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    INTRODUCTION

This essay attempts to analyse to what extent can drugs scheduled under the Misuse of Drugs Act of 1971 Class A and Class B

be prescribed within a medical context to treat health issues and mental illness.

These include

Class A Ecstasy (MDMA), LSD

Class B Cannabis, Cannabinoids and Ketamine

This will be done through a comparison of case studies comparing the individual use of these drugs with other case studies showing the application and results of common prescription based medications like SSRI's and benzodiazepines.

A BRIEF HISTORY OF LEGISLATION

Merek in Germany was one of the first opening pharmacies founded in Darmstadt 1668 by  Heinrich Emanuel Merek. He was responsible for the manufacturing and selling of alkaloids (morphine, quinine). American was next to catch up to Germany's pharmaceutical success in1849. As the American Civil War grew there was an increase in demand for new medicine to be developed, e.g painkillers and antiseptics. Britain soon began to catch on as well, with research being done on as many drugs as possible to look for benefits. Research on the medical benefits of now class A drugs such as LSD was then halted as in the 20th century the British government passed an act illegalising particular state-altering substances consequently to the amount of recreational users and deaths due to improper consumption. The tougher control on drugs and more legislations e.g storage, researching and the categorising of drugs in class A, B, C and D along with having to acquire a Home Office Licence to perform research on them meant fewer people were interested in researching the potential medical effects of them

The contemporary pharmaceutical industry has roots as far back as 400 BC, before this the medical industry being predominantly based in religion and superstition. In Corpus Hippocraticum, Hippocrates, an ancient Greek physician, made the earliest record of medicinal plants used to treat his patients, some of which were synthesized to form a cornerstone in modern medicine. Hippocrates was followed by the Roman physician Galen, whose methods in turn were developed and commercialised by medieval apothecaries and pharmacies.

The past 120 years has seen a revolution in new therapeutic medicines which have been refined to cure all types of disease and pain relief. Together with these we have seen a dramatic increase in their misuse.

Heroin was first thought to be non addictive when it was introduced in the 1890's. Similarly was Opium and Morphine which were known as patent medicines and widely used. Until 1916 there was little control over the use of drugs and opium and cocaine (coca) was in common use.

Amphetamines to assist soldiers to stay awake during days of combat by both sides during the first world war and following this amphetamine use by civilians increased dramatically. This led to the amendment of the Dangerous Drugs Act 1920 which limited production, export, import, possession and sale of heroin, morphine, cocaine to licenced persons only. A further amendment in 1925 included cannabis.

In the late 1940's the introduction of national marketing saw a rise in the use tranquilizers, barbiturates and new varieties of amphetamines and opioids and the 1960's introduced the criminalisation for possession of amphetamines and the cultivation of cannabis. A series of further amendments to the laws controlling these substances lead to the legislation currently in force.

The first safe and effective non-addictive medicine was Aspirin was introduced into medical practice by the Bayer Company of Germany. The commercialisation of aspirin and the lucrative profits of the penicillin market kick-started a new incentive for the pharmaceutical industry to develop new drugs.

This led to a huge increase in the number of commercially available drugs and eventually resulted in the development of the first widely available pill-based treatment for psychological issues namely diazepam.

Diazepam was marketed under the trade name ‘Valium' by Roche in 1963. Its widespread availability and popularity as a psychoactive substance saw the start of an era of self-medication with illegal street sales facilitating wider use of  amphetamines and barbiturates.

