Psychoactives, Volume 2, Issue 2 (June 2023) – 8 articles

Ayahuasca is an Amazonian psychoactive plant medicine being explored for its potential therapeutic uses in Western contexts. Preliminary studies link ayahuasca use with improvements across a range of mental health indicators, but studies have not yet explored qualitative aspects of the post-treatment process known in the psychedelic literature as “integration”. This includes how participants make sense of their ayahuasca experiences and minimise harm/maximise benefits after ayahuasca use. A global online survey, conducted between 2017 and 2019, collected responses from 1630 ayahuasca drinkers (50.4% male, mean age = 43 years) to an open-ended question about their integration experiences after consuming ayahuasca. Inductive codebook thematic analysis was used to identify themes in participants’ integration experiences. Participants described integration experiences in three main ways. First, was an overall appraisal of the integration experience (e.g., as easy, challenging, or long-term/ongoing). Second, was describing beneficial tools which facilitated integration (e.g., connecting with a like-minded community and ongoing practice of yoga, meditation, journaling, etc.). Third, was describing integration challenges (e.g., feeling disconnected, going back to “old life” with new understandings, etc.). These findings suggest that integrating ayahuasca experiences can be challenging and take considerable time, though working through integration challenges may facilitate positive growth. Findings also challenge the role of individual psychotherapy as the primary integration tool in Western psychedelic therapy, suggesting that communal and somatic elements may also be useful. An expanded definition of psychedelic integration is proposed which includes working with integration challenges and adjusting to life changes. Full article

This paper uses Geoffrey Rose’s theory of population health change to identify that part of lack of resolution of the harm reduction debates emerges from the philosophical question of the possibility of group-level causation. Group-level causation, otherwise known as the supervenience of higher levels onto lower levels, has been a core matter of philosophical and ethical debate. This paper argues that there, the public health standard depends crucially on the contextual environment rather than the individual product’s intrinsic properties. Interpretation of the benefits or the harms of e-cigarettes or other harm reduction products depends on the often unstated assumptions of the potential policy and cultural environments in which e-cigarettes exist, as well as the separate debate over the absolute or relative level of harm of e-cigarettes. Unfortunately, most of the research conducted will not contribute to our understanding of the potential impact of e-cigarettes until we focus on the potential changes to the social and political environment. Full article

Objective: To explore the perceived influence of psychedelic experiences on participants’ relationship with the natural world. Method: A total of 272 participants reporting previous use of psychedelics completed free-text response requests via an online survey. Thematic analysis was used to explore group participant responses. Results: Participants who described a pre-existing relationship with nature reported that psychedelics acted to re-establish and bolster their connection to nature. Those reporting no previously established connection to nature described psychedelics as helping them bond with the natural world. Underlying both of these were reports of transpersonal experiences, of which ‘interconnectedness’ was most frequently linked to shifts in attitudes and behaviours. Participants were also asked to reflect on previous psychedelic experiences that took place in nature and reported a range of benefits of the natural setting. Conclusions: These findings suggest that psychedelics have the capacity to elicit a connection with nature that is passionate and protective, even among those who were not previously nature oriented. More research is needed to explore the potential implications of psychedelic use outside laboratory-controlled settings in order to enhance these important effects. Full article

Psychedelics have been studied extensively in their broad treatment potential for a variety of mental health disorders. Recently, scholars have turned their attention to the role of psychotherapy in the augmentation, follow-up, and support mechanisms relevant to psychedelic administration. While it is tempting to position psychedelic substances as standalone medicines akin to SSRIs or SNRIs, their unique neurochemical action and potential for psychological transformation calls for a broader examination of the role of counseling and psychotherapy, within the context of a bio-psychosocial model. I outline well-established and emerging therapeutic modalities that are well-placed in complementary and augmented psychedelic treatment. I do so with the intention of opening a broader conversation to those situated in medical and medical-adjacent fields, including psychoanalysts, counselors, support workers, and other allied professionals. Ultimately, practitioners working in medical-aligned fields hold diversly vested interests in understanding the place of psychedelic therapies in mental health, and more attention should be given to a balanced consideration of treatment and support mechanisms. Full article

