Five Minutes in the Wrong Direction Every psychedelic in this series shares one assumption: the experience, however strange, is generally recognizable as an experience, something that happens to a self that persists through it. Salvia divinorum breaks even that. The Mazatec sacred plant, whose name means "sage of the diviners," produces an experience that users […]
Category Archives: Articles
The Upper That Never Left Cocaine has been a fixture of the pharmacological landscape for over a century and a half, and its modern profile is a study in contradiction: a drug with a genuinely modest acute-overdeath profile relative to its reputation, a genuinely serious chronic cardiac burden that accumulates invisibly, a compulsion profile so […]
Where the Need Is Highest and the Resistance Is Hardest The logic of harm reduction is most acute precisely where it is least welcome: inside prisons. Incarcerated people use drugs at rates far exceeding the general population; the drugs available inside are the most contaminated and unpredictable in the supply (the smuggling chain filters for […]
The One-Trip Detox That Might Actually Be One Trip Every treatment in addiction medicine is a maintenance strategy. Methadone replaces heroin daily. Buprenorphine daily. Naltrexone daily. Even the best psychotherapies work session by session, forever. And then there is ibogaine, a compound from the West African shrub Tabernanthe iboga about which the most extraordinary claim […]
The Most Common Use Case Nobody Studied Migraine is among the most prevalent disabling conditions on earth, affecting roughly a billion people, and cannabis use among migraineurs is proportionally enormous: surveys consistently find that a large fraction of migraine patients have used cannabis for their attacks, and patient-report studies describe meaningful relief rates that, if […]
The Cough Medicine Problem Dextromethorphan is the most quietly consequential drug in the American household. It sits in nearly every medicine cabinet in the country, the active ingredient in Robitussin, Delsym, NyQuil, and a hundred store-brand cough syrups, available without prescription at every pharmacy and grocery store, bought without question by parents and teenagers alike. […]
The Claim the Market Was Built On Chronic pain is the engine of the medical cannabis market. It is the most common qualifying condition in every medical program, the reason most patients cite in surveys, and the indication the state ballot measures leaned on hardest in the political campaigns that built the legal landscape. It […]
The Quietest Drug in the Room Nitrous oxide occupies a unique position in this series: the only drug that a room full of strangers at a dinner party will use together without anyone calling it drug use. The laughing gas of dentistry, the whipped-cream chargers in every supermarket, the balloons at every festival, nitrous is […]
The Stimulant That Rewires No drug in this series carries a heavier public reputation or a more instructive gap between reputation and pharmacological nuance. Methamphetamine is genuinely one of the most destructive substances in the recreational pharmacopeia, and the popular depiction of it is not wrong so much as it is incomplete in a specific […]
The Largest Public Health Settlement in History Between 2021 and 2024, a cascade of legal settlements resolved the lawsuits brought by state attorneys general, counties, cities, and tribal governments against the pharmaceutical companies, distributors, and pharmacy chains whose conduct fueled the opioid crisis. Purdue Pharma's bankruptcy settlement, the master settlements with the "big three" distributors […]