SOCIAL AND POLITICAL CONSEQUENCES

The social and political implements of legalising illegal substances for medical use are huge. as there is now a more difficult system to be approved for drug testing and drug testing is now associated with a previously government-developed stereotype, ‘drugs are bad, drugs cause harm'. The stereotype carries some truth however its fundamentally flawed, many drugs which are being investigated for their therapeutic value produce no neurotoxins or very little. Drugs cause harm due to a lack of education and improper use (recreational use) alongside with the illegal marketer using adulterate or substituting chemicals with 2,383 (https://www.gov.uk/government/publications/health-matters-preventing-drug-misuse-deaths/health-matters-preventing-drug-misuse-deaths)

Drug misuse deaths registered in 2016

This preceding stereotype has previously produced a devastating effect on the implementation of them into medical use and only recently has a large group of researchers decided to do trials with Class A drugs in order to study their therapeutic values. Pharmaceutical companies who were less interested in researching Class A drug then began producing alternative drugs to help combat diseases staying within the lines of the ‘dangerous drugs act' and having them categorized as class B and C meaning with a prescription the drug is available and you do not require a home office license to run tests on it.

However, modern researcher are beginning to see the potential benefits from using alternative drugs to help treat illnesses the studies are mostly based around stimulants, hallucinogenic, opioids and dissociatives, however, alongside the benefits there are risks when taking psychotropic drugs. However, many people are now asking, ‘Are some of the substances in the category class A able to provide us with new effective treatment?' Cannabis, LSD and ketamine are all under clinical trials to assess their values and to become more informed of the risks that there are by being medicated with these drugs. The first of these substances to be examined within the context of this essay, is cannabis.

The British government alongside many other governments have been waging a war on drugs since the 19th century. Legalising drugs would be a massive step backward regarding the war on drugs but a major advancement in clinical health. Some politics are commenting saying the war on drugs is ‘irreversibly lost' (Lord Hague) and a change of policy, is needed what better way to show a change in policy then to legalise them for medical use. The benefits to our country's mental health would be immense if we were to give these drugs a fair trial on everyday patients with positive effects being found on select clinical patients in labs already. With more research, these drugs have the potential to become life-saving and effective treatments working faster than SSRI's or more common treatments, which require baseline moods to be achieved. Many countries have acknowledged this and acted upon it such as Portugal in July 2001, have decriminalised drugs, meaning the punishments regarding drugs are much softer and adequate research into drugs and medicine can be approved much easier than that in the UK. While many American states and Israel have relaxed the laws regarding the cultivation and usage of Marijuana.

https://www.nimh.nih.gov/about/strategic-planning-reports/highlights/highlight-ketamine-a-new-and-faster-path-to-treating-depression.shtml)

A DECLINE IN AVAILABILITY

More recently there has been a significant decline in our capability to find new and effective treatments for patients with medical issues such as epilepsy and depression.

From some of our earliest civilisations have seen tribesmen and occupiers of the rainforests use the plants that grow there to treat a variety of medical conditions some of which are in current use in western medicine and society.

One of the oldest pieces of evidence that shows medicine derived from plants now are classed as class A drugs dates back to 1550 BCE, to a transcript called the Ebers Papyrus which refers to over 850 different varieties. This particular transcript includes plants and herbs like garlic, juniper and cannabis, castor bean, aloe, and mandrake for their medical values.

Some twenty five percent of prescribed medicine is derived from ten percent of known rainforest plants. The cultivation of these forests and a recent increase in deforestation and environmental catastrophes have resulted in an increasing decrease in the availability of key chemicals currently used in the production of many contemporary drugs.

Consequently, medical practitioners are now having look at more unconventional medicines as effective forms of treatment for new diseases. Although they were once considered to lack therapeutic value to modern medicine some of the drugs currently listed as being illegal in the UK are being used to treat patients in other parts of the world are showing some exciting and optimistic results.

These trials to discover more efficient medicine with fewer side effects for people who have tried conventional medicines with little success, could herald a whole new dimension in pharmaceutical medicine that as a new generation we should be supporting both in the UK and throughout other parts of the world where these trials have already shown progress.

MARIJUANA

Marijuana is a psychoactive plant used for medicinal and recreational purposes. Since recent legalisation in the United States of America, marijuana known more commonly in the United Kingdom as cannabis has been seen to make a lot of progress with medical trials done on epilepsy, its use as a painkiller and on addiction. Britain is now calling for its legalisation. The Advisory Council on the Misuse of Drug has recommended it now be placed as a Class B drug in Britain this means doctors can now prescribe medicine derived from this plant.

