Food-Drug Interactions

Dangerous Food-Drug Interactions

Food-Drug Interactions | Johns Hopkins Medicine

Fall 2008

Dangerous Food-Drug Interactions
By Carol M. Bareuther, RD
Aging Well
Vol. 1 No. 4

Consider these surprising facts: Older adults comprise 13% of the population but account for 34% of all prescriptions and 30% of all over-the-counter drugs used in the United States.

In addition, a survey of 17,000 Medicare beneficiaries conducted in 2007 found that two of every five patients reported taking five or more prescription medications.

This same survey also revealed that older patients often have more than one prescribing physician, making it difficult to track the total number and types of medications elders take. At the same time, physiological changes related to aging affect the absorption, distribution, metabolism, and excretion of drugs, as well as food.

What these facts add up to, says Joel Zive, PharmD, vice president of Zive Pharmacy & Surgical, Inc in Bronx, NY, and a spokesman for the American Pharmacists Association, “is a greater risk of food-drug interactions in older Americans.”

Below are the ill-advised combinations that Zive believes comprise the top 10 types of drug-nutrient interactions affecting older adults, along with his recommendations for preventing potentially deadly problems.

1. Warfarin and Vitamin K
Warfarin (Coumadin) is a blood-thinning medication that helps treat and prevent blood clots.

Eating certain foods, especially those rich in vitamin K, can diminish warfarin’s effectiveness.

The highest concentrations of vitamin K are found in green leafy vegetables such as kale, collards, spinach, turnip greens, Brussels sprouts, broccoli, scallions, asparagus, and endive.

“It’s not that patients should avoid foods that contain vitamin K,” advises Zive. “Rather, they should keep their intake consistent from day to day.”

He describes a scenario that could spell trouble for an older adult: “If a doctor tells a patient that they should lose weight and they, in turn, start to eat more greens, their vitamin K intake will go up, and this will counteract the anticlotting action of warfarin.”

2. Insulin, Oral Diabetic Agents, and Alcohol
An alcoholic drink can increase or prolong the effects of insulin or oral diabetic agents (pills) and thus lead to hypoglycemia or low blood sugar.

The glucose-lowering action of alcohol can last as long as eight to 12 hours.

Symptoms of hypoglycemia include nervousness, sweating, trembling, intense hunger, weakness, palpitations, confusion, drowsiness, and ultimately coma.

With a doctor’s approval, and in the absence of other health conditions such as pancreatitis, elevated triglycerides, and neuropathy, older adults with diabetes may be able to enjoy up to two drinks per day.

A drink is defined by the American Diabetes Association as a 12-ounce beer, a 5-ounce glass of wine, or 1.5 ounces of a distilled beverage such as whiskey, vodka, or gin.

Individuals can reduce the risk of low blood sugar by having alcoholic drinks at mealtime or by having a snack along with the drink.

In addition, certain oral diabetic medications such as chlorpropamide (Diabinese) can cause dizziness, flushing, and nausea when taken along with alcohol.

3. Digoxin, High-Fiber Diets, and Herbs Digoxin (Digitalis, Digitek, Lanoxin) is used to strengthen the contraction of the heart muscle, slow the heart rate, and promote the elimination of fluid from body tissues.

Dietary fiber, specifically insoluble fiber such as wheat bran, can slow down the absorption of digoxin and lessen its effectiveness. To prevent this, elders should take digoxin at least one hour before or two hours after eating a meal.

Herb use can also affect digoxin. For example, ginseng can elevate blood levels of digoxin by as much as 75%, while St. John’s Wort decreases blood levels of this drug by 25%.

“It’s important for the patient to recognize signs of digoxin toxicity,” says Zive. “These include a yellow tint to vision and the appearance of halos around objects, as well as weakness, confusion, dizziness, and nausea and vomiting.”

4. Statins and Grapefruit
Statins are highly effective cholesterol-lowering drugs. Unfortunately, says Zive, “Drinking grapefruit juice or eating fresh grapefruit can increase the amount of some statins in your blood and lead to potentially greater side effects of these drugs.”

Side effects of statins include muscle soreness and liver abnormalities reflected in high transaminase levels (serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic transaminase) on a blood test.

