New Ways to Use Old Drugs: Innovative Research on Controlled Substances

A male pharmacist dressed in a white coat is standing next to tall shelves of pharmacy inventory and examining a drug.

With every passing year, research continues to reveal new findings that demand changes to how we address medical conditions. New best practices, technologies, and medications can dramatically improve the quality of life for countless individuals. The field of healthcare faces countless challenges, and continued innovation is necessary to ensure optimal patient outcomes. 

However, rules and regulations can make adapting to the changing medical landscape difficult. This is particularly true when it comes to alternative medicines. Controlled substances that have great potential to handle health concerns, such as chronic pain and anxiety, are often prohibited due to legal restrictions and unfair biases. Nevertheless, innovative medical research has revealed many potential use cases that make such drugs serious contenders for widespread use. 

Interested in learning more? This article will discuss research about five controlled substances that could reshape healthcare.

Ketamine

Ketamine is an established medication in healthcare that can be used as an anesthetic due to its ability to induce a loss of consciousness in patients. Nevertheless, it has earned a bad reputation due to its widespread abuse as an inexpensive club drug under street names such as “Special K,” “Vitamin K,” or “Jet.”

Ketamine has been approved for hospital use as a class III scheduled drug for many years, and it has seen use in many battlefields and operating rooms over the past 50 years. Typically administered intravenously, it is currently used for acute and chronic pain management and anti-inflammation.

But could this drug have more applications in modern healthcare? In recent years, ketamine has seen growing support as a potential solution to treat depression and anxiety. As noted by Dr. Robert C. Meisner, writing for Harvard Medical School, “If a person responds to ketamine, it can rapidly reduce suicidality (life-threatening thoughts and acts) and relieve other serious symptoms of depression.” 

Meisner notes, however, that “It’s not entirely clear how ketamine works … (I)t exerts an antidepressant effect through a new mechanism.” He concludes that ketamine likely targets NMDA receptors in the brain, helping neurons communicate along new pathways and improving mood and cognition. Ketamine may be a powerful tool in how we address depression — particularly for individuals who do not improve with available antidepressants. 

More research must be completed before ketamine can see widespread use in this capacity. Further, healthcare practitioners must be watchful for potential side effects, including issues like blurred vision, dizziness, nausea, and insomnia. Gaining a greater understanding of this drug, as well as methods to avoid or mitigate side effects, is vital to unlocking its full potential for treating depression.

Marijuana

Marijuana, often called “pot,” “weed,” or “Mary Jane,” is the dried leaves and flowers of the cannabis plant. While marijuana is still illegal on the federal level, it is growing in popularity in states where it has been legalized — including in healthcare facilities. With growing public acceptance and availability, including easing regulations on medical use, marijuana has begun to make a major impact on healthcare innovation.

Marijuana contains mind-altering compounds, like THC, and other non-psychoactive active compounds, like CBD. The former can cause a pleasurable “high” that releases dopamine in the brain, while the latter contributes to a variety of other mental and physical effects. When taken in excess, THC can lead to short-term memory issues, mood changes, impaired cognitive function, hallucinations, and delusions. Studies suggest long-term use may impact brain development, though there is much contradictory research and debate on such effects.

The FDA has approved some cannabinoid medicines to treat seizures, as well as some symptoms of chemotherapy. Marijuana also has many properties that make it a useful drug for individuals with Crohn’s disease, eating disorders, glaucoma, multiple sclerosis, and a variety of mental health conditions, among other concerns.

Recently, marijuana has begun to see increased use as a medication for pain relief, particularly after surgeries. While doctors must weigh the risks outlined above, many find that it is a far safer alternative to opiates. Indeed, medical marijuana prescriptions have been linked to better patient outcomes. As research on medical marijuana use continues, it may see even further use in healthcare.

CBD 

As noted above, CBD (short for “cannabidiol”) is a chemical compound found in cannabis. It is generally a legal product throughout the U.S. It can be administered as an oil, through topical ointments, or via CBD concentrates.

CBD is now popular as a natural remedy for a wide variety of medical concerns. It is primarily used to treat seizures and epilepsy, though research indicates that CBD has anti-inflammatory and analgesic properties. It also improves cardiovascular function and has been proven to help with pain management, among many other benefits.

Unlike marijuana, which includes THC, CBD has no psychoactive components. As such, many of the negative side effects and risks outlined above for marijuana do not apply to this drug. Known side effects for CBD are minor and include dry mouth, diarrhea, and fatigue. It’s also important to discuss CBD use with your doctor, as it can interact with other medications (such as blood thinners).

As with other controlled substances in this list, further studies are required to assess the full range of potential benefits of CBD. Until these are well-known in the medical community, CBD use in healthcare settings will be restricted to FDA-approved medications such as Epidiolex, a seizure medication.

Psilocybin

Psilocybin is a schedule-I controlled, hallucinogenic substance found in specific types of mushrooms. Colloquially known as “magic mushrooms,” psilocybin provides feelings of euphoria, though the substance is not addictive. Users may experience hallucinations, which are sometimes accompanied by feelings of anxiety. Other side effects include dizziness, fatigue, and impaired cognitive function.

In healthcare research facilities, psilocybin has begun to see limited use to address depression, obsessive-compulsive disorder, or end-of-life distress. Healthline notes that psilocybin has a number of potential medical benefits: it has been used to address addiction, and it has been used effectively in smoking cessation programs. Research points to a variety of benefits, including improved mood and enhanced neurological connectivity.

Psilocybin is unlikely to see widespread use in healthcare in the near future. Healthline continues, “Unlike marijuana, which has seen a dramatic shift both in terms of support of legalization and recognized therapeutic uses … psilocybin lacks the same degree of cultural cachet.” Nevertheless, this substance may see a gradual increase in support over the years as research continues to reveal its many benefits. While frightening hallucinations may impact some users and necessitate some caution, its applications in the medical world cannot be ignored.

LSD

LSD, which stands for “lysergic acid diethylamide” and is commonly referred to as simply “acid,” is a potent synthetic compound that has strong hallucinogenic effects. LSD intoxication, known as taking an “acid trip,” can lead to serious sensory distortions, including changes in how users perceive time. These trips can lead to feelings of contentment and euphoria, but they can also lead to fear and sadness; these are referred to as “good trips” and “bad trips,” respectively.

These changes are caused by how LSD impacts the brain. While current research presents conflicting interpretations of how LSD affects the brain, there is evidence that LSD affects how our brains process serotonin and dopamine. When taken in moderation, this may help patients with depression, anxiety, or obsessive-compulsive disorder refocus their thoughts in more productive directions.
LSD trials have been limited, but they indicate that it may be an effective drug for treating a variety of mental health conditions. For instance, one study assessed LSD’s viability as a therapeutic treatment for alcohol addiction, and it found that subjects experienced “improved levels of optimism and positivity, as well as an increased capacity to face their problems.” While there is much more to learn through further research, LSD should not be dismissed merely as a street drug.

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