 Cannabis contains tetrahydrocannabinol and at least 113 other active Cannabidiols. The psychoactive component responsible for the ‘high' state is THC. Different strains of the plant have different concentrations of THC and CBD. The most medically used component is CBD, however, there is now a respectable amount of research being done into the effects of THC on cancer cells... Effects of the plant often last for between 2-6 hours when smoked and 1-8 hours when orally ingested.  

Cannabis is nowadays a Class A drug. Being categorised as a Class A drug prohibits anyone from producing research on it without a home office license, it also means the drug is considered to have no medical value.

However recent trials done on CBD have challenged this. CBD has been found to not produce an intoxicating feeling on the user and has been found to have success in treating addiction and epilepsy when it has been tested in lab studies. CBD was found to have an effect on neurotransmitters that were associated with addiction. The way addiction works is all down to how the brain is structured. The brain has a ‘reward system' that is based on neurotransmitters. Dopamine is one of the chemicals responsible for our initial survival instincts and a craving it is plays a huge part in addiction. When we give in to cravings we feel pleasure this is because dopamine is released combined with the amino acid glutamate, which triggers ‘richer visuals', it then reaches the amygdala where it stimulates your cravings even more by using previous experiences e.g smoking. This causes it to remind you of the pleasure you received from doing this activity. Cannabinoids can help to regulate our receptors in our nervous system by acting as a depressant and  dulling down the patients cravings.(https://ministryofhemp.com/blog/cbd-for-addiction/) (https://www.royalqueenseeds.com/blog-can-cbd-help-with-nicotine-addiction-n798)

This essay will now examine a variety of case studies involving cannabis use to treat several different illnesses.

Cannabis has been recently trialled clinically for treatment of addiction. There was a recent case study by Crippa et alinto how CBD helped a woman. The woman had a daily habit of cannabis use. She proclaimed to have withdrawal symptoms when she had tried previously to stop however with the aid of CBD oil she was found to experience no anxiety or negative consequences that were associated with stopping her cannabis intake.  Another study conducted by Ren et al found that animals that were given opioids and psycho-stimulants didn't struggle as much with addiction withdrawals when fed CBD orally.

CBD has also been tested in regards to its effects on epileptic seizures. Dr. Orrin Devinsky conducted an experiment on CBD and epilepsy his findings were twelve out of two hundred and thirteen people did not finish the trial due to negative effects, however, those who completed the study averaged on a 54% decrease in the number of seizures they were having . This decrease of seizures could mean that the patient now can carry on with their everyday life.

Cannabis has also been found to have success in helping to treat certain cases of cancer as THC and cannabidiol compounds along with others encourage programmed cell death which normal cells are not affected by. Some components of cannabis are also considered to be an Anti-proliferative, which stops the multiplying of cancer cells, this theory was proven in a test on rodents. Alongside all of this it is also considered to be an anti-angiogenesis in some cases. Being an anti-angiogenesis means it prevents tumours from being able to grow and develop a blood supply.

In 2011, results of a study on pain treatment or people with cerebral palsy. A total of 83 adults with cerebral palsy participated in the study, which consisted of trying 23 different medications for pain, including medical marijuana. The legs, lower back, and hips, were reported as being the most common areas of pain. According to this research it was reported

“Although the treatment rated as providing the most relief was marijuana, less than 5% of the sample reported ever using this drug for pain.”

First published 2011 in the National Institutes of Health (NIH).

California, Connecticut, Massachusetts, Nevada, Oregon, Rhode Island and Washington. Holland and Israel have all decriminalised the medical use of marijuana

(https://www.macmillan.org.uk/information-and-support/coping/complementary-therapies/complementary-therapies-explained/cannabis-oil.html)

SELECTIVE SEROTONIN REUPTAKE INHIBITORS

SSRI are a class of drugs that are usually pill based which are prescribed predominantly for depression. Eli Lilly released the first selective serotonin reuptake inhibitor, Prozac, in 1987. SSRIs are still our current solution to treating the symptoms of depression. There are many different types. They are administered orally and work by blocking the reuptake of 5-HT also known as the neurotransmitter, ‘serotonin.' It does this by acting on the serotonin receptor SCL6A4, the SSRI blocks the receptor by acting on the transporter making it unable to pickup 5-HT this in consequence results in more serotonin being made and released. SSRIs take 2-6 weeks for the patient to feel the effect. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896866).