This interaction is especially strong with simvastatin (Zocor) and lovastatin (Altoprev), milder with atorvastatin (Lipitor), and nonexistent for pravastatin (Pravachol), so it’s important for elders to check whether their prescribed statin drugs do interact before giving up vitamin C-rich grapefruit.

5. Calcium Channel Blockers and Grapefruit
Calcium channel blockers are prescribed for high blood pressure. A natural element found in grapefruit latches onto the intestinal enzyme called CYP3A4, which alters the breakdown of the calcium channel blockers, possibly resulting in excessively high blood levels of the drug, along with an increased risk of serious side effects.

It doesn’t take a jumbo serving of grapefruit to produce a deleterious effect either. For example, a single 6-ounce glass of juice can reduce levels of CYP3A4 by nearly 50%. This effect dissipates slowly. One study indicated that one third of the impact on CYP3A4 from grapefruit juice was still evident a full 24 hours later.

The interaction between grapefruit and calcium channel blockers is strongest, for example, with felodipine (Plendil), nicardipine (Cardene), and nisoldipine (Sular) and weaker with amlodipine (Norvasc), diltiazem (Cardizem), and nifedipine (Adalat).

Tangelos, a cross between a tangerine and grapefruit pomelo and Seville oranges, a bitter citrus fruit used to make marmalades, can have the same deleterious effects as grapefruit on both statins and calcium channel blockers.

6. Erectile Dysfunction Drugs and Grapefruit
Although unproven, evidence points to the ly fact that grapefruit juice gives a boost to blood levels of erectile dysfunction drugs such as sildenafil (Viagra). This may seem a boon to some men, but it could trigger headaches symptomatic of fatal or near fatal conditions, flushing, or low blood pressure.

7. Acetaminophen and Alcohol The over-the-counter pain reliever acetaminophen (Tylenol) and alcohol don’t mix.

“Two or more alcoholic drinks per day can increase the liver toxicity of Tylenol,” says Zive. “This toxicity can happen even if a patient takes less than the maximum 4 grams, or eight tablets, of Tylenol per day.”

This interaction can be especially problematic in older adults, says Zive, since the liver’s ability to diminish drugs decreases with age. “The liver of a 65 year old doesn’t function the same way it did at age 25,” he says.

8. Antibiotics and Dairy Products
Dairy products such as milk, yogurt, and cheese can delay or prevent the absorption of antibiotics such as tetracyclines and ciprofloxacin (Cipro). This occurs because the calcium in such foods binds to the antibiotics in the stomach and upper small intestine to form an insoluble compound.

To avoid problems, Zive recommends taking an antibiotic one hour before or two hours after a meal.

However, there’s no need to avoid milk and dairy with all antibiotics. For example, it’s recommended that metronidazole (Flagyl) should be taken with water or milk to prevent stomach upset.

9. MAOIs and Tyramine-Containing Foods
Monoamine oxidase inhibitors are an older type of antidepressant still prescribed, albeit less frequently, due to their serious side effects.

“Foods containing tyramines, such as some red wines, malt beer, smoked fish, aged cheeses, and dried fruits, can cause a hypertensive crisis or severe and dangerous elevation in blood pressure when taken with this class of antidepressants,” says Zive.

10. Antithyroid Drugs and Iodine-Rich Foods
Antithyroid drugs are compounds that interfere with the body’s production of thyroid hormones, thereby reducing the symptoms of hyperthyroidism. According to a broad body of research, Americans’ high-iodine diets account for the lower remission rate of hyperthyroidism in those who are prescribed antithyroid drugs.

Antithyroid drugs work by preventing iodine absorption in the stomach. A high-iodine diet requires higher doses of antithyroid drugs. The higher the dose of antithyroid drugs, the greater the incidence of side effects that include rashes, hives, and liver disease.

The richest dietary sources of iodine are seafood and seaweed, such as kelp and nori. Iodine is also found in iodized salt and to a lesser extent in eggs, meat, and dairy products.

— Carol M. Bareuther, RD, is a St. Thomas, U.S. Virgin Islands-based writer who contributes to a variety of regional, national, and international publications.

