Psychedelic microdosing is the trending practice of using tiny repeated doses of psychedelic substances to facilitate a range of supposed benefits. With only a few published studies to date, the ...subject is still under-researched, and more knowledge is warranted. Social media and internet discussion forums have played a vital role in the growing visibility of the microdosing phenomenon, and the present study utilized YouTube contents to improve comprehension of the microdosing practice as well as the social interactions and discussions around microdosing.
Microdosing self-disclosure in YouTube videos and their following comments were qualitatively analyzed by inductive thematic analysis. Various software was utilized to enable gathering and sorting relevant data.
Microdosing of psychedelic substances, primarily LSD and psilocybin, was used for therapeutic and enhancement purposes, and predominantly beneficial effects were reported. Many different applications and outcomes were discussed, and therapeutic effects for depression appeared especially noteworthy. Intentions for use were recognized as an influencing factor for the progression and outcomes of microdosing. The function of social interactions was mainly to discuss views on the microdosing phenomenon, strategies for optimal results, minimize risks, and share emotional support.
Potentially, microdosing could provide some of the same benefits (for certain conditions) as full-dose interventions with less risk of adverse reactions related to the sometimes intense experiences of higher doses. Microdosing may well also mean additional benefits, as well as risks, through the repeated exposure over extended periods.
Aim:
The purpose of this qualitative study was to investigate the effects experienced by users of a novel psychoactive substance, the benzodiazepine flubromazolam, by analysing users’ own accounts on ...the Swedish forum Flashback.org.
Method:
A thematic analysis of anonymous self-reports published on the forum was performed and generated five general themes describing effects and experiences by flubromazolam users.
Results:
The themes which emerged were: Onset and duration, Desired effects, Adverse effects and addiction, Loss of control, General estimations and evaluations. The main reported characteristics of flubromazolam were heavy hypnotic and sedative effects, long-lasting amnesiac effects and the rapid development of tolerance. Flubromazolam was also anxiolytic and acted as a muscle relaxant for many users. Some users experienced euphoria or intense wellbeing. Other prominent characteristics were loss of control (leading to poor choices and actions, with unpleasant consequences) and long-lasting, often severe withdrawals. There were also serious incidents where users had been admitted to hospital, acute psychiatric treatment or taken into custody by the police.
Conclusion:
Flubromazolam appears to be a highly addictive and precarious benzodiazepine with many, possibly severe, side effects. The substance is generally described as very potent and with long-lasting effects. Memory loss and loss of control are common adverse effects, and withdrawals appear to be severe for many users.
Treatment resistant cluster headache and migraine patients are exploring alternative treatments online. The aim of this study was to improve comprehension regarding the use of non-established or ...alternative pharmacological treatments used by sufferers of cluster headaches and migraines.
A qualitative thematic analysis of the users' own accounts presented in online forum discussions were conducted. The forum boards https://shroomery.org/ , http://bluelight.org , and https://clusterbusters.org/ met the inclusion criteria and were used for the study.
The analysis resulted in six themes: a desperate need for effective treatments; the role of the forum-finding alternative treatments and community support; alternative treatment substances; dosage and regimens; effects and treatment results; and adverse effects. The results provide an insight into why, how, and by which substances and methods sufferers seek relief from cluster headache and migraines.
These patients are in a desperate and vulnerable situation, and illicit psychoactive substances are often considered a last resort. There appeared to be little or no interest in psychoactive effects per se as these were rather tolerated or avoided by using sub-psychoactive doses. Primarily, psilocybin, lysergic acid diethylamide, and related psychedelic tryptamines were reportedly effective for both prophylactic and acute treatment of cluster headache and migraines. Treatment results with cannabis were more unpredictable. No severe adverse events were reported, but it was observed how desperation sometimes spurred risky behavior when obtaining and testing various treatment alternatives. The forum discourse mainly revolved around maximizing treatment results and minimizing potential harms.
Background
Burnout is a hidden productivity killer in organizations. Finding a solution to efficiently measure and proactively prevent or rehabilitate employees with burnout is a challenge. To meet ...this unabated demand, companies and caregivers can focus on proactive measures to prevent “Burnout as an Occupational Phenomenon.”
Objective
We aimed to address effectiveness, reliability, and validity of the empowerment for participation (EFP) batch of assessments to measure burnout risk in relation to the efficacy of web-based interventions using cognitive behavioral therapy (CBT) and floating to improve mental health and well-being. We introduced three risk assessments: risk for burnout, risk of anxiety, and risk for depression.
