Experience Vault Micro Update: Published Date Added

Summary: Added a new field “Date Published” to Experience Reports and moved all code over to use that instead of “Date Reviewed”. If anyone sees errors in the Experience Vault lists or What’s New, please let me know.

tl;dr

Changes to the Experience Vaults are hard because I wrote the code for almost all of it back in 2000 and then a major update in 2004. All written in ancient Perl that’s extremely fragile and a pain to set up as a development environment. On the plus side, it mostly works.

As a preliminary step towards a couple of other new features for crew and public, yesterday I added the very obvious “date published” field. We’d been skating by using Reviewed Date (the date that the first reviewer edited the report and marked it ready to be live) as the date published. But there are lots of reasons why one doesn’t want to have a single value for editing history and publication date. So, editing history is now properly just editing history and we don’t have to jury-rig and falsify the editing date in order to have the date of publication be correct. woo. :]

Date published is now the primary sort.

It’s a tiny update, but because of the complexity and fragility of the old code, the perl library I chose to use was failing in weird ways and it took five hours to debug to the point where I realized I could solve the problem by moving the logic out into a separate library (namespace) and it all magically just started working.

Stupidly Misused Neo-Terminology: E-Psychonaut

In reading a recent paper by Schifano F, Orsolini L, Papanti D, Corkery J, we ran across their ridiculous term “e-psychonauts” from this and a previous paper.

It’s always sad to see people writing new articles, especially medical or anthropology papers that pretend that the use of electronic communication is somehow noteworthy or aberrant. It is not.

Vulnerable subjects, including both children/adolescents and
psychiatric patients, may be exposed to a plethora of pro drug web pages, from which unpublished/anecdotal levels of knowledge related to the NPS are typically provided by the ‘e-psychonauts’ (e.g. drug fora/blog communities’ members; [124]).

That refers back to a a paper from 2015 by the same authors.

The authors define the term in their abstract:

Within online drug fora communities, there are some educated and informed users who can somehow provide reliable information on psychoactive compounds and combinations. These users, also called e-psychonauts, may possess levels of technical knowledge relating to a range of novel psychoactive substances (NPS).

And then go on to tout how excitingly new the idea of “e-psychonauts” is, despite the idea of online drug geeks being not remotely new by any reasonable standard. Not new to published articles, not new to published medical articles, not new to agencies funding massive “web surveillance”, not new to the mega mainstream media scare machinery, not new to anyone.

To the best of the authors’ knowledge, this paper represents the first systematic study aimed at providing a description of e-psychonauts, which may be of some use in prevention activities.

Demographics of online drug geeks? Not new. Perhaps it’s just a simple indictment of the “authors’s knowledge” and the knowledge of the article’s unnamed reviewers and editors.

The term “e-psychonaut” seems like it could be useful to mean psychonauts who are using new electronic psychoactives, such as electroceuticals, mind machines, transcranial magnetic stimulation, direct neural stimulation, or the like.

But, no, these authors and the terrible editors who helped them foist the term into the medical literature, seem to have missed that very approximately 100% of the adult populations under 60 years old in advanced countries now use “computers” or “electronic devices”. [To be clear, I know that it’s not actually 100%, it’s more like 90% of adults in the US under 60 years old, but virtually everyone /has used/ the internet.]

Perhaps in the 1990s it might have been helpful to distinguish between “psychonauts” who used electronic communication and those who did not. But in 2016? Not so much.

We appreciate that the authors and the low-end journals they publish in are willing to use Google to learn about “novel drugs” like 2C-B. But it really seems depressingly quaint in 2016.

As one indication of how well edited their papers are, in reading through them, I noticed this excellent reference in the opening paragraph of their 2015 paper “Ectasy.org [sic]”, cited to “Ectasy.org. www.ectasy.org (accessed Jan. 22, 2014).”

Oops. Don’t they use spell check? Regardless of spell check, getting through publication with a sad typo in the opening paragraph indicates bad things about the publication’s editorial process and overall quality. In case it’s not clear, that’s a typo for Ecstasy.org. Ectasy.org is a long-squatted typo domain with no content.

