I want to make myself useful and I want to build up a steady source of income. For this reason, I’ve been pondering a suggestion people offered me in the past, which is to set up my own substack. The idea I have is to write a newsletter, The Forgotten Treatment, where I look at treatments for medical conditions that have been forgotten about, from the perspective of a medical historian.
I don’t want to be a grifter and knowledge should be free, to promote the flourishing of all of humanity, so all the articles would be publicly available. Rather, paid subscribers would get to vote on what I should sink my teeth into next. You’d be paying to steer my mental effort in a direction.
And obviously, I would adhere to basic standards of professionality. For example, I would refrain from referring to my readers as “low IQ low status white males”. It’s the difference between doing a job and revealing the depths of your soul. You’re the employer, so I will have to work on meeting your expectations. I managed to hold onto an office job for four years, so maybe I can meet your expectations for four years too.
You can’t offer someone medical advice for a treatment that hasn’t been sufficiently studied. That would be irresponsible and I don’t want to go to prison for trying to help people. I’m not going to do anything stupid like telling someone to ditch his chemotherapy either.
Rather, my goal would be to get people who ran out of options and medical professionals to discover potential treatment avenues that have been lost to history. And then perhaps, in consultation with a medical professional, you may find out you discovered a new option.
Some people, lackeys for the system, tend to argue that alternative medicine would be called medicine if it worked. However, I disagree. The incentives of the industry favor treatments that can be patented. There are plenty of forms of alternative medicine that would be called medicine, if they could be patented.
I feel as if by now at age 32, I have built up sufficient knowledge from consistent reading about a range of disciplines for almost two decades that I have something useful to contribute. So with no further ado, I want to share a trial article, then you can judge in the comments here whether you think this would be useful and worth setting up a Substack for.
The Forgotten Treatment: Overcoming Opioid Dependence
The ongoing opioid crisis is symptomatic of the failure of the American healthcare system. Provisional data suggest that in the past 12 months, 108,000 Americans died from drug overdose. Not all of these deaths are the result of opioids, nor are most opioid deaths the direct result of prescription opioids.
However, the overdose epidemic is the direct outgrowth of a for-profit healthcare model that allowed the Sackler family among others to earn billion dollar fortunes by promoting the use of opioids for people in circumstances where the benefit to be gained was modest and the risk of addiction severe.
Between 2006 and 2014, 226 million prescription opioid pills were distributed in Spokane county, 54 pills per person per year, an absurd amount. Once people are hooked they tend to become dependent on the black market, where the profit incentives and the risk of getting caught favor highly potent opioids that can be easily sent across the country, like fentanyl.
The crisis is now a reality and a major cause of the severe decline in American life expectancy. Someone who dies at forty of an opioid overdose has a greater impact on measured life expectancy than someone who dies at ninety of Alzheimer’s disease. The question I’m interested in is: How do we get people off opioids again?
We wouldn’t have an overdose crisis, if getting people off opioids was easy. The reality is that it isn’t. The best established treatment with the longest history of use is Methadone, but even Methadone is not highly effective. People on methadone are 33% less likely to test positive on tests. And keep in mind, Methadone itself is not a harmless drug. It works because Methadone itself is an opioid. When we treat addicted people with Methadone, we’re not so much curing opioid addiction as we are substituting one opioid for another. And people die of Methadone as well.
The question I’m interested in asking is: What are the alternative routes we have available to us? How do we move towards getting people off opioids, rather than just filling the void left by withdrawing people from dangerous opioids with safer opioids?
To answer that question requires me to delve into what we know about human neurochemistry. But first, I wish to briefly mention a treatment that has been argued to work well at achieving complete remission of addiction: Iboga.
Iboga is an African plant that leads to an intense visionary journey, it has been used by Pygmy tribes for generations. It is in some aspects comparable to Ayahuasca, but it affects a much wider range of receptors in the brain and last much longer. In the 70’s heroin addicts discovered they lost their cravings after taking Iboga, so today there are centers around the world where people receive Iboga.
It doesn’t work for everyone and it can hardly be considered a desirable treatment option for most people. An estimated 1 in 300 people don’t survive an Iboga experience. The impact of the cardiovascular system is severe and so you can imagine that if middle-aged people with pre-existing conditions like obesity received Iboga, the risk of death would be even higher.