Source: https://www.todaysgeriatricmedicine.com/archive/101308pe.shtml

Food-Drug Interactions

Food-Drug Interactions | Johns Hopkins Medicine

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Food-medicine interactions can happen with both prescription and over-the-counter (OTC) medicines. These include antacids, vitamins, iron pills, herbs, supplements, and beverages.

Some nutrients can affect the way you metabolize certain medicines by binding with the medicine's ingredients. This reduces their absorption or speeds their elimination. For example, the acidity of fruit juice may decrease the effectiveness of antibiotics such as penicillin.

Dairy products may blunt the infection-fighting effects of tetracycline. Some green leafy vegetables can cancel out the effects of warfarin, an anticoagulant medicine. One kind of antidepressants called MAO inhibitors are dangerous when mixed with foods or drinks that contain tyramine.

These include beer, red wine, chocolate, processed meat, avocados, and some cheeses. Grapefruit juice can interfere with some blood pressure medicines and organ transplant medicines by increasing their metabolic breakdown.

Some medicines are only absorbed if they are taken with a full meal or even a meal high in fat content.

Not all medicines are affected by food, but many can be affected by what you eat and when you eat it.

Sometimes, taking medicines at the same time you eat may interfere with the way your stomach and intestines absorb medicine. Other medicines are recommended to be taken with food.

Be sure to ask your healthcare provider or pharmacist for specific directions on eating before or after taking any medicine.

What you should remember about food-medicine interactions

Be aware of the following:

  • Ask your pharmacist or healthcare provider if there are foods, beverages, vitamins, or supplements you should avoid with your medicines.
  • Read the prescription label on the container. If you do not understand something, or think you need more information, ask your healthcare provider or pharmacist.
  • Read directions, warnings, and interaction precautions printed on all medicine labels and instructions. Even over-the-counter medicines can interact with foods, beverages, or supplements.
  • Take medicine with a full glass of water unless told otherwise by your pharmacist or healthcare provider.
  • Do not stir medicine into your food or take capsules apart (unless directed by your pharmacist or healthcare provider). This may change the way the medicine works.
  • Check with your pharmacist or healthcare provider before taking vitamin pills at the same time you take medicine—vitamins and minerals can interact with some medicines.
  • Do not mix medicine into hot drinks, because the heat from the drink may destroy the effectiveness of the medicine.
  • Never take medicine with alcoholic drinks. Alcohol can change medicine absorption and may increase or decrease the effectiveness of many medicines.
  • Be sure to tell your healthcare provider and pharmacist about all medicines you are taking, both prescription and nonprescription.
  • Obtain all your medicines from one pharmacy and tell your pharmacist about any OTC, supplements, herbs, or vitamins that you take.
  • Keep all medicines in their original containers so they can be easily identified.  

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fooddrug-interactions

Media Mentions – Johns Hopkins Drug Access and Affordability Initiative

Food-Drug Interactions | Johns Hopkins Medicine

Home > Research > Affiliated Programs > Johns Hopkins Drug Access & Affordability Initiative > Media Mentions

Both the work and the people associated with the Johns Hopkins Drug Access and Affordability Initiative (JHDAAI) make frequent appearances in the media.  We are always glad to contribute to public discourse on the topic of drug pricing.

View the latest “Media Mentions” involving the JHDAAI project team below.

2020:
 

When President Donald Trump recently touted the common malaria treatments hydroxychloroquine and chloroquine as potential remedies for coronavirus disease 2019 (COVID-19), he ignited unprecedented demand for the drugs—and set scientists’ teeth on edge. Joshua Sharfstein is quoted.
Science Magazine | March 26, 2020
 

“Everybody knows it’s a severe undercount,” said Dr. Joshua Sharfstein, former Maryland health secretary and vice dean for public health practice and community engagement at Johns Hopkins Bloomberg School of Public Health.

  Governors, mayors and other local leaders across the country have joined with public health officials to implement strict measures to halt the spread, from shutting down schools and businesses to asking everyone to isolate themselves as much as possible.