Woohoo! New SSL Cert (4096 key)

Since all of our HTTPD traffic is forced SSL, valid credentials are required to prevent visitors to Erowid.org and EcstasyData.org from seeing a very nasty error message when trying to access the sites. With an expiration date looming, it was time to renew Erowid.org’s low-end SSL certificate. Why low end? Because we consider the browser certificate authority to be an illegal global racket.

First, the good news. Check out our “A” rating from Qualys SSL Labs:

SSL Labs A Rating of Erowid HTTPD Server Security
SSL Labs A Rating of Erowid HTTPD Server Security

We mostly achieved this a couple of years ago when our sysadmin team worked to eliminate all of the basic problems, like removing support for dangerously weak encryption ciphers and forcing more secure handshake methods. But, if you look at the Qualys report, you’ll see that our server doesn’t allow the known-broken encryption algorithms.

And, as of today, we’re trying out a 4096 bit key. Many of the sites I looked at suggested that the CPU load cost of doing the key negotiation wasn’t worth the extra security, but JL, our main sysadmin, said we should give it a try. We’ll watch the server load over the next week or two, but right now it seems fine.

As far as the rant about the global criminal conspiracy that is the certificate authority, well, I will leave that to others. To be clear, I think it’s all a money scam, facilitated by the browser folks.

We choose to buy a cheap chained certificate because of the usurious pricing of the better, greener, happier certificates. They punish us by making the URL bar not as pretty and also making the certificate viewing experience worse. Despite the CSR having all the right info, the $50-100 per year wildcard-SSL certs don’t display our organization name or location properly. Pay $200-1000 per year and, with no additional security, we would get a happy-looking green bar and Erowid displayed in the browser URL bars.

Snake oil forever.

As I was searching for an example of an expensive green bar, I discovered that trying to view the front page of CNN via SSL resulted in terrifyingly bad browser behavior. It looks like a hijack (MTM) or just fails.

I'm Glad I'm Not a CNN Sysadmin
I’m Glad I’m Not a CNN Sysadmin

In early 2015, Erowid joined EFF’s HTTPS Everywhere campaign, because we believe that, today, virtually no communications should occur online in clear text. It is a sad statement about humanity that most of us, including institutions handling sensitive data about us, still use  unencoded plaintext email that requires no warrant and is, essentially, a public broadcast.

P.S. In an insanely conspiratorial way, I believe that the NSA and other anti-public-crypto agencies have worked to torpedo efforts over the last twenty years to get email more secure. In the United States, a fig leaf of privacy is enough to trigger Fourth Amendment protections.

CDC : Start Low. Go Slow.

It’s nice to see the US Centers for Disease Control (CDC), part of the Department of Health and Human Services (HHS), use the harm reduction message: “Start Low. Go Slow.” The concept nor phrasing are new, but we don’t know of any federal government education programs that have used this sane approach wording before. Anyone know of any government programs that have used “Start Low, Go Slow” before?

CDC Start Low Go Slow Campaign
CDC Start Low Go Slow Campaign

Amazing: Swiss Hospital Summary of All Recreational Drug Cases in their Emergency Department for 12 months

One of the thing that stands out to us as problematic when encouraging our species and societies to have balanced views about psychoactives, and is part of the reason that the public policy is a rolling global disaster, is that most data published about harms is selectively chosen for greatest impact.

Some authors published a complete summary of all “all cases presenting at the emergency department (ED) of the University Hospital of Basel, Switzerland, between October 2014 and September 2015 with acute toxicity due to self-reported recreational drug use or with symptoms/signs consistent with acute toxicity.”

It is unfortunately, from our view, that they did not also then include in their analysis presentations related to pharmaceutical drugs, but this is a great start.

Their summary speaks for itself, but imagine a world where all major hospitals published anonymized case data and we could get this type of summary every year?! It’s just too much to imagine that we might base education, expectation, and public policy on real world understandings of that relative magnitude of harms, rather than the most recent scary news story or the grieving parents of a tragic fatality.

Their paper is not as extensive as it could be and we’d really like to see a matrix table of what drugs were found combined with other drugs. Also, the authors did not have the ability to detect or identify new synthetic cannabinoid receptor agonists.

