This is a great thread guys.
Somethings I've been thinking about recently
1) Dosing - as meth cost has plummeted (I've seen it priced at 20/30$/g on markets, and heard not too far off numbers from people buying on the street) it's a lot easier on the wallet to just do more. As
@seiko mentioned earlier, Rx methamphetamine is orally dosed at 5-10mg with a MDD of what 20 or 25mg? When looking at dosage conversion charts (obviously not absolute) 5mg of oral dextromethamphetamine is considered equivalent to 20mg oral dextroamphetamine. With that back of the napkin math, you're talking about a maximum therapeutic dose of 25mg being somewhere around 100mg of dextroamphetamine equivalent. Obviously, we're talking different receptors being activated etc, but 100mg of dex would get you lifted AF.
I talk with patients who are doing shots of street meth in the ballpark of .2g/.3g injected. Due to much less significant NE agonism, you can dose so much higher than would be possible with regular old amphetamine, and not feel completely miserable. Imagine shooting a gram of dextroamphetamine? I don't want to.
Given all of that, we know that antipsychotic drugs are dopamine antagonists. Psychosis is linked to some degree with hyperactivation of dopamine systems. I was actually reading just a little while ago about how Deja Vu actually seems to be linked to
hyperactivation of Dopamine in the temporal lobe, something that came out of a person taking Phenylpropylamine and Amantadine for a cold and experiencing recurrent significant experiences of deja vu, likely owing to the drugs interacting and rapidly increasing dopamine. Deja Vu isn't psychosis, but it's not too far off from the type of cognitive alteration present. All of this is not to mention that we already have working models of psychosis linked to dopamine.
I wonder if part of this is fueled by meth being less difficult to come by, cartels are making enough of it to reach the whole US, it's becoming incredibly inexpensive, and as a result people are much more reckless with their use. Widespread availability of syringes could also play into this as it's a lot harder to smoke .3grams than it is to shoot it.
2) Pharmacology, chemistry, toxicity - We know that the method of production has moved from predominantly small batch pseudoephedrine cooks to large volume p2p cooks. Whether or not they are taking the extra steps to further clean up their batch from l-meth to most or all d-meth, we also don't know what kinds of other contaminants are left over in the products being used from using industrial chemicals instead of food safe drugs as your starting point. Are there heavy metals in the resulting product that don't get picked up by GC/MS - I don't know a lot about this part of things, so I'm hoping one of y'all might have some insight, but I do wonder if there's some degree of toxicity that could be at play here.
3) Context and mindset of users - There was a thread on reddit recently where people were discussing how they felt MDMA effects had changed since the 90s/00s. People were speculating on why it seemed like oldschool pressed pills just 'hit harder'. Some of that is tolerance, some is nostalgia, and some is novelty wearing off, but I speculated in that thread that another component was linked to context of use, as well as downstream effects from other drug tolerances and mindset of use. MDMA use in the 90s/00s was often in the context of raves, settings particularly designed to enhance the effect of MDMA, in a crowd of people who you can feel free to be all loved up around, and in the context of the dawn of a new millenium. It was the future, and it was about to happen! The Internet was coming! The world was relatively stable. Most people hadn't been prescribed SSRIs or amphetamines, especially not the 16-35 year olds taking MDMA for the first time. Those receptor systems were pretty pure.
Fast forward a couple of decades, and our social context has changed drastically. The internet has come, and for all the good it promised, it brought a whole lot of instability that continues to be felt in many ways. The world has felt unsafe due to war and a media addicted to war, fear, violence, and trauma. We're a hypermedicated society, having multiple generations grow up exposed to prozac, adderall, and welbutrin, not to mention the widespread availability of so many types of drugs that would just be near impossible to source unless you were deep in the scene a few decades ago. All of that stuff has to effect user tolerance, even if it's not direct cross tolerance.
I tried MXE recently for the first time, it was good, I liked it. It was an older batch, but seemed well preserved and I'm reasonably confident that it's good to high quality stuff. I've also done a fuckton of ketamine over the years, these NDMA receptors been antagonized. I'm missing out on some of the subtle effects that MXE offered a whole bunch of people whose first disso exposure was taking it when it was pure cheap and plentiful in 2011. Don't get me wrong, I liked it a lot, and will do it again when I can, but it wasn't magical in the way that people describe it. I can sense where the magic was, but I just can't really get that same effect that leads people to gush about the drug as 'the truth'. Some of it may be batch related, but I'm quite certain that my own neurotransmission just can't be impacted by it the same way a novel user can AND it's not a new drug that is mysterious and unique, and exciting in the way that it was when it first came out. Read the old threads about it on here, the anticipation of taking it is palpable. People were jazzed up for it, and for good reason, it's great stuff. That context had some impact on the way people experienced it.
Meth use these days has gone from a rural issue to an urban one, left the gay discos and entered the homeless encampments. It's being used by a generation of people who have been exposed to all sorts of pharmaceuticals, who can afford to do absurdly high doses, who are living in a day and age that many people find scary. There are plenty of people who have kind of gone off the deep end due to politics and conspiracy theory run rampant without using drugs, so adding meth to that equation is only going to exacerbate it. We have a burnt out mental health system that can barely keep up with the crises that we face every day, let alone actually make meaningful progress in helping the vast majority of people improve, and so many people, and communities, have suffered the repetative trauma of violence, suicide, and overdose death that has escalated these past 20 years in the US. If that's not going to harsh your buzz, not much else will.
So, that's my late in the day on a Friday contribution to this really wonderful forum. I hope y'all are setting up to have a fine weekend