Methods
We used an interventional, empirical, and parallel design using raw EFP psychometric data to measure the effectiveness of web-based therapy to reduce the risk of burnout between a control group and web-based therapy group. A total of 50 participants were selected. The rehabilitation and control groups consisted of 25 normally distributed employees each. The rehabilitation group received therapy, whereas the control group had not yet received any form of therapy. IBM SPSS was used to analyze the data collected, and a repeated measures ANOVA, an analysis of covariance, a discriminant analysis, and a construct validity analysis were used to test for reliability and validity. The group was selected from a list of employees within the My-E-Health ecosystem who showed a moderate or high risk for burnout. All assessments and mixed-method CBT were web-based, and floating was conducted at designated locations. The complete EFP assessment was integrated into a digital ecosystem designed for this purpose and therapy, offering a secure and encrypted ecosystem.
Results
There was a statistically significant difference between pre- and postassessment scores for burnout. The reliability of the burnout measure was good (Cronbach α=.858; mean 1.826, SD 3.008; Cohen d=0.607; P<.001) with a high validity of 0.9420. A paired samples 2-tailed test showed a good t score of 4.292 and P<.001, with a good effect size, Cohen d=0.607. Web-based therapy reduced the risk for burnout in participants compared with the control group. Tests of between-subject effects show F=16.964, a significant difference between the control group and the web-based therapy group: P<.001, with movement between the group variables of 0.261 or 26.1% for the dependent variable.
Conclusions
This study suggests good reliability and validity of using web-based interventional mixed methods CBT to reduce the risk of burnout. The EFP batch of web-based assessments could reliably identify morbidity risk levels and successfully measure clinical interventions and rehabilitation with consistently reliable results to serve as both a diagnostic and therapeutic tool worthy of major research in the future.
Trial Registration
ClinicalTrials.gov NCT05343208; https://clinicaltrials.gov/ct2/show/NCT05343208
Background:
New troublesome drug trends constitute a challenge for public health. Sweden has the second highest drug-related mortality rate in Europe. This calls for an investigation into the ...help-seeking attitudes of young adults to early middle-aged individuals asking how they would act in acute drug-related emergency or overdose situations.
Methods:
In total, 1232 individuals completed an online survey promoted on Sweden’s largest discussion forum Flashback.org. Their free-text responses were analysed according to inductively generated categories.
Results:
Around 60% of the sample would act as expected and contact emergency care without hesitation. However, approximately 32% of the sample showed palpable resistance and would put off seeking help and use emergency care only as a last resort due to, for example, fear of legal repercussions and stigma. Moreover, 8% displayed a total lack of confidence in public healthcare and would avoid it at all costs or entirely disregard it as an option due to the alleged risk of negative consequences and experienced restrictions on their personal freedom.
Conclusions:
While the inevitable criminalisation and stigmatisation associated with Sweden’s “zero tolerance” drug policy putatively serve as deterrents to drug use, our results demonstrate that these measures may also contribute to attitudes which discourage help-seeking. Such attitudes may at least partly explain the growing and comparatively high number of drug-induced deaths. Therefore, attitudinal and structural barriers to acute help-seeking in drug-related emergency situations should be acknowledged and investigated further in order to minimise harm.
Ethylphenidate is a novel psychoactive substance with undocumented effects, risks, and motivation for use. In this study, we investigated the experience of ethylphenidate by analyzing self-reports ...published on Internet forums, which revealed seven overarching themes: (1) compulsive redosing and addiction; (2) impacts on the mental state; (3) bodily agitation; (4) increased sociableness; (5) administration; (6) diverse evaluations based on intention; and (7) safety and precaution. Ethylphenidate appeared as a potent psychostimulant with an imminent abuse potential. It was mainly used for recreational purposes. The effects included not only pleasurable stimulation, euphoria, and cognitive enhancement but also indecisiveness, anxiety, and cognitive fragmentation. The users reported an increase in body temperature, heart rate, and blood pressure, but they also experienced profuse sweating and muscle tension. Ethylphenidate acted as a social lubricant, enhancing intimacy, communication, and social skills. Two opposing user mentalities were uncovered: (1) pleasure seeking and risk neglecting, and (2) safety-first orientation. This information could be of importance to legislators, public health personnel, and prevention strategists.
Spice is a smoking mixture containing synthetic cannabinoids with psychoactive effects similar to herbal cannabis. It is sold on the Internet and has become popular among young people. The purpose of ...the present study was to investigate experiences of intoxication induced by Spice, as described on a Swedish internet-based discussion forum. A systematic search yielded 40 reports, which were analyzed using phenomenological method. A total of 7 themes (composed of 27 categories) emerged from the analysis: 1. Spice use as social ritual; 2. Social secretiveness; 3. Intoxication remarks; 4. Well-being and elation; 5. Altered perception of reality; 6. Fears and coping; 7. Unpleasant physical effects. The results show that smoking was a social activity mostly carried out in small peer-groups, and that the substances induced strong intoxication with both positive and negative effects. Despite fears and unpleasant effects, the intoxication was often considered fascinating and rewarding.