About a third of the cases were “related to” cocaine and a third “related to” cannabis. The next most common self-reported substances were heroin, benzodiazepines, MDMA, amphetamine/meth, unknown, and then opioids (excluding heroin and methadone).

Perhaps the biggest question is how good their detection / analysis is. Would they be able to detect MXE or deschloroketamine or other really new substances if they had been present?

http://bmcpharmacoltoxicol.biomedcentral.com/articles/10.1186/s40360-016-0068-7 [ Erowid Ref ]

Background
Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations, in particular regarding novel psychoactive substances (NPS) that have emerged on the illicit market in the last years.

Methods
We included all cases presenting at the emergency department (ED) of the University Hospital of Basel, Switzerland, between October 2014 and September 2015 with acute toxicity due to self-reported recreational drug use or with symptoms/signs consistent with acute toxicity. Intoxications were confirmed using immunoassays and LC-MS/MS, detecting also novel psychoactive substances.

Results
Among the 50’624 attendances at the ED, 210 were directly related to acute toxicity of recreational drugs. The mean patient age was 33 years and 73 % were male. Analytical drug confirmation was available in 136 cases. Most presentations were reportedly related to cocaine (33 %), cannabis (32 %), and heroin (14 %). The most commonly analytically detected substances were cannabis (33 %), cocaine (27 %), and opioids excluding methadone (19 %). There were only two NPS cases; a severe intoxication with paramethoxymethamphetamine (PMMA) in combination with other substances and an intoxication of minor severity with 2,5-dimethoxy-4-propylphenethylamine (2C-P). The most frequent symptoms were tachycardia (28 %), anxiety (23 %), nausea or vomiting (18 %), and agitation (17 %). Severe complications included two fatalities, two acute myocardial infarctions, seizures (13 cases), and psychosis (six cases). Most patients (76 %) were discharged home, 10 % were admitted to intensive care, and 2 % were referred to psychiatric care.

Conclusion
Most medical problems related to illicit drugs concerned cocaine and cannabis and mainly included sympathomimetic toxicity and/or psychiatric disorders confirming data from the prior year. Importantly, despite the dramatic increase in various NPS being detected in the last years, these substances were infrequently associated with ED presentations compared with classic recreational drugs.

Experience Vault List Minor Update : Cellar Button

After a phone call with an expert earlier this month where Earth was reminded how few people understand the more technical options in the Experience Vaults, we decided to try adding a button to the bottom of search results and lists to show Cellar reports.

So, now viewing search results lists will tell the reader whether there are matching results in the Cellar:

Search Experiences for 1,4-Butanediol

Before this week, the “Show Cellar” button only showed up if there were no reports matching a given search. There has always* been an Advanced Search option to include Cellar reports in a search, but very few people used this option.

We’re not 100% certain this is a good idea, because we don’t want to highlight Cellared reports too much. We don’t want to shame authors for writing reports our triagers and editors consider below our cutoffs, nor do we want people to have to slog through reading reports that are considered to contain data but have some serious problem that caused them to be relegated to the Cellar.

New York City Warns about Synthetic Cannabinoids (“K2”) — Suggests Natural Cannabis is Safer

Our New York colleague KevinB notified us today about New York City’s new anti-K2 campaign:

NYC K2-BusShelter

The filename for that image on their site is “K2-BusShelter” and the campaign is designed to be seen by the general public in the United State’s largest city. As we call it, the United States’ only Real City.

Perhaps the most interesting part of the campaign is the suggestion that natural cannabis is not dangerous. Their main catch line is:

“K2 is 0% marijuana and is 100% dangerous.”

This mirrors a lot of what we’ve been hearing from drug geeks, parents, and government regulators since the release of Spice, K2, and synthetic cannabinoid receptor agonists (CRAs) in 2006/2007:

Everyone would rather have young people smoking pot instead of waxy solid research chemicals from China. Everyone.

The threat of synthetic CRAs being a replacement drug for cannabis is so frightening, it is part of the pressure that has moved us to the point where cannabis legalization is pretty much a done deal in the US. The disaster that is prohibition can take full ownership of the dangers that the city of New York warns people about here.