There is also of course Kratom, which appears succesful in weaning people off more dangerous opioids. However, it doesn’t cure the addiction cycle, it is again a case of choosing the lesser of two evils. In a world where profit incentives did not dictate medical policy, we might see Kratom used on a wider scale. But Kratom is quite well known about by now and so it doesn’t fit the conditions of what I wish to offer you, namely, a Forgotten Treatment. What do we know, that we forgot we know about?
This is where we have to get into neurochemistry. The general tendency for the nervous system is to aim towards homeostasis. When we administer a psychoactive chemical on a regular basis, the brain will attempt to compensate for this in one way or another, often with the involvement of other organ systems as well. Suddenly withdrawing a drug can be sufficient to kill a person, as is seen in alcohol withdrawal. The body has grown accustomed to the drug and can no longer function without it.
Similarly, the dose of opioids taken by an opioid addict is often enough to kill an inexperienced user. As a person consumes opioids more often, the m opioid receptor is downregulated and becomes less sensitive to the administered opioid. It thus takes more of the drug to achieve the same effect and the natural opioids produced by the human body are no longer sufficient to perform their required functions.
So how do you break that cycle? How do you resensitize the Mu opioid receptor, so that it can depend on our endogenous opioids to properly perform its function again? That’s where the Kappa opioid receptor comes in. The Kappa opioid receptor is often thought of as the body’s natural control mechanism for addiction. Activating it upregulates the sort of receptors that are downregulated in addicted people, like the Mu opioid receptor and the Dopamine 2 receptor.
We don’t know exactly why Iboga works to treat opioid addiction. However, it is known that the Kappa opioid receptor is one of the locations where it binds most strongly. It’s thought this receptor may be responsible for the unique effects Iboga has on the human mind. The Kappa opioid receptor makes people feel disconnected from the world. After taking Iboga it’s common to hear experiences where people feel as if they were another animal, like a gorilla in the African forest.
And this brings me to a special plant, which has unique effects on the human mind because of its focused effect on the Kappa opioid receptor through a terpenoid known as Salvinorin A: That plant is Salvia Divinorum. This plant became popular among teenagers in the early 2000’s, where extremely high concentrated doses were smoked and led to bizarre behavior in videos that went viral.
This is entirely contrary to how it is used by the Mazatec, who cultivate this plant. They don’t like smoking it, they prefer to chew the fresh leaves. Smoking the Salvia Divinorum Plant versus chewing the fresh leaves leads to two very different experiences. Because the effects slowly introduce themselves when chewing, they do not terrify the user. It is perhaps best thought of as the difference between going on a train journey and entering a rollercoaster.
What you’ll notice after chewing Salvia Divinorum, which is preferably done while laying down in a dark room, is that you feel rejuvenated after you stop chewing and the effects stop. It’s not easy to feel the effects, it takes a bit of technique. You need to chew a lot and use your tongue to press the plant matter against your gums to draw in enough of the active chemical, but it does work. In my own experience chewing Salvia allows me to gain pleasure again from things I grew disinterested in.
It would obviously be reckless to encourage heroin addicts to switch to chewing Salvia to cure their condition. That’s not what I’m proposing. But what I can envision, is that after weaning people off severe opioids, the final step would be for people to chew Salvia, so that the Mu opioid receptors are sensitized again and can function properly through our endogenous opioid system again.
Presumably because it upregulates the Dopamine 2 receptor, there is also evidence to suggest it works well in people who have abused stimulants. Cocaine craving appears to be gone after a single administration of a Kappa opioid agonist in rodents.
What other options are there? Well, chewing Salvia can feel a bit like walking into a sauna. Your body feels warm. There is evidence to suggest taking a Sauna releases large amounts of Dynorphin, the natural ligand for the Kappa opioid receptor. You may thus find that sauna bathing would help people recover from opioid addiction too. Some people addicted to Kratom report that sauna bathing helps them.
The poor Salvia Divinorum plant can not be patented, nor can its active chemical, Salvinorin A. Scientists have experimented with various derivative chemicals, but these tend to be more potent and last much longer, which is not desirable. Sadly, it seems to me the profit incentives of modern healthcare leave this plant isolated from the people who would benefit the most from it.