The politics and economics of marijuana in the Netherlands: The above piece from PBS NewsHour makes the point that the illogical patchwork system controlling the market for recreational cannabis in the Netherlands is nothing like the comprehensive regulation being instigated in Colorado and Washington state. HT @erowid)
Must-read: Meth in Germany: A recent issue of Der Spiegel has an extensive report on the growing problem of methamphetamine abuse in Germany. Apparently, much of the meth is manufactured in Czechoslovakia and slipped across the border. Many of the people who become hooked on the drug are students and young mothers whose workloads are more intense than their natural energy.
It only takes months for many users to transform themselves from high-flyers to zombies. Meth releases massive amounts of neurotransmitters, like the happiness-inducing serotonin or dopamine or the stress-inducing noradrenalin, and, in the long term, damages the nerve cells in the brain. Users struggle with paranoia and days of sleeplessness. They are aggressive, feel neither hunger nor thirst nor pain. Addicts first lose weight, then their teeth and finally their sanity.
At this point, meth seems to have overtaken other addictive drugs such as heroin and alcohol.
According to the Federal Criminal Police Office, the number of people who tried meth for the first time went up by 51 percent in 2012. “This means meth has outstripped heroin in terms of new users,” says Roland Härtel-Petri, a doctor specializing in addiction in the city of Bayreuth in Bavaria. “Crystal is flooding our country,” he wrote in a book published earlier this year on the subject. He argues that critically acclaimed series like “Breaking Bad,” in which a chemistry teacher becomes a drug boss, have made this “shitty, idiotic substance” hip for many people.
Nicotine by the barrel: An article in the New York Times today notes that liquid nicotine — a preparation used to refill e-cigarettes, can be purchased in enormous bulk amounts. For example, one retailer sells a liter of the preparation for $109.99, with a nicotine concentration of 100 mg/ml. By way of comparison, since the minimal lethal pediatric dose of nicotine is approximately 1 mg/kg, this amount has the potential to kill as many as ten-thousand 10 kg children. The volume of this potentially lethal dose would be 0.1 ml — much much less than a teaspoon.
In a related story, USA Today points out that liquid nicotine is not regulated and is often supplied in containers that are not child-proof.
Nicotine is a cholinergic agent. Signs and symptoms of toxicity would reflect the cholinergic toxidrome: nausea, vomiting, diarrhea, sweating, salivation, lacrimation, muscle weakness, tremors and fasciculations. Pupils may show miosis or mydriasis. More severe toxic manifestations include seizures, coma, confusion and agitation. Respiratory muscle weakness can lead to respiratory arrest.
These products often come in attractive colors and with flavors such as cherry and bubble gum. They are well absorbed after ingestion. Although to date no deaths have been reported from inadvertent ingestion of e-cigarette liquid, Lee Cantrell of the California Poison Control System says that: “It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of time.” (HT @DavidJuurlink)
I am not a fan of “Fox & Friends,” but the following story — despite some inaccuracies — makes good points:
To read TPR‘s previous discussion of e-cigarettes, click here.
Buried chemical weapons in the U.S.: While the world’s attention is focused on the problem of finding and destroying chemical weapons in Syria, the United States has it’s own problems in this area. An interesting article in the Los Angeles Times reports that the military is engaged in a decades-long program to dig up and destroy chemical agents buried at the Redstone Arsenal outside of Huntsville, Alabama (population nearly 200,000.) These weapons — seized from Germany and Japan after World War II — include mustard, Lewisite, Adamsite, phosphorus, chlorine, tear gas, and possibly the nerve agent tabun.
Just when you though it was safe to go back to the fruit stand . . .: The Nature’s Poisons blog has a short essay about Ackee fruit, including the history and toxicology of the fruit as well as a recipe for ackee and salt fish. If you are not aware that ackee causes Jamaican vomiting sickness or that hypoglycin is the toxin involved you’ll want to read this. (HT @BCDPIC)
Pre-med student charged with manufacturing ricin: Georgetown University’s newspaper The Hoya reports that a sophomore pre-med student at that school has been charged with manufacturing ricin. A correction to the piece makes it appear that the total amount of ricin involved was much less than the lethal dose. To read my Emergency Medicine News column arguing that ricin — a toxin found in castor beans — has, with one possible exception, never been shown to have killed anyone, and that the hysteria claiming it is a feasible biological weapon is tremendously overblown, click here.
Old Cigarette Ads: The National Museum of American History at the Smithsonian has posted a great small collection of old cigarette advertisements. My favorite boasts that “20679 physicians say ‘Luckies are less irritating’” and are a protection against cough (“It’s toasted.”)
Toxicology long-reads: In the April issue of The Atlantic, an article by James Hamblin explores the recent controversial paper by Grandjean and Landrigan that suggested the world is facing a “silent pandemic” of neurodevelopmental toxicity from chemicals in the environment. As evidence, the scientists point to increasing rates at which conditions such as attention-deficit hyperactivity disorder. I find this less than convincing —as TPR has argued before, there are many possible explanations for the explosion in ADHD diagnoses, including pressure from pharmaceutical companies and direct-to-consumer advertising. Everyone, including a spokeswoman from the American Chemistry Council, agrees that the Toxic Substances Control Act of 1976 is useless and needs to be reformed.
In the New York Review of Books, Jerome Groopman reviews Martin and Rashidian’s book A New Leaf: The End of Cannabis Prohibition. In the piece, Dr. Groopman talks about the history of marijuana and potential medical uses. He also talks about the plant’s neurological effects:
What is clear is that cannabis impairs cognition and psychomotor responses. Numerous studies show that it lengthens a person’s reaction time and impairs his or he attention, concentration, short-term memory, and assessment of risks. These changes in psychomotor performance can last longer than the feeling of being high. . . . Several studies demonstrate associations between cannabis and collisions: drivers who use it are estimated to be some two to seven times more likely to be responsible for accidents compared to drivers not using drugs or alcohol.
The review concludes that while loosening of restrictions on cannabis should make it easier to carry out medical research into potential benefits, the effects on driving and traffic may well prove detrimental. The current situation represents a huge social experiment whose ultimate outcome is not yet known.
Podcast of the week: The current episode of ToxTalk features a discussion with Matt Lozier and Molly Boyd of the CDC and emergency physician Katherine Kimball from Rhode Island about the recent cluster of opiate overdoses and deaths in that state attributed to acetyl fentanyl.
Whew! That was a lot of stuff. Had to catch up on a backlog after coming back from the spectacular SMACCgold conference in Brisbane last week. This was, by far, the best medical conference I’ve ever attended. The good news is that next year SMACC is coming to sweet home Chicago, May 20-22 2015. Can’t wait!
Dutch marijuana trade, German meth, and more! Tox on the Web | The Poison Review
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