Background
Synthetic cannabinoids in smoking mixtures (such as Spice) or as raw powder are sold for recreational use as an alternative to herbal cannabis (hashish and marijuana). Although clinical ...case studies have documented an array of side effects, there is also information available at Internet based drug discussion forums.
Aim
Our study investigates experiences of side effects from use of synthetic cannabinoids, as described and anonymously shared on Swedish online discussion forums.
Methods
A systematic search yielded 254 unique and publicly available self-reports from the Swedish forum flashback.org. These texts were analysed thematically, which resulted in 32 sub-themes, which were combined into three overarching themes.
Results & Conclusion
The experiences of negative side effects were described as (1) Adverse reactions during acute intoxication; (2) Hangover the day after intoxication; (3) Dependency and withdrawal after long-term use. The first theme was characterized by an array of fierce and unpredictable side effects as tachycardia, anxiety, fear and nausea. The acute intoxication reactions were congruent with the side effects published in clinical case studies. The day after intoxication included residual effects of dullness, apathy, nausea and headache. Long-term use resulted in dependency and experiences of being emotionally numb and disconnected. Furthermore, withdrawal was described as sweating, shaking, loss of appetite and insomnia. Both the hangover and the long-term effects have previously been given little scientific attention and need to be investigated further. Drug related Internet discussion forums constitute an overlooked source of information which can aid in the identification of previously unknown risks and effects.
The increasing number of Novel Psychoactive Substances (NPS) constitutes a challenge for public health agencies and researchers worldwide. Scientific studies about NPS and their users are limited and ...there is a need to explore the general motivations for NPS use but also to examine if and how the motivations differ between substances from separate effect classes. The aim of the present study was to investigate the characteristics, including attitudes and motivations, of a self-selected sample of international NPS users.
An online survey containing questions about drug use history, attitudes, motivations for use, and WHO-5 Wellbeing Index was promoted at the drug discussion forum bluelight.org. The data was analysed using SPSS.
The sample consisted of 619 international NPS users with overall good emotional well-being despite extensive experience of both traditional and novel drugs. The main incentive for use of NPS in general was pleasure and enjoyment. However, going beyond the general approach to NPS revealed significant variations between drug groups. For example, the use of hallucinogens was substantially motivated by self-exploration and spiritual attainment and showed very low levels of addiction potential while the use of opioids and especially GABA activating substances was mainly motivated by coping and showed much higher levels of addiction potential. Synthetic cannabinoids were the least appreciated and least likely to be used again, and were mainly motivated by circumstances such as availability and legality.
Understanding the different motivations for NPS use in terms of drug groups could enable more effective prevention and consequently a reduction in harm.
Novel psychoactive substances (NPS) are continuously and increasingly appearing on the international drug market. Global Internet forums are a publicly available reality where users anonymously ...discuss and share information about NPS. The aim of this study was to explore and characterize the discussions about NPS on international Internet forums.
The most post-frequent NPS discussions were collected from three "leading edge" international Internet forums. A total of 13,082 posts from 60 threads of discussion were systematically examined and interpreted to reveal recurring topics and patterns. Each thread was coded with emerging topics and supporting quotations from the data set. Eventually, codes with coherent meaning were arranged into 51 broader categories of abstraction, which were combined into four overarching themes.
Four themes emerged during the analysis: (1) uncovering the substance facts, (2) dosage and administration, (3) subjectively experienced effects, and (4) support and safety. The first theme dealt primarily with substance identification, pharmacology, and assessed not only purity but also legal status and acquisition. The second theme focused on administration techniques, dose recommendations, technical talk about equipment, and preferred settings for drug use. The third theme involved a multitude of self-reported experiences, in which many different aspects of intoxication were depicted in great detail. The users emphasized both positive and negative experiences. The last theme incorporated the efforts of the communities to prevent and minimize harm by sharing information about potential risks of the harmful effects or contraindications of a substance. Also, online support and guidance were given to intoxicated persons who experienced bad or fearful reactions.
The findings showed that the discussions were characterized by a social process in which users supported each other and exchanged an extensive and cumulative amount of knowledge about NPS and how to use them safely. Although this publicly available knowledge could entail an increase in drug use, the main characteristics of the discussions in general were a concern for safety and harm reduction, not for recruiting new users. Drug-related Internet forums could be used as a location for drug prevention, as well as a source of information for further research about NPS.
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