Many may say that SSRIs are already doing enough, however SSRI's effectiveness has been challenged,In a meta-analysis conducted byIrving Kirschonplacebo trials it was found that the placebo group had a 75% improvement. Therefore it can be concluded that the placebo effect, that the patient feels better due to them taking something that they have been told will make them feel better does come into play with the treatment of depression using SSRIs.(https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/)

   BENZODIAZEPINES

Benzodiazepines are a class of drugs that have hypnotic, anticonvulsant and muscle relaxant properties. At current benzodiazepines are being prescribed to patients to treat depression, anxiety, seizures and to act as mood stabilizers. An example is diazepam more commonly known as Valium. Valium is used to treat anxiety, alcohol withdrawal, and seizures. The drug works by acting as a depressant on the brain increasing the strength of the neurotransmitter, gamma-aminobutyric acid. GABA reduces activity in the brain. The drug is dangerous as with time the brain begins to stop being able to function without the drug's effects leading the user to become addicted. The effects when a patient stops taking Valium are a lot more serious than those of CBD. Addiction to Valium can cause the patient to throw up blood, have seizures, dizziness, feeling sad along with psychosis.  The safer alternative, CBD has been declared by the World Health Organisation as non-addictive and to produced no negative side effects.

LYSERGIC ACID DIETHYLAMIDE (LSD)

LSD is a drug belonging to the hallucinogenic category. There has been considerable research into the benefits of using lysergic acid diethylamide more commonly known as LSD.  Albert Hofman in Switzerland first synthesized this drug in 1938 to treat respiratory depression.

The drugs psychedelic properties remained a mystery for 5 more years until in 1943 Hofman accidentally ingested the drug and as a result fell off his bicycle while hallucinating. Following this for some twenty years or more LSD gained use by some therapists to support psychoanalysis.  The counterculture of the 1960s however, led to it being used for recreational purposes which quickly gained adverse media attention. As a result of this production was stopped, and in 1967, LSD was banned and classified as a Schedule 1 drug.  

When used in high doses LSD causes an altered sense of reality, hallucinations and a distorted sense of time. The drug can also cause an awakening of the senses in

the user. One disease LSD is believed to be able to treat is chronic depression. This disease is believed to be a chemical imbalance in the brain as a result of reduced activity in the neurotransmitters, Monoamines (dopamine and serotonin) alongside with Norepinephrine.  These neurotransmitters are believed to have an affect on mood, social behaviour, sleep, appetite and sexual desire. Low serotonin levels is a symptom of depression; This reduced level of activity can be caused by negative thinking, and not engaging in pleasure-inducing activities which prompt a release in the neurotransmitter. To understand why LSD may have a positive effect in therapy the workings of there needs to be some understanding of the human thought process. Beck, a highly regarded psychologist produced the cognitive trial which is an irrational and pessimistic view on the 3 elements in a person's thought processes that play a part in depression, self-thought, environmental thought and thinking about the future.

Someone who is depressed will follow a rigid mode of thinking where he or she will only think about negative preconceptions and generalisations concerning themselves. In consequence of not having a flexible mode of thought the patient will have difficulty in changing their thought processes regarding themselves and their lives.

Research has shown LSD to break down the rigid thinking structure. One researcher, Amanda Feilding, describes the usage of LSD as, “ a kind of mental anarchy, a more chaotic state, in which new ideas, associations, and observations can come up.”

The drug is said to have the ability to connect and increase activity in certain areas of the brain such as the default mode network, a collection of hub-like centers that control the lower areas of the brain. This part of the brain is responsible for building up our perception/consciousness. The drug mimics serotonin and causes a mass stimulation of more serotonin neurotransmitters causing a mass release.

