The Molecule That Got Misunderstood No neurotransmitter carries a heavier pop-culture burden than dopamine: it is the pleasure molecule, the chemical of reward, the neurobiological explanation of everything enjoyable from chocolate to cocaine to Instagram, the word that headlines the self-help books and the productivity podcasts. The science, however, has moved far past the pleasure […]
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The Virus the System Refused to Cure for Decades Hepatitis C is the injection-drug-using population's most prevalent infectious disease (the majority of the Americans living with the virus having acquired it through injection, the seroprevalence of the older injection cohorts running far above half in the studies), the leading cause of the chronic liver disease […]
The Neurotransmitter Behind the Renaissance's Next Chapter If the serotonergic system was the first golden age's star and the dopamine system the addiction literature's, the glutamate system is the current era's emerging protagonist: the brain's most abundant excitatory neurotransmitter, the workhorse of nearly every neural circuit, and the mechanism behind the renaissance's most consequential recent […]
The Tobacco Harm Reduction Sweden Built While the world's nicotine debates cycle between cigarettes and vapes, Sweden quietly ran the largest tobacco harm reduction experiment in history and produced a result that the rest of the world keeps rediscovering: a nation that switched, at population scale, from smoking to a smokeless oral tobacco product, and […]
The Two Men Behind the Era's Signature Acid Every mythology needs its craftsmen, and the 1960s psychedelic mythology's were the chemists: the anonymous laboratory workers whose product made the era's experiences possible and whose names, unknown to most of the users, anchored the era's pharmacological reality. The most consequential were two: Tim Scully and Nick […]
The Alphabet Beyond THC and CBD The cannabis plant produces well over a hundred cannabinoids, but the market and the research have concentrated, almost exclusively, on the two famous ones: THC, the intoxicant, and CBD, the non-intoxicant that earned pharmaceutical legitimacy. The rest, the so-called minor cannabinoids (CBN, CBG, CBC, THCV, and the longer tail), […]
The Panic That Outran the Pharmacology During the fentanyl era's rise, a new phenomenon appeared in American policing and emergency response: the officer or the deputy who reported exposure to fentanyl powder, then developed the overdose symptoms (the dizziness, the nausea, the racing heart, the collapse) on the scene, sometimes captured on the body cameras […]
The Body's Infrastructure and How to Keep It For people who inject drugs, the veins are the infrastructure, and the infrastructure's maintenance is the difference between years of manageable use and the cascade of complications (the abscesses and the infections and the collapsed veins and the endocarditis of the companion posts) that the unsafe-injection practices […]
When the Party Moves to the Screen The convergence of smartphone apps, specific drugs, and sexual culture has produced one of the most consequential and least publicly discussed drug phenomena of the past decade: chemsex, the intentional use of drugs (most prominently methamphetamine, GHB and GBL, and mephedrone) in sexual contexts, concentrated in gay and […]
The Pill That Changed the Epidemic, and Who It Has Not Reached In 2012, the FDA approved pre-exposure prophylaxis (PrEP): a daily pill (tenofovir-emtricitabine, the antiretrovirals that treat HIV repurposed as prevention) that reduces the risk of acquiring HIV through sexual contact by roughly 99 percent when taken as prescribed, one of the most effective […]