The addictiveness of a substance is directly proportional to how quickly and potently it increases dopamine in the brain
For example: crack and cocaine have exactly the same chemical structure and pharmacological activity, but crack reaches the brain in as little as ~5 seconds when smoked, while powdered cocaine takes a few minutes to reach full effect
The same goes for nicotine gum vs. tobacco/vape, and smoked/injected opiates vs. oral pain pills

Generally addictiveness increases something like this: smoking > IV/IM injection > insufflation > sublingual > topical/oral
Injection and smoking are VERY close together in compulsiveness, but the reason I rank smoking first is because it actually reaches the brain faster (IV takes something like 30 seconds to full effect)

IV has much greater bioavailability however, so the same dose feels stronger
The reason I mention this is because it has key implications in recovery from addiction

If you're dependent on a substance that's administered through one of the more addictive routes, it'll be far easier to reduce consumption over time using a less compulsive ROA
If you're currently dabbling with a substance known to cause addiction I'd opt for a slower onset here as well

Nicotine is a good example, if you're trying to quit nicotine or minimize your risk of dependence on it try something like nicotine gum rather than vaping it

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More from @ck_eternity_

19 May
PSA: your microbiome does not feed on carbohydrates or alcohol

Your microbiome is located in your colon at the end of your digestive tract, at this point your three essential macronutrients have been absorbed and only fiber remains as an energy source
When your diet contains low/no fiber your microbiome loses strain diversity and begins to seek out other food sources, this occurs in two ways

1. bacteria begin to consume the mucus lining separating them from the intestinal wall, as mucus is made up primarily of polysaccharides
2. bacteria/yeast may begin to grow further up your digestive tract into the small intestine where they are able to consume some amount of your dietary carbs/sugars before they can be absorbed
Read 7 tweets
17 May
For many of those suffering from depression, SSRIs don't provide any benefit just by increasing serotonin, but rather through the downstream effects of serotonin receptor activation
Only a subset of depression patients actually present low serotonin

Other issues like reduced neurogenesis factors, elevated neuroinflammation, skewed GABA/glutamate ratios, etc, are present in the majority of cases
Activation of 5HT1A and 5HT2A receptors seems to be responsible for much of these effects

Research suggests they mediate changes in inflammation and BDNF levels long term

SSRIs have even been shown to provide analgesic effects, likely through their effects on endorphin levels
Read 4 tweets
17 May
As I understand it babies crying constantly is a fairly modern phenomenon

In previous generations when a baby's cry would have been a safety liability, mothers would use techniques like holding the babies nose to train them not to cry at a very young age
And even into the late 19th and early 20th century it was very common to give babies alcohol and/or opium preparations to calm them
Let me expand since some of you are responding without actually reading this:

The key word here is constantly

Of course babies have been crying since the beginning of time, but historically cultures have minimized this in different ways that aren't employed today
Read 5 tweets
16 May
Cravings are almost universally associated with a combination of low dopamine, low GABA, and elevated glutamate and cortisol
The endopioid system seems to play a role as well, unifying both dopamine and GABA in brain regions associated with pain perception and positive reinforcement
Managing cravings at the deepest level means understanding this well enough to correct any inbalance necessary

For example: managing stress, avoiding alcohol, avoiding activities like watching porn that desensitize dopamine/opioid receptors, avoiding hyper-palatable foods, etc
Read 4 tweets
6 May
Asking a dermatologist if you should get daily sunlight exposure is like asking an atheist if you should go to church every week
In dermatology, one of the worst things that could possibly happen to you is skin cancer

In medicine in general, skin cancer is not common compared to other cancers or metabolic issues, and not very fatal, especially if caught early (even melanoma survival rate is 98+%)
On the other hand, daily sun exposure actually reduces risk for many other types of cancer, heart disease, and many other health issues

Skin cancer risk is increased by sunburn, NOT sun exposure, so as long as you don't burn your risk of skin cancer is not increased
Read 6 tweets
3 May
The idea that cultures that use entheogens for the purpose of religious experience or enlightenment are not practicing "real spirituality" couldn't be further from the truth
All religion has roots in shamanism, it's only in more recent history that other religions have replaced shamanism with non-psychoactive sacraments

This is an excellent lecture that expands on this point:
There's nothing wrong with any religion, with or without the use of substances, all can provide genuine religious experience

The issue we're seeing in Western society is that because the experience of shamanism isn't available, it has been co-opted out as a tourist attraction
Read 5 tweets

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