Talk:Therapeutic index: Difference between revisions

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==Applications in non-medical and recreational contexts==

The concept of a "therapeutic window" or "safety ratio" is sometimes informally applied in the psychonaut and recreational substance using community to communicate the relative degree of risks associated with the use of various [[psychoactive substances]]. These typically relate to the likelihood of experiencing desired effects (such as [[disinhibition]], [[stamina enhancement]], [[sociability enhancement]] and [[euphoria]] in the case of traditional street drugs and in the case of [[hallucinogens]] sensory distortions, [[hallucinatory states]], and [[euphoria]]) relative to the likelihood of experiencing side-effects which can range from extremely discomforting to life-threatening.

The concept of a "therapeutic window" or "safety ratio" is sometimes informally applied in the psychonaut and recreational substance using community to communicate the relative degree of risks associated with the use of various [[psychoactive substances]]. These typically relate to the likelihood of experiencing desired effects (such as [[disinhibition]], [[stamina enhancement]], [[sociability enhancement]] and [[euphoria]] in the case of traditional street drugs and, in the case of [[hallucinogens]], sensory distortions, [[hallucinatory states]], and [[euphoria]]) relative to the likelihood of experiencing side-effects which can range from extremely discomforting to life-threatening.

While the exact values for the safety ratios of psychoactive substances are rarely, if ever, referenced (and many are not even available given the prevalence of novel substances and the lack of pharmacological and toxicological data on them), the notion of a particular substance possessing a "high" or "low" safety ratio can serve to inform users about whether they want to experiment with a substance given their own personal comfort levels and degree of acceptable risk they are willing to take. Factors which complicate this include the unreliability of the purity and dosage of drugs obtained from gray or black markets due to a lack of regulatory oversight. Assessing a substance's safety ratio in advance by conducting independent research is considered to be an integral part of [[responsible drug use]] given the large variations in potential responses and the range of precautions one can take to mitigate potential risks.

While the exact values for the safety ratios of psychoactive substances are rarely, if ever, referenced (and many are not even available given the prevalence of novel substances and the lack of pharmacological and toxicological data on them), the notion of a particular substance possessing a "high" or "low" safety ratio can serve to inform users about whether they want to experiment with a substance given their own personal comfort levels and degree of acceptable risk they are willing to take.

Factors which complicate this include the unreliability of the purity and dosage of drugs obtained from gray or black markets due to a lack of regulatory oversight. Assessing a substance's safety ratio in advance by conducting independent research is considered to be an integral part of [[responsible drug use]] given the large variations in potential responses and the range of precautions one can take to mitigate potential risks.

Examples of this include knowing the general dosage of any particular substance liable to put one at risk of an overdose, particularly those that can be sudden and fatal, such as those associated with [[opioids]] like [[heroin]] and [[stimulants]] like [[cocaine]]. In the case of [[hallucinogens]], a substance may have a very low safety ratio, such as [[LSD]], which has no established, reasonable lethal dose{{citation needed}}) relative to a [[25x-NBOMe]] substance, in which the dose needed to produce the desired psychoactivity is only a few multipliers lower than a dose which can produce [[seizures]], coma or death.{{citation needed}} For this reason, the NBOMe family of psychedelic substances are considered to be significantly more dangerous to use than [[LSD]] despite sharing many [[psychedelic]] properties that can be difficult to distinguish, particularly for inexperienced users.

Likewise, the three major subclasses of [[hallucinogens]] ([[psychedelics]], [[dissociatives]], and [[deliriants]]) are each associated with their own generalized safety ratios. ~~Substances~~ in the deliriant subclass (such as [[diphenhydramine]], [[benzydamine]], and [[datura]]) are associated with higher degrees of physical toxicity at doses which produce the desired hallucinogenic effects and are thus considered to have the lowest safety ratio, which means a greater amount of precaution and preparation must be undertaken if one chooses to experiment with them. Psychedelics and dissociatives tend to have higher ~~physical~~ safety ratios. ~~However, it~~ should be noted that this pharmacological concept is limited in its scope when determining the total degree of risk or safety associated with hallucinogen use, as the low risk of ~~physically~~ overdose does not mitigate the profound changes in perception and cognition ~~they can induce~~ which can lead to dangerous [[delusions|delusional]], [[psychosis|psychotic]], or [[amnesia|amnesic]] states in ~~which the behaviors they induce may lead to~~ physical or psychological injury or death.

Likewise, the three major subclasses of [[hallucinogens]] (i.e. [[psychedelics]], [[dissociatives]], and [[deliriants]]) are each associated with their own generalized safety ratios. For example, substances in the [[deliriant]] subclass such as [[diphenhydramine]], [[benzydamine]], and [[datura]] are associated with higher degrees of physical toxicity at doses which produce the desired hallucinogenic effects and are thus considered to have the lowest safety ratio, which means a greater amount of precaution and preparation ([[harm reduction practices]]) must be undertaken if one chooses to experiment with them. [[Psychedelics]] and [[dissociatives]] tend to have higher safety ratios.{{citation needed}}

It should be noted that this pharmacological concept is limited in its scope when determining the total degree of risk or safety associated with hallucinogen use, as the low risk of physical overdose does not mitigate the profound changes in perception and cognition which when produced, can lead to dangerous [[delusions|delusional]], [[psychosis|psychotic]], or [[amnesia|amnesic]] states leading to behaviors that result in physical or psychological injury or death. Examples of this include walking into moving traffic or driving while intoxicated.