  But after more than a week of “social distancing,” with the economy on the ropes, President Donald Trump has begun suggesting it’s time to open things back up.
Baltimore Sun | March 24, 2020
 

All told, more than 100 clinical trials of dozens of potential treatments have already begun in multiple countries.  The start of these trials, however, does not mean a treatment is imminent.  Caleb Alexander is quoted.
NBC News | March 24, 2020
 

ECMO machines are the only thing that can save the life of a severely infected coronavirus patient when ventilators won’t work, said Ge Bai, an associate professor of accounting and health policy and management at Johns Hopkins University.
Orlando Sentinel | March 21, 2020
 

Johns Hopkins University’s professor Gerard Anderson said an uninsured patient ‘could expect to pay at least $500-$1,000 just to get tested for the virus, and a 10-day hospital stay could amount to a bill of at least $75,000.’ The number of uninsured patients, as the Census Bureau reported, was 28.6 million in 2018.
Prothomalo English Op-Ed | March 19, 2020
 

President Trump directed the Food and Drug Administration to repurpose an anti-malarial drug for use against the raging coronavirus pandemic and told states to order badly needed ventilators instead of relying on him.  Gerard Anderson is quoted.
Washington Times | March 19, 2020
 

Borrow Medicare’s medical and billing infrastructure to give everyone in America access to coronavirus diagnosis, treatment and recovery services.  Joshua Sharfstein and Gerard Anderson are co-contributors. 
USA Today | March 19, 2020
 

 Many shopkeepers will want to keep his or her business open if they don’t have the funds to keep an office closed for 14 days.  Gerard Anderson is quoted.
CNBC News | March 12, 2020
 

Americans’ health may not be the only thing at stake as the coronavirus continue its unrelenting spread in the U.S. The virus could also prove financially crippling for many individuals.  Gerard Anderson is quoted.
CNBC | March 10, 2020
 

The growing coronavirus outbreak in the United States revealing serious gaps in the health system’s ability to respond to a major epidemic, forcing hospitals and doctors to improvise emergency plans daily, even as they remain uncertain how bad the crisis will get.   Gerard Anderson is quoted.
The Washington Post | March 4, 2020
 

Agree or disagree with an idea of importing prescription drugs from Canda?  Gerard Anderson is quoted.
Telegram.com | January 31, 2020
 

New drugs are being approved by the U.S. Food and Drug Administration for patients less and less solid evidence, thanks to incentive programs that have been created to promote drug development, a new study shows.  Joshua Sharfstein is quoted.
WebMD | January 14, 2020
 

The cost of prescription drugs for all kinds of medications is taking a heavy toll on the average American’s wallet, and officials appear divided on how to stop them from rising.  Gerard Anderson is quoted.
WPMT FOX43 News | January 13, 2020
 

Members of a new prescription drug panel pledged to do a deep dive into the factors that cause consumers to experience sticker shock at the pharmacy counter.  Gerard Anderson is quoted.
Maryland Matters | January 13, 2020
 

The skyrocketing cost of many prescription drugs in the U.S. can be blamed primarily on price increases, not expensive new therapies or improvements in existing medications as drug companies frequently claim, a new study shows.  Gerard Anderson is quoted.
NPR | January 7, 2020

Read older stories in archived news

Source: https://www.jhsph.edu/research/affiliated-programs/johns-hopkins-drug-access-and-affordability-initiative/media-mentions/index.html

Prescription Drug Coverage | Johns Hopkins Advantage MD

Food-Drug Interactions | Johns Hopkins Medicine

We know prescription drug coverage is very important to you. That’s why Johns Hopkins Advantage MD offers a Part D prescription benefit with our plan options.

The Johns Hopkins Advantage MD comprehensive formulary is a complete list of Medicare-approved, prescription brand-name and generic medications we cover.

Download the comprehensive formulary or use our formulary search tool to find drugs that are covered by Advantage MD:

We include formulary alternatives in the formulary search tool to help you and your prescribing doctor determine the proper course of action to take when one of your medications is not covered by your plan.

To help your doctor decide whether to prescribe a formulary alternative, please download and print your plan’s comprehensive formulary and take it with you when you visit your doctor.

Remember, by switching to an alternative generic or brand-name drug included on our formulary, you can avoid paying the full cost for a non-formulary drug.

Note: This is not a complete list of all formulary alternatives covered by your Part D plan. The drugs listed are for comparison purposes and may differ in effectiveness, dosing, side effects and/or drug interaction profiles. Always seek the advice of your doctor regarding your prescription medications.