And, of course, the synthetic cannabis replacements are often far more illegal to possess than plant cannabis. NYC technically decriminalized marijuana in the 1970s. In 2016, cannabis possession for personal use 25g or less is a “violation” / infraction — a ticketable offense with a fine between $100 and $250. Since it’s not a legal ‘crime’, being caught with cannabis does not trigger most of the negative social and legal repercussions of ‘drug crimes’.

The text of their info about “K2” says:

K2 is 0% marijuana and is 100% dangerous. Since 2015, there have been more than 6,000 synthetic cannabinoid-related emergency department visits in NYC. Males account for approximately 90% of these emergency room visits. Death is a rare but serious risk associated with the use of K2. In New York City, there have been two confirmed deaths caused by K2.

Since the chemicals found in K2 vary from packet to packet, and potency can differ even within one packet, the effects of K2 are unpredictable. People who use K2 may feel fine one time, and become extremely sick the next. Regular users may also experience withdrawal and craving.

Some of the adverse health effects of using K2 include: extreme anxiety, confusion, paranoia, hallucinations, rapid heart rate, vomiting, seizures, fainting, kidney failure, and reduced blood supply to the heart. If you see anyone who is unconscious, unresponsive, or experiencing a seizure, call 911.

Their PDF FAQ states the following:

What are synthetic cannabinoids (K2)?

Synthetic cannabinoids are a class of compounds designed to mimic the action of 9-tetrahydrocannabinol (THC), the primary psychoactive constituent of marijuana. But, K2 is not marijuana. Many different synthetic cannabinoids can be manufactured. The chemicals involved can cause unpredictable and dangerous effects, detailed below.

How is K2 packaged?

It is sold as incense, herbal mixtures, or potpourri with a variety of names including, but not limited to “Spice,” “Mr. Nice Guy,” and “Green Giant” It often carries a warning that the products are “not for human consumption”. An expanded list of product names can be found on the next page.

What are the dangerous effects of K2 use?

The most common adverse effects that have been reported include lethargy, confusion, drowsiness, respiratory depression, nausea and vomiting, tachycardia (increased heart rate), paranoid behavior, agitation, irritability, headache, seizures, and syncope (loss of consciousness). Severe side effects may include acute renal failure and significant negative effects to the cardiovascular and central nervous systems. In rare instances, use of synthetic cannabinoids has been linked to death.

What is the legal status of K2 in New York State?

It is illegal in New York State to possess, sell, offer to sell, or manufacture synthetic cannabinoids. Stores in possession of synthetic cannabinoids can be fined $250 per packet. Additionally, continuing or repeat violation may result in closure of the retail establishment and entities and persons who have been ordered by the DOHMH to stop selling synthetic cannabinoids risk additional civil and criminal penalties if found to have them.

Who has experienced negative health consequences?

In New York City, males account for 90% of K2-related emergency department visits. Patients have a median age of 37 and 99% of the patients are age 18 or older.

Why the concern?

There has been a rapid and significant increase in K2-related emergency department visits in New York City. These substances have the potential to be extremely harmful due to their severe adverse effects and a mistaken belief that they are a safe, legal alternative to marijuana.

How may I contact the Poison Control Center?

The Poison Control Center can be reached at (800) 222-1222 or by calling 311.
How can I report a store that is selling these products in New York City?
Call 311 to report retailers that are still selling these products.

Names under which these products are being sold include, but are not limited to: AK-47

Alice in Wonderland
Amped
Aroma
Atomic
Bath Salts
Bernie
Bizarro
Black Giant
Black Mamba
Bliss Plant Feeder
California Dreams
Caution
Cherry Blast
Chill X
Chronic Spice
Dafuq
Darkness
Demon
Diablo
Diesel
Dream Burner
Earth Impact
Extreme
Extreme Aroma Therapy
Fake Weed
Fire
Flame
Flamingo
Frog(e)
G-13
G-20
Galaxy
Galaxy Gold
Geeked Up
Genie
Green Giant
Herbal Incense
Hypnotic
iBlown
Ice Dragon
Jersey Shore
Joker
K2
K3
K3 Legal
K4
Kick Plant Feeder
Kisha Cole
Kronic
Makes Scents
Moon Rocks
Mr. Bad Guy
Mr. Nice Guy
Nirvana
Nuke 20x
One Wish
Phantom
Red Giant
Rocket Fuel
Scooby Snax
Scope
Scrubba
Sence
Skunk
Sky High
Smacked
Smiley Dog
Smoke
Sofa King Amazing
Solar Flare
SPACE
Space Truckin
Spice
Spice Gold
Spice Silver
Strong Incense
Sweet Leaf
Tiger Shark
Trippy
Tropical Blaze
Wet Lucy
White Tiger
Wicked X
Wow
XXX Ultra
You Only Live Once
Yucatan
Zohai