==See also==

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*'''[[Pharmacology portal]]'''

*'''[[Effective dose]]'''

==External links==

*[[wikipedia:Therapeutic index|Therapeutic index (Wikipedia)]]

==References==

@@ Line 22: / Line 22: @@
 ==Applications in non-medical and recreational contexts==
-The concept of a "therapeutic window" or "safety ratio" is sometimes informally applied in the psychonaut and recreational substance using community to communicate the relative degree of risks associated with the use of various [[psychoactive substances]]. These typically relate to the likelihood of experiencing desired effects (such as [[disinhibition]], [[stamina enhancement]], [[sociability enhancement]] and [[euphoria]] in the case of traditional street drugs and in the case of [[hallucinogens]] sensory distortions, [[hallucinatory states]], and [[euphoria]]) relative to the likelihood of experiencing side-effects which can range from extremely discomforting to life-threatening.
+The concept of a "therapeutic window" or "safety ratio" is sometimes informally applied in the psychonaut and recreational substance using community to communicate the relative degree of risks associated with the use of various [[psychoactive substances]]. These typically relate to the likelihood of experiencing desired effects (such as [[disinhibition]], [[stamina enhancement]], [[sociability enhancement]] and [[euphoria]] in the case of traditional street drugs and, in the case of [[hallucinogens]], sensory distortions, [[hallucinatory states]], and [[euphoria]]) relative to the likelihood of experiencing side-effects which can range from extremely discomforting to life-threatening.
-While the exact values for the safety ratios of psychoactive substances are rarely, if ever, referenced (and many are not even available given the prevalence of novel substances and the lack of pharmacological and toxicological data on them), the notion of a particular substance possessing a "high" or "low" safety ratio can serve to inform users about whether they want to experiment with a substance given their own personal comfort levels and degree of acceptable risk they are willing to take. Factors which complicate this include the unreliability of the purity and dosage of drugs obtained from gray or black markets due to a lack of regulatory oversight. Assessing a substance's safety ratio in advance by conducting independent research is considered to be an integral part of [[responsible drug use]] given the large variations in potential responses and the range of precautions one can take to mitigate potential risks.
+While the exact values for the safety ratios of psychoactive substances are rarely, if ever, referenced (and many are not even available given the prevalence of novel substances and the lack of pharmacological and toxicological data on them), the notion of a particular substance possessing a "high" or "low" safety ratio can serve to inform users about whether they want to experiment with a substance given their own personal comfort levels and degree of acceptable risk they are willing to take.
+Factors which complicate this include the unreliability of the purity and dosage of drugs obtained from gray or black markets due to a lack of regulatory oversight. Assessing a substance's safety ratio in advance by conducting independent research is considered to be an integral part of [[responsible drug use]] given the large variations in potential responses and the range of precautions one can take to mitigate potential risks.
 Examples of this include knowing the general dosage of any particular substance liable to put one at risk of an overdose, particularly those that can be sudden and fatal, such as those associated with [[opioids]] like [[heroin]] and [[stimulants]] like [[cocaine]]. In the case of [[hallucinogens]], a substance may have a very low safety ratio, such as [[LSD]], which has no established, reasonable lethal dose{{citation needed}}) relative to a [[25x-NBOMe]] substance, in which the dose needed to produce the desired psychoactivity is only a few multipliers lower than a dose which can produce [[seizures]], coma or death.{{citation needed}} For this reason, the NBOMe family of psychedelic substances are considered to be significantly more dangerous to use than [[LSD]] despite sharing many [[psychedelic]] properties that can be difficult to distinguish, particularly for inexperienced users.
-Likewise, the three major subclasses of [[hallucinogens]] ([[psychedelics]], [[dissociatives]], and [[deliriants]]) are each associated with their own generalized safety ratios. Substances in the deliriant subclass (such as [[diphenhydramine]], [[benzydamine]], and [[datura]]) are associated with higher degrees of physical toxicity at doses which produce the desired hallucinogenic effects and are thus considered to have the lowest safety ratio, which means a greater amount of precaution and preparation must be undertaken if one chooses to experiment with them. Psychedelics and dissociatives tend to have higher physical safety ratios. However, it should be noted that this pharmacological concept is limited in its scope when determining the total degree of risk or safety associated with hallucinogen use, as the low risk of physically overdose does not mitigate the profound changes in perception and cognition they can induce which can lead to dangerous [[delusions|delusional]], [[psychosis|psychotic]], or [[amnesia|amnesic]] states in which the behaviors they induce may lead to physical or psychological injury or death.
+Likewise, the three major subclasses of [[hallucinogens]] (i.e. [[psychedelics]], [[dissociatives]], and [[deliriants]]) are each associated with their own generalized safety ratios. For example, substances in the [[deliriant]] subclass such as [[diphenhydramine]], [[benzydamine]], and [[datura]] are associated with higher degrees of physical toxicity at doses which produce the desired hallucinogenic effects and are thus considered to have the lowest safety ratio, which means a greater amount of precaution and preparation ([[harm reduction practices]]) must be undertaken if one chooses to experiment with them. [[Psychedelics]] and [[dissociatives]] tend to have higher safety ratios.{{citation needed}}
+It should be noted that this pharmacological concept is limited in its scope when determining the total degree of risk or safety associated with hallucinogen use, as the low risk of physical overdose does not mitigate the profound changes in perception and cognition which when produced, can lead to dangerous [[delusions|delusional]], [[psychosis|psychotic]], or [[amnesia|amnesic]] states leading to behaviors that result in physical or psychological injury or death. Examples of this include walking into moving traffic or driving while intoxicated.
 ==See also==
@@ Line 34: / Line 38: @@
 *'''[[Pharmacology portal]]'''
 *'''[[Effective dose]]'''
+==External links==
+*[[wikipedia:Therapeutic index|Therapeutic index (Wikipedia)]]
 ==References==