12-7a)
Increased incidence of suicide completion (12-7b)
Increased incidence of social anxiety disorder (regular cannabis use) (12-8b)"
National Academies of Sciences, Engineering, and Medicine. 2017. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press. https://doi.org/10.17226/24625.
I would warrant that these summaries should be a concern for anyone using cannabis and that blanket statements regarding the overall tone and summation of the report negating health effects of cannabis is somewhat misguided.
None of which are causal associations. Given the millennia-long history of cannabis use to self-medicate, and lack of evidence (not without trying!) for a biological mechanism of any of this, it’s probably safe to assume this is largely people with an issue (or a proto-issue) self-medicating.
This has also been studied more since 2017 now that there are a lot more people taking cannabis, and many of these links have been confirmed, although some have not.
It has also been confirmed that heavy use of marijuana has negative effects on cognitive performance and short-term memory even in adults, although these symptoms go away after you stop using.
I think the evidence is closer to “completely harmless” than “mostly harmless” there’s literally never been a reproducible study that shows cannabis is in any way “bad for you.”
My wife is a psychiatrist. It’s not unheard of for her to have to deal with cannabis induced psychosis.
One of the more challenging things with cannabis is it can trigger people who are more predisposed to issues. Some of these things can stick around for a while, after an initial incident. Compared to something, like alcohol, cannabis based issues don’t only affect heavy or long term users. You might just be the unlucky person that cannabis doesn’t jive with.
That being said, I think she largely thinks legal cannabis is good. She’s seen recovered alcoholics who’ve turned to cannabis as their outlet without killing their liver and destroying their body.
However, acting like there are no risks to cannabis is not helping anyone.
The negative effect on brain development of young people has been extensively studied and proven, by many different studies across many different countries.
>> Most physicians will agree that cannabis is fairly harmless in adults.
It's a recreational drug. Unless a patient needs it to counter some other malady such as for pain relief, most doctors will say that less is better and none is best.
Well, most physicians will tell you the same about smoking and drinking (i.e. "less is better and none is best"), but some/many then go in their private lives and smoke and drink.
This is a thing physicians say but often don't heed themselves, and I don't think it singles out cannabis in particular.
The thing that horrifies me the most is physicians who smoke. There's an activity of which there is no safe level of doing other than "none", plus they've definitely seen what a smoker's lung looks like, and yet I've seen plenty of doctors who smoke regularly.
It's looks like you have wrong assumptions about liberal philosophy. In liberal philosophy, price of human life is set to infinity, thus price of life of any individual (even worthless ones) is equal to price of life of any group (even top of the top).
However, unlike anarchy, any harm to human life is very costly (because value of human life is infinite!), for example: killing of someone, suicide, death because of incompetence or laziness, or self damage because of self medication, etc. are «sins» for libertarians.
> most physicians will agree that cannabis is fairly harmless in adults.
This isn’t a good argument. Cannabis is harmless in adults that it’s harmless in. However, there’s a percentage of the population that has strong, adverse reactions to cannabis. Some of these can be life altering, requiring treatment to correct or mitigate.
The problem with cannabis is you can’t predict if any single person will be susceptible to negative outcomes until they have that negative outcome.
I didn’t refer to it as harmless. I referred to it as “fairly harmless”. An acknowledgment of what you are referring to. I don’t see this as terribly different than referring to cough syrup containing DXM as fairly harmless. If you are on MAOIs or have liver issues it can be quite dangerous- but for the vast majority of the population it is perfectly safe
That's fair, and I really don't fundamentally disagree with what they said I just wanted to add some cultural context here. Will plead ignorance that my experience working on issues of "addiction" or compulsions outside of the U.S. is incredibly thin but, knowing how compulsion tends to play out stateside- these are my observations. I'm genuinely concerned considering how poorly we've done treating those with substance use disorder, which I think is arguably simpler than gambling addiction in some respects
I don't necessarily disagree, but the original comment didn't suggest that gambling and cannabis are equally harmful, or even that cannabis is harmful. The point was that policymaking seems to tend toward all-or-nothing (either fully prohibited, or anything goes), and the legalization of cannabis is a recent example of that. The goods or harms of cannabis are beside the point.
That being said, I too have experienced tolerance with ketamine infusions- even with a month between doses. Always found it a bit troubling and I'd rather not have to continue to increase the dose.