Notice of Part D Formulary Updates

Our formulary is updated monthly and as formulary changes occur. We may remove drugs from the formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier during the plan year. The list of changes that have been made to the formulary is called the errata.

We may immediately remove a brand name drug on our Drug List if, at the same time, we replace it with a new generic drug on the same or lower cost sharing tier and with the same or fewer restrictions.

Also, when adding the new generic drug, we may decide to keep the brand name drug on our Drug List, but immediately move it to a different cost-sharing tier or add new restrictions. If you are taking the brand name drug at the time we make the change, we will provide you with information about the specific change(s) we made.

This will also include information on the steps you may take to request an exception to cover the brand name drug. You may not get this notice before we make the change.

For other changes to drugs on the Drug List, if the change affects a drug you take, we will notify you in writing at least 30 days before the change is effective or we will give you a 30-day refill on the drug you are taking at a network pharmacy.

However, if the U.S. Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe or if the drug’s manufacturer removes a drug from the market, we will immediately remove the drug from the formulary and notify all affected members as soon as possible.

To view the latest changes that have been made to the formulary, you can download and refer to the errata sheet:

Source: https://www.hopkinsmedicare.com/members/rx-coverage-overview/

Tools and Resources

Food-Drug Interactions | Johns Hopkins Medicine

Data Safety and Monitoring/ Data Safety Monitoring Boards

What is a DSMP or DSMB? A Data Safety Monitoring Plan (DSMP) establishes the process for overseeing the progress of a human subjects research project or clinical trial.  At JHU, all studies must provide a description of the DSMP.  The JHM IRB will review the plan for appropriateness related to the design, risk profile, and study population for each study.

A DSMP’s purpose is to maximize research participant safety and welfare and data accuracy by periodically

  • evaluating a study’s adherence to the IRB approved research plan, by affirming all study procedures are being followed;
  • assuring compliance with applicable institutional policies and regulatory requirements, by ascertaining, for example, that informed consent is being effectively obtained and documented, or that all changes in research received IRB approval before initiation of any changes;
  • confirming adverse events are properly identified, documented, reported, and resolved (if necessary);
  • verifying the maintenance of accountability of the investigational product (i.e., drugs or devices); and
  • examining data (and appropriate source documentation) for quality, validity, and consistency.

A DSMP designates who is responsible for the monitoring activity, while outlining when monitoring will occur (per established intervals), and what study documents and data will be reviewed.

  A critical component to the DSMP is that all detected deficiencies (i.e.

, “deviations”) are communicated to the Principal Investigator (PI) and study team for reconciliation, and for implementation of appropriate corrective action plans.

A Data Safety Monitoring Board (DSMB) is convened when an investigation’s design, risk profile, and/or study population warrants an independent review by a group of experts (e.g., a multicenter randomized trial of a high-risk new drug, or pursuant to NIH requirements).  Per procedures outlined in the DSMP operational plan (i.e.

, “DSMB Charter”), the DSMB reviews data and safety information provided by an investigator. The DSMB assesses study progress via statistical analysis of interim study outcomes and safety signals, and then renders a decision that the study may proceed, be amended, or should cease enrollment.

DSMBs will compile a summary report that, per JHM IRB requirements, are to be reported to the IRB.

JHM IRB Policy: https://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/organization_policies/103_6c.html

FDA Guidance:
https://www.fda.gov/RegulatoryInformation/Guidances/ucm127069.htm

SKCCC CRO Guidance:
http://cro.onc.jhmi.edu/pageData/dsmp.pdf

Guidance for Data and Safety Monitoring Plans (ICTR DDRS):
DSMP/DSMB Consultation is provided by the JHU Office of Human Subjects Research Compliance Monitoring Program. Contact Fed Ludthardt at fluthar1@jhmi.edu for additional information.

Please email our Research Navigators at ICTR_Navigators@jhmi.edu to access any of these templates.

FDA Guidance Document http://www.fda.gov/OHRMS/DOCKETS/98fr/01d-0489-gdl0003.pdf

Cancer Center’s DSMP provides helpful guidance on risk assessment, auditing and monitoring, and DSMBs http://cro.onc.jhmi.edu/pageData/dsmp.pdf

Guidance for Data and Safety Monitoring Plans (ICTR DDRS)
Please email our Research Navigators ICTR_Navigators@jhmi.edu to access any of these templates.

