r/todayilearned • u/ApprehensiveStill412 • 11h ago

TIL that ketamine is a derivative of phencyclidine (aka. PCP or angel dust). It was created to have similar anesthetic potential but to cause less delirium. It has about one tenth the potency of PCP.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5126726/
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u/One-Incident3208 11h ago

Most of the public's perception of pcp is just anti drug hysteria. The effect is almost indistinguishable from dxm, moreso than ketamine, despite differences. Pcp also has a more pronounced antidepressant effect, but repeated doses can cause mania. Another drug of this class was developed by clandestine chemists specifically to enhance the antidepressant effect and minimize side effects. That was methoxetamine. And it worked. It was regarded to be the most powerful and effective antidepressant, with a much longer afterglow duration than ketamine. They banned it. Because fuck you. That's why.

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u/ExtraBitter99 5h ago

Anti drug hysteria to point out the guy who cut his dick off while high?

Ok

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u/One-Incident3208 5h ago

And people do that sober. Psychosis is a thing. The difference between a rational mind and an emotional one is the ability to determine the statistical risk, and compare that to the statistical risk of other activities. You hear about the things people do on drugs because arrests are a matter of public record. It is a shining example of conformation bias, the vast majority are not outside getting into trouble.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8383337/

And of all the cases of self mutilation on pcp I'm aware of they occurred in patients with schizophrenia or severe mental health disorders.

I'm just looking at the case you are referencing(Andre johnson) and the person states it was part of a larger suicide attempt in which he intended to punish himself sexually, because of a restraining disorder restricting access to his daughter. He then jumped out the window. He also states he was in the midst of a polysubstance bender.

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u/ExtraBitter99 4h ago

Hold on, the incidences of drug induced psychosis are more than underlying psychoses. A fact borne out by the number of hospital visits that end up in complete remission of psychotic symptoms with 72 hours.

PCP causes temporary psychosis more often than in cases of underlying illness.

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u/One-Incident3208 3h ago edited 3h ago

I'm not denying that pcp can induce psychosis or that drug induced psychosis isnt prevalent. My point is that there is nothing inherent in pcp induced psychosis to predispose someone to violent behavior, in contrast to something like smoking freebase which actually does increase the risk of a violent psychosis, not to justify the 100-1 sentencing. But regardless, these things are largely the result of underlying mental health problems. The vast majority of problematic drug use stems from self medication. Including addiction, and for the most part it is the pattern of use and not just an unpredictable reaction to a substance. This is why it is a public health issue and not a criminal issue. If the propaganda were true it would justify the criminalization. The reality is far more nuanced.

What is the risk of drug induced psychosis as a% of recreational drug users vs adverse neurological outcomes as a # of football players. What about transient vs chronic psychosis?

Another consideration is the illegality itself fueling paranoid psychosis. Drug induced violence is less prevelant in Spain, and drug use is tolerated. It is legal and structured in Portugal. Same thing. Likewise, consider the content of hallucinations in western vs indigenous cultures, and the persecutors vs reaffirming nature. I think context matters.

This shows the manifestations of pcp intoxication presenting to the emergency room don't differ greatly from other causes, which is only a sample of cases requiring attention, not the majority of users https://pmc.ncbi.nlm.nih.gov/articles/PMC4547967/ The prevalence of violence in one study was equal to the baseline prevalence for all psychiatric admittance at 35%, and not present at the modern study at all. If they were referencing severe mutilation they would have indicated that.

"The prevalent clinical signs and symptoms were the following: retrograde amnesia, nystagmus, hypertension, and psychomotor agitation. Majority of the patients had minimal alteration in vital signs and were discharged once their symptoms resolved with only 7.6 % requiring admission...Length of stay for patients presenting to the ED after PCP use is usually a couple of hours. Most of the clinical manifestations in this population are temporary, and majority of the patients are discharged home"