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NAME THAT DRUG BY DR. KIM SAMANO AND AARON ATKINSON, QUEST DIAGNOSTICS


Penicillin for the Soul O


riginally created during the development of other drugs to help stop bleeding, our mystery drug


got its start in Germany in 1912. Merck patented the compound in 1914, believing that it would act as a precursor drug with pharmaceutical value. Several decades passed before further development would take place in the 1950s, and the drug next resurfaced during the Cold War when the U.S. Army and CIA experimented with it and other hallucinogenic drugs as potential psychological weapons. Despite the fact that the drug never underwent formal clinical trials and did not received approval from the U.S. Food and Drug Administration (FDA) for human use, in the 1970s, a psychotherapist by the name of Leo Zeff popularized the drug as a psychotherapeutic tool, believing it made patients more willing to engage in the therapeutic process. By the 1980s, it had become a popular recreational and party drug, and in 1984 it was listed as a Schedule 1 drug under the Controlled Substances Act, meaning it had a high potential for abuse and no real medicinal value. It wasn’t until the late 2000s that the FDA first approved a small clinical trial of the drug, allowing some medical researchers to conduct controlled experiments, particularly focused on the drug’s potential to help treat post-traumatic stress disorder (PTSD), depression, anxiety, and other behavioral problems. And in 2008, our mystery drug was added to the list of drugs tested under the Department of Health and Human Services’ (HHS) Mandatory Guidelines. While it is sometimes snorted or


smoked, our drug is generally taken by mouth and is usually ingested as a pill, capsule, or tablet. Te pills can differ in colors, and sometimes have cartoon-like


36 datia focus


images, supplier logos, or words imprinted on them. Other forms of the drug, including it’s pure, crystalline powder, are oſten sold in capsules. In an effort to increase volume, suppliers oſten mix or “cut” the pure form of the drug with a variety of substances including caffeine, cough suppressants, ephedrine, and other illicit compounds. As with many drugs of abuse, it’s also common for users to consume this drug in combination with other substances like alcohol, ketamine, LSD, and marijuana. Te drug increases the release and slows


the reuptake of multiple neurotransmiters in key parts of the brain which lead to feelings of increased empathy, euphoria, relaxation, and inner peace while producing heighted sensations, perception, sexuality, and increases in locomotion. Our drug reaches maximal concentrations in the blood stream between 90 minutes and three hours aſter ingestion. It is then slowly metabolized and excreted, with a duration of action around three to six hours. Te drug is metabolized by the liver to another psychoactive metabolite commonly monitored by drug testing laboratories with parent drug and metabolite usually detected in the urine for up to one to two days aſter initial use. Drug testing laboratories generally employ commercially-available immunoassay techniques for initial screening, with confirmation testing by more definitive methods such as gas-chromatography- mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Involuntary teeth grinding, blurred vision,


nausea, sweating, muscle cramping and chills are commonly reported adverse effects of the drug. Residual drug effects can last for approximately one week aſter ingestion and include depression, anxiety, and loss


of appetite and sex drive with disturbances in personality, memory and sleep encountered. Some fatalities have been reported due to increased body temperature (hyperthermia) and organ failure alone or in combination with water intoxication and subsequent hyponatremia (excessively low sodium concentrations in the blood) as users atempt to thwart dehydration by consuming excessive amounts of water. While the list of adverse effects is long


and startling, of even more concern is the impact the drug may have on the brain and brain chemistry of its long- term users. Studies suggest that the loss of serotonin-containing nerve endings following repeated exposure to the drug can result in depression and issues with memory and focus. Tere is also evidence of neurodegeneration and changes in areas of the brain responsible for decision making, learning, memory, and complex thought processing with continued drug use. Interestingly, our mystery drug is currently in clinical trials as a treatment for social anxiety in adults with autism and for post-traumatic stress and anxiety disorders in the terminally ill. Listed under the United National


Convention on Psychotropic Substances, the drug is generally illegal in most countries. However, the 2016 World Drug Report published findings indicating that in 2014 there were 19.4 million users of this drug worldwide. According to data


fall 2017


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