Source: https://ictr.johnshopkins.edu/study_team/tools-and-resources/

Johns Hopkins Bayview News – Dangerous Combinations

Food-Drug Interactions | Johns Hopkins Medicine

You are diligent about taking your medication each day. But did you ever think that the bologna sandwich, grapefruit or glass of milk you have with it could be making your medicine less effective, or even dangerous? Read on for five facts you need to know about food and drug interactions.

1. Beware of grapefruit.

This popular breakfast fruit interacts with a variety of medications, including blood pressure medications, statins, HIV medications and organ transplant medications, says Charlie Twilley, Pharm.D., a pharmacist at Johns Hopkins Bayview Medical Center.

The culprits are furanocoumarins, compounds found in grapefruit that block the enzymes in the intestines responsible for breaking down these drugs. This can make the drugs more potent, and raise the level of drug in your bloodstream.

If you are a big grapefruit fan, talk to your doctor or pharmacist to find out whether it is safe to eat with the medications you are taking.

2. Dairy diminishes antibiotics’ infection-fighting powers.

Twilley warns that the calcium in milk, yogurt, cheese, ice cream and antacids can interact with tetracycline and the tetracycline group of antibiotics used to treat a number of bacterial infections. To make sure you are getting the full benefit of your antibiotic, take it one hour before, or two hours after you eat anything containing calcium.

3. Leafy greens cancel the effects of warfarin.

The vitamin K in spinach, collards, kale and broccoli can lessen the effectiveness of warfarin, a blood thinner used to prevent blood clots and stroke. The darker green the vegetable is, the more vitamin K it has.

“You don’t want to eliminate leafy greens from your diet, because they do have many health benefits,” says Twilley. The key is to be consistent with the amount you eat.

If you plan to drastically change the amount of these veggies in your diet, talk to your doctor or pharmacist first.

4. Beer, red wine and chocolate are dangerous to mix with some antidepressants.

These popular indulgences may be a nice way to relax in the evening, but they contain tyramine, a naturally occurring amino acid that can cause an unsafe spike in blood pressure when mixed with MAO inhibitors.

Tyramine also is found in processed meat, avocados and some cheeses. “This is a significant, dangerous interaction,” says Twilley. If you take MAO inhibitors for depression, talk to your doctor or pharmacist before eating anything with tyramine.

Alternative therapy may be considered.

5. Think before you crush medication in applesauce.

Many people who have trouble swallowing pills to crush them up and mix them with applesauce or pudding. Always ask your doctor or pharmacist before you crush or take apart medication. “This method can dump too much of the drug into your system at once, or change the way the drug works,” says Twilley.

Also keep in mind that some medications are affected by whether or not you eat with them. Before you start any new drug, talk to your doctor or pharmacist about whether it is affected by food. “They can help you come up with a schedule that’s good for the drug and convenient for you,” says Twilley. Even over-the-counter medications and supplements can have food interactions.

For additional reliable information about common food and drug interactions, you can search for this topic in Johns Hopkins’ online Health Library at hopkinsmedicine.org/healthlibrary, or contact the Johns Hopkins Bayview Outpatient Pharmacy at 410-550-0961.

Source: https://www.hopkinsmedicine.org/news/publications/jh_bayview_news/fall_2014/dangerous_combinations

New Johns Hopkins research center tests psychedelics to treat mental health

Food-Drug Interactions | Johns Hopkins Medicine

Johns Hopkins Medicine is launching a new psychedelic research center where scientists will test the potential of “magic mushrooms” and other drugs to treat some of the toughest mental health and addiction challenges.

The center is believed to be the first center in the United States and the largest in the world to focus on drugs still better known as symbols of 1960s counterculture than serious medicine.

The Center for Psychedelic and Consciousness Research at Johns Hopkins Medicine in Baltimore is being funded by a $17 million donation from a group of private donors. Because federal funding cannot be used for such research, the center needs private support.

The center’s research will focus on applications of the drugs for treating opioid addiction, Alzheimer’s disease, post-traumatic stress disorder, eating disorders and depression, among other diseases.

“Psychedelics are a fascinating class of compounds,” said Roland Griffiths, the center’s director and a professor of behavioral biology in the Hopkins School of Medicine.

