The highly regarded neurologist, psychologist and author Oliver Sacks has released a podcast with the New Yorker and a video on his blog (embedded below), describing some of his experiences with cannabis, amphetamines and LSD. In the podcast Sacks describes the inspiration and insights he gained from using the drugs, including the effect on his writing and the increase in his ability to be empathic with patients, but in the video Sacks issues a stark warning in which he describes amphetamines as “the most dangerous drugs physiologically” due to the powerful impact on the reward pathway and the cardiovascular system.

The media coverage comes in the run up to the release of Sacks’ new book “Hallucinations” (due for release in November), which if his previous writings are anything to go by should prove to be a truly fascinating read. If Sacks’ work inspires you to want to know more on the topic, Henry Lester a professor of neuroscience at California Institute of Technology (Caltech) is coincidentally unveiling an introductory course on “Drugs and the Brain” this November which is completely free and available right from your home computer.

Update: Post mortem has confirmed that the Miami cannibal was not high on bath salts, LSD or synthetic cannabinoids.
A freak attack described as drug induced “zombie face eating” has hit international headlines this week. Until the results of a toxicological analysis emerge, the drug(s) involved is unknown and open to speculation. This has not stopped the newspapers, who understandably have gone absolutely bat-shit over the story. The Daily Mail has claimed the attacker was “high on LSD”, while the Guardian initially claimed the assailant was “under the influence of a potent LSD-like drug called bath salts”, the Guardian went on to make the bizarre claim that the assailant had taken “the delirium-inducing drug, which is similar to cocaine and other forms of LSD” – as if cocaine is a form of LSD. The Guardian have now “corrected” the piece to state that “the delirium-inducing drug, which can have effects similar to cocaine and LSD” – as if the effects of LSD and cocaine are similar. Reading a local news report goes some distance in helping us understand how matters have been confused, a head of Miami police has stated: “We have seen, already, three or four cases that are exactly like this where some people have admitted taking LSD and it’s no different than cocaine psychosis”, clearly misinformed local police have also reportedly used the phrase “bad LSD”. It’s unclear precisely what previous cases of acid-fuelled-zombie-face-eating the Miami police are referring to, it seems the media and the Miami police have jumped on LSD with zero evidence, apparently confusing LSD with the disease in 28 days Later. It seems far more probable that if this attack is connected to drugs, the attacker was in a severe state of stimulant induced psychosis as opposed to being under the influence of psychedelics.

Just in case it isn’t clear from the two reports above, the proposal that the assailant had consumed the famously tranquil hallucinogen depicted below is pure uninformed speculation, the idea that this could be the result of a “bad batch of LSD” is completely nonsensical and appears to be based on utterly uniformed conjecture.

A closer reading of the news reports reveals that rather than LSD, a chemical listed as one of the safest psychoactive drugs in relative terms (Nutt et al, 2010), it is now being reported that the assailant was under the influence of an unspecified drug known as a “bath salt”. Bath salts are not unique to the US, in some areas of the UK, a study (Measham et al, 2011) found that self reported use of “bubble” was higher than for mephedrone or amphetamines. 18% of people asked reported having taken “bubble” whilst amphetamine use in the past month crashed to 3% compared to 9% for bubble. “Survey respondents were not only unclear about, but also apparently unconcerned about the specific chemical identity of the stimulant white powders they consume”… “a considerable number of respondents were adamant that they had never heard of mephedrone but that they had taken Bubble”.

It is impossible to estimate the harms of cocktails of drugs which neither user nor dealer knows the contents of, the risks are exacerbated by the complete obliteration of harm reduction strategies such as basic dosage management that rely on users understanding what drug they are consuming.

Both the danger and sudden prevalence of unknown white powders is a direct result of government restrictions on the precursors of relatively safe drugs such as LSD and MDMA and the clamp down on labs producing pure alternatives such as Mephedrone. The end result is that drug developers are rushing endless new drugs on to the market place in order to stay ahead of legislation and now more worryingly, producers are avoiding labelling their produce in an attempt to help distributors stay at least one step ahead of the plods on the ground. This vicious circle is unhealthy in the extreme and is being entirely fuelled by zero tolerance legislation. The zombie case may prove to be just one possible result of what can happen when a policy of harm reduction becomes a policy of harm maximisation.

What was in the bath salts?

The million dollar question remains, what were the chemicals in the “bath salts” that are reported to be involved? It is worth noting that this incident is clearly an unusual occurrence, the incident can certainly not be described as typical of any single drug. Far from LSD or even formerly popular legal chemicals such as mephedrone, the consensus among speculators appears to be that the “zombie face eater”, in addition to likely having an undiagnosed pre-existing mental condition, may have been in a state of severe drug induced psychosis and/or may have taken something more along the lines of a PCP analogue. This is obviously pure guess work, however PCP is known for its astounding ability to precipitate psychosis, bizarre behaviour and extreme violence. It has even been linked to cases of cannibalism in the past, cases such as this are of course rare and heavily publicised but the fact that people are now taking drugs blindly as a matter of course, the contents of which may contain substances they are utterly unprepared for is extremely worrying. Another key factor pointing to PCP is that it is well known that PCP users are prone to getting naked and becoming violent. Another popular guess that may be more grounded in reality is that the drug could be MDPV, a drug with a thoroughly unpleasant reputation that has been known to be marketed as bath salts in the past. These guesses are of course, absolute speculation based on the apparently unfounded claim that “bath salts” were involved, judging by the fact that the event occurred in down-town Miami it seems perhaps more logical to propose that the attacker might have been using old fashioned nasties such as crack or crystal methamphetamine. We will not discover what the drug was that the “zombie face eater” had taken until after a forensic investigation, this goes to once again underline the danger of “bath salts”, until they are tested we simply do not know what is in them. It is certainly worth taking this particular horror story with a pinch of salt, the assailant had previous convictions for beating his own mother in 1994, on this day he was the first person to ever be tasered by his local police force. It therefore seems clear that whatever drug he took, it was not the only factor at play.

 References:

Measham,F. Moore, K. Østergaard, j. (2911). Mephedrone, “Bubble” and unidentified white powders: the contested identities of synthetic “legal highs”, Drugs and Alcohol Today, 11 (3), 137-146 (PDF)

Nutt, D., King, L., & Phillips, L. (2010). Drug harms in the UK: a multicriteria decision analysis The Lancet, 376 (9752), 1558-1565 DOI: 10.1016/S0140-6736(10)61462-6 (Subscribe to the Lancet fore free for access)