Drug Analysis in the Nederlands

The Dutch drug testing program does not allow for mailed-in samples (folks have to bring them in person) and they never publish individual results publicly, nor do they publish summaries contemporaneously. Only warnings about “dangerous drugs” are published soon after a sample’s analysis. Despite these limitations, the Nederlands Ministry of Health’s Drug Information and Monitoring System (DIMS) is one of the best testing projects in the world.

The DIMS Annual Report for 2015 says the project analyzed nearly 12,000 samples in 2015 alone.

Their program works by individuals bringing samples in to one of the approved locations, in person. In some cases (like with pharmaceutical tablets) the drug identification is provided immediately. In other cases (they do not specify frequency) they send the sample in to a lab and the individual who brought in the sample is given a unique code, which they can use to call back in a week and get the analysis result.

They had an amazing 28 physical locations in 2015 in a country the size of Ohio. Free testing, in every major city and some minor ones. NOt more than an hour’s transit away. There’s nothing else like it.

Some highlights (thanks roi):

  • 57% of the ecstasy pills they tested contained over 140 mg MDMA
  • The highest dose in an ecstasy tablet was 293 mg MDMA
  • Average cocaine purity was 64%
  • Average amphetamine purity was 46%
  • 4-FA (4-fluoroamphetamine) was the most tested “research chemical”
  • LSD blotter contained an average of 74 ug LSD
  • 27% of samples sold as “LSD” didn’t contain LSD
  • 11% of ketamine samples contained MXE or deschloroketamine
  • Average MDMA dose in tablets has greatly increased over the last 10 years
  • Amphetamine and cocaine purity slightly increased over the last 10 years
  • 2C-B tablets on average contain 11 mg 2C-B

Check out the PDF of the report:

Drugs Information and Monitoring System (DIMS) 2015 Annual Report [Cache]

The Church of Sleep – Sleepists & Dreamists

Fire had a dream last night where she went to a religious retreat that was oriented around “Sleep as Prayer”. Participants were required to sleep more than 12 hours, but could not stay in bed more than 16 “because it would attract the wrong sort”.

In the dream, “Somnambulation” was the term that stuck in her head. Beds lined up like military cots. Fire and Earth were coming in late and had to pull a bed out lengthwise, we had to pull it out in order to get into our spot because there was no walking path without rearranging the beds.

In what-seems-not-to-be-dream life, there is no question that we are believers in the Church of Sleep. Sleep cures physical and spiritual ailments of all sorts and scientifically brings us closer to the Atman / Buddha Mind.

And, of course, the curious, dubious, yet telling world of dreams.

Get back to work!

Into the Arms of Morpheus

First, sleep is good.

Second, I enjoy the double entendre (quadruple?) of “arms of Morpheus” of sleep and morphine, of unconsciousness, dream, and nightmare.

As a not opioid-phile myself, I do not have an association between sleep and opiates/opioids, but as a life-long serious insomniac, I have a strong association of sleep intertwined with medications, drugs, technologies, and the hard-fucking-work necessary to get my brain to go down.

And, once the sleep comes, am I lost in tax-law-complicated, mirrored puzzle box universes? Or will I just get some down time?

Usually the former. I long for more of the latter.

“Into the Arms of Morpheus” can imply both sleep and dreams, where dreams can also be nightmares. If one adds in opioids, there’s the additional meanings of sleep, death, and treating withdrawal effects.

P.S. Erowid Life Tip: For those with the same hyper-vigilant brain cycling: meditation is the art of not falling to sleep when the mind is at ‘rest’. Learning meditation techniques is super useful, but none of them are methodologies for putting the brain into unconsciousness.