“They produce unique and profound change in consciousness,” he said. “The center will allow us to expand on research to develop new treatments for a wide variety of psychiatric disorders. And it will allow us to extend on past research in healthy people to improve their sense of well being.”

“Johns Hopkins is deeply committed to exploring innovative treatments for our patients,” Paul B. Rothman, chief executive of Johns Hopkins Medicine and dean of the medical school’s faculty, said in a statement. “Our scientists have shown that psychedelics have real potential as medicine, and this new center will help us explore that potential.”

Psilocybin and MDMA are illegal drugs in the United States classified by the federal government along with heroin and cocaine. Laws relating to salvia vary by state, but it’s illegal in most states.

But researchers at Hopkins and elsewhere have said such drugs could help in areas of pain, addiction and brain disorders.

The center is being funded by the Steven & Alexandra Cohen Foundation and philanthropists who include Tim Ferriss, an author and technology investor; Matt Mullenweg, co-founder of WordPress; Blake Mycoskie, founder of the shoe company TOMS; and Craig Nerenberg, an investor.

Ferriss said his interest in the drugs is personal. There is depression and brain disease among family members, and a good friend died of a drug overdose. He said his contribution, between $2 million and $3 million, is the largest investment he has made in a corporate or nonprofit endeavor.

He said he was hoping to “affect the timeline” of federal regulatory approvals for psychedelic drugs, though he opposed over-the-counter uses.

“Good science takes time,” he said, adding that he wanted to support “unlocking the full potential of productive teams.”

The center will look at how psychedelics affect behavior, brain function, learning and memory, the brain’s biology and mood.

The Hopkins researchers said they understood the risks and dangers of using psychedelic drugs that they said were not addictive but could be abused. They said they could control for potential abuse or bad outcomes, such as long-term effects of the drug’s use on those with undiagnosed mental health disorders, in a laboratory setting where people and drugs are carefully screened.

The National Institute on Drug Abuse says there are many potential short- and long-term harms from hallucinogens. Users can see, hear and feel things that don’t exist, experiences that can be unpleasant, known as a “bad trip.”

Users can suffer increased heart rate and blood pressure, nausea, intensified feelings, loss of appetite, sleep problems, excessive sweating and panic, though others may have intense spiritual experiences and feelings of relaxation. Users also can be a danger if they drive.

Over time, according to the drug abuse institute, users can suffer persistent psychosis, visual disturbances, disorganized thinking, paranoia and mood changes, among other problems.

The institute said people can overdose on some hallucinogens, such as PCP, though serious medical emergencies are not common and not associated with drugs typically used in the research studies. Drugs also can be contaminated, and those trying to use psilocybin could consume poisonous mushrooms that look the ones containing the compound.

There are not currently any federally approved psychedelic drugs for medicinal purposes.

“The field is chock full of lessons, and we take them seriously,” said Matthew Johnson, an associate professor of psychiatry and behavioral sciences in the medical school, who is the center’s assistant director. But he said the potential benefits could be enormous.

The rate of fatal opioid overdoses will probably make use of psilocybin more acceptable to the public, after a “war on drugs” in the 1970s and ’80s stymied all research into psychedelic substances for decades, said Sara Lappan, a visiting instructor in the counseling program at the University of Alabama at Birmingham’s department of human studies.

Lappan is working on a study using psilocybin to treat addiction to cocaine, a drug that has been making a comeback among users after years of declines. The Alabama study is among a handful around the country testing psilocybin for a variety of treatments.

That study aims to give people “the ability to change” because of how they view themselves. It’s giving them “10 years of therapy smashed into six hours,” she said.

Researchers, she said, hope eventually to use their scientific data to change the legal status of the drug, though she said she knew of no researcher who wants recreational use of psilocybin. And she agreed that the studies have shown promise because the participants and the substances are carefully screened.

At Hopkins, the funding is expected to support five years of research and a team of six faculty neuroscientists, experimental psychologists and clinicians.

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Source: https://www.washingtonpost.com/national/health-science/new-johns-hopkins-research-center-tests-psychedelics-to-treat-mental-health/2019/09/06/651521b8-cffa-11e9-8c1c-7c8ee785b855_story.html