Purpose: When compared to the general population, people experiencing homelessness have significantly higher rates of TBI (traumatic brain injury). Individuals experiencing homelessness and a TBI require social support because it can serve as a protective factor in reducing the risks of substance use and positively impact housing stability. This study aimed to better understand how social networks influence housing stability among individuals experiencing homelessness and a TBI. Materials and methods: A purposive sampling design was utilized to recruit and survey 115 adults experiencing homelessness. Quantitative questions captured data on demographic information, brain injury-related variables, homelessness-related variables, social network support types and characteristics, and correlates of housing instability including self-report substance use variables. Results: Findings showed that substance use was, indeed, a barrier to stay in or afford housing. Additionally, rates of social support were uniformly low across the sample, showing the unique vulnerabilities associated with homelessness and TBI and homelessness in general. Conclusion: Intervention efforts may consider fostering support networks, as social support has been linked to both housing stability and non-housing outcomes such as reduced substance use, improved health, and community reintegration. Full article

Engagement in risky sexual behaviour after consuming different substances is more prevalent among Indian men. Sometimes, practicing risky sexual behaviour increases the risk of sexually transmitted diseases (STDs), including HIV, among individuals. Around 6 percent of the adult Indian population are diagnosed with STDs every year. Thus, the chief purpose of this study was to investigate the association between the use of substances and engagement in risky sexual behaviour. Descriptive statistics, Pearson’s chi-square test of association, and multivariate binary logistic regression models were performed in this present study by using the data obtained from the NFHS-5 (2019–2021). The results showed that respondents who consumed alcohol were more likely to engage in extramarital sexual affairs (AOR: 1.94; 95% CI: 1.79–2.09; p < 0.001) and sexual intercourse without any precautions (AOR: 1.23; 95% CI: 1.17–1.29; p < 0.001). Poor socio-economic conditions and low levels of educational attainment were found as crucial factors for involvement in risky sexual behaviour. Increasing awareness among individuals through mass media may be considered an effective way to prevent risky sexual behaviour. Full article

Adolescence is a phase of life between childhood and adulthood marked by rapid biological, social and psychological changes. During this phase, individuals bear a more emotional and curious mind and may engage in risky behaviours. Decades of investigations have revealed that substance use usually begins in adolescence. The main essence of this paper is to carry out an elaborative review of earlier works to recognize familiar risks and protective factors for substance use among adolescents at the global level. Additional emphasis was given to identifying the various statistical modelling approaches, widely used in earlier studies, to promote research methodological issues for future research in this specific domain. Articles published from 1991 to 2021 on adolescent substance use were downloaded, and after carrying out a preliminary full-text review, 50 articles were selected keeping the priority of the aforementioned objectives. After an intensive review, risk factors were identified and clustered around five broad domains such as individual, parental, familial, peer and environmental factors. Protective factors were also categorized under the headings of five broad domains viz. individual, parental, familial, social and interventional. Specific statistical modelling techniques were identified to evaluate the relative risk of specific groups of adolescents being in the clutches of substance use. It is necessary to recognise the potential risk and protective factors and their combined effect on substance use among adolescents to prevent this menace from society. For a better understanding of research about the exact vulnerable age of onset of substance use during the adolescence period, both the orthogonally placed risk and protective factors necessarily need to be distinguished with an attempt to protect adolescents from the further abuse of substances, as recognised by parents and society. To prevent substance use, interventions such as regulating substance price & accessibility, school intervention programs, academic monitoring, social support, clear expectations between parents and child, addressing family trauma, awareness activities, healthy lifestyle habits, mental health support, family health counselling and substance abuse treatment should be implemented. Full article

Post-traumatic stress disorder (PTSD) is a severe mental illness with grave social, political, economic, and humanitarian implications. To apply the principles of personalized omics-based medicine to this psychiatric problem, we implemented our previously introduced drug efficiency index (DEI) to the PTSD gene expression datasets. Generally, omics-based personalized medicine evaluates individual drug action using two classes of data: (1) gene expression, mutation, and Big Data profiles, and (2) molecular pathway graphs that reflect the protein–protein interaction. In the particular case of the DEI metric, we evaluate the drug action according to the drug’s ability to restore healthy (control) activation levels of molecular pathways. We have curated five PTSD and one TRD (treatment-resistant depression) cohorts of next-generation sequencing (NGS) and microarray hybridization (MH) gene expression profiles, which, in total, comprise 791 samples, including 379 cases and 413 controls. To check the applicability of our DEI metrics, we have performed three differential studies with gene expression and pathway activation data: (1) case samples vs. control samples, (2) case samples after treatment or/and observation vs. before treatment, and (3) samples from patients positively responding to the treatment vs. those responding negatively or non-responding patients. We found that the DEI values that use the signaling pathway impact activation (SPIA) metric were better than those that used the Oncobox pathway activation level (Oncobox PAL) approach. However, SPIA, Oncobox PAL, and DEI evaluations were reliable only if there were differential genes between case and control, or treated and untreated, samples. Full article