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Ketamine causes what doctors call a “dissociative experience” and what most anyone else would call a “trip.” That’s how it became a club drug, called K, Special K, Super K, and Vitamin K among others. Partiers inject it, put it in drinks, snort it, or add it to joints or cigarettes. “Ketamine can produce feelings of unreality; visual and sensory distortions; a distorted feeling about one’s body; temporary unusual thoughts and beliefs; and a euphoria or a buzz,” says John Krystal, MD, chief of psychiatry at Yale-New Haven Hospital and Yale School of Medicine in Connecticut, where he is a leader in studying ketamine’s antidepressant effects.
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There is a growing understanding that paracetamol is not as safe as once believed. The long-term use of paracetamol is now discouraged due to concerns that may increase the risk of heart attack or stroke. The results from four studies suggest that long-term use of paracetamol is associated with a 19% to 68% higher risk of developing cardiovascular problems. Another study found that long-term use of paracetamol was associated with an 11% to 49% increased the risk of intestinal bleeding. Researchers have also found that long-term use of acetaminophen (paracetamol) is associated with a 21% increase in self-reported hearing loss. Whether these findings relate to the use of the painkiller, or to the underlying conditions for which it is used, remains uncertain.
Use paracetamol concurrently. The concurrent use of paracetamol with tramadol or codeine is more effective than tramadol or codeine alone.2 Co-prescribing of paracetamol is an effective and widely used strategy for reducing tramadol and codeine use thereby improving patient safety and providing pain relief as these Step 2 analgesics are withdrawn. Tramadol is associated with a decreased risk of respiratory depression and is therefore often preferred over codeine or dihydrocodeine in patients who are at increased risk of breathing difficulties, e.g. for musculoskeletal pain in a person with chronic obstructive pulmonary disease (COPD).2 Tramadol may also be preferred over codeine or dihydrocodeine in patients with a history of constipation or in those taking anticholinergic medicines. There is weak evidence that tramadol is effective in patients with neuropathic pain.
The drugs usually prescribed to treat ADHD are generally effective and safe. Most children and teenagers (60 percent to 80 percent) who take them become less hyperactive and impulsive, are better able to focus, and are less disruptive at home and school. But there is no good evidence showing that these benefits last longer than about two years, and the long-term consequences of taking stimulants for years on end have not been fully evaluated in studies. Fortunately, many children with ADHD—even when they are not treated—improve as they reach the teenage years and early 20s. But the disorder can persist into adolescence and adulthood about 30 percent to 70 percent of the time.
Over-the-counter sleep aids: Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They’re safe enough to be sold without a prescription. But if you’re taking other drugs that also contain antihistamines — like cold or allergy medications — you could inadvertently take too much.
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