Using hallucinogenes to treat depression has risks that other options do not have. Artificially altering someone's mindset has the ability to open them up to undesirable experiences.  For example, many people who have taken hallucinogens have experienced a sequence of paranoid hallucinations which could be most detrimental to those experiencing mental health issues.

Some patients may become even more depressed or experience psychosis due to the extreme psychological consequences that come about even once the drug has left the body.  Known as a ‘persisting perception disorder' this can also occur when the effects of the drug do not reduce in the desired time and may even stay for many months provoking the user into periods of psychosis with mild hallucinations.

These effects are usually known to follow excessive doses or frequent usage of LSD.  

Although LSD was/is classified as having no acceptable medical use

recent studies, using reduced dosages of LSD, to treat mental depression was found to ‘elevate oxytocin levels… increase connectivity between networks which normally are more dissociated….. global increases in brain entropy that were associated with greater trait openness 14 days later.

This trial was done with patients whose anxieties were associated with terminal disease. The results showed that two doses of LSD, ‘ reduced their anxiety for 2 months.' No issues with administering the LSD were observed afterward.

With no adverse effects also being observed during this trial has lead the lead researchers to claim ‘LSD is relatively safe when used in medical settings and according to safety guidelines' These to limit the strength and ensure the quality of the drug.

LSD unlike its derivatives is physically non-toxic and produces no neurotoxins. Studies linked to regulated therapeutic trials of  LSD have found results that suggest the drug LSD has the ability to get the patient to ‘impair the recognition of sad and fearful faces and enhance emotional empathy' which is considered to be of high value in psychotherapy.

KETAMINE

This is a relatively new drug currently on trial to test its efficacy in the realm of modern medicine. Ketamine is already in use as an anaesthetic to treat postoperative and chronic pain. It has been found effective in the treatment of neuropathic pain which arises from the somatosensory nervous system. A system which does not respond well to conventional analgesics.

Ketamine is under review as an adjunct to psychotherapy and has been found useful in the treatment of depression and post traumatic stress disorder. However, a more comprehensive review at this drug and its uses in all territories of modern medicine as yet remains unavailable.

Currently in common mis-use as a recreational drug ketamine induces an aesthetic trance-like state in the user which is experienced as a feeling of floating. A detachment of the mind to the body.The popularity of ketamine as a recreational drug has given rise to whole new genre of music commonly known as ‘trance'.

Ketamine however, is not without its adverse effects. It can cause confusion and panic and can be accompanied by visual and auditory hallucinations. It can also render the user immobile and incapable of any movement. This known as a near death experience termed ‘entering the K hole' which for some people can be deeply disturbing.

Its effects last from one hour to several with after-effects still being experienced for a number of hours following. Long term regular usage is linked to depression and disorders of the bladder and urinary tract.

Ketamine seems a viable short term anaesthetic to subdue pain and sedate a patient during an operation. Its medical value comes from the fact that the heart and respiratory systems remain functional even during heavy sedation allowing for breathing and blood flow to remain constant.

To understand how ketamine works its important to understand how our consciousness is built up and what has the ability to alter it. Glutamate molecules going into N-methyl-D-aspartate receptors build up our reality, ketamine acts as a blocker, it blocks the NMDA receptors in the brain causing an altered sense of reality.

John Krystal chief of psychiatry at Yale-New Haven Hospital has referred to the effects of the drug as profound claiming it works quickly to change the mood of the user with effects lasting one to four hours.  Ketamine's rapid effect make it extremely useful in suicide prevention with mentally unstable patients.

Krystal says although they are unsure why the drug works so well with depression one theory is that it promotes the regrowth of connections between the brains cells which are associated with emotion and feelings.

Ketamine's medicinal value was observed during a study in 2000 that was conducted by Berman et al. to study the effect of ketamine on the symptoms of depression. 0.5mg/Kg was injected into 8 patients 4 out of 8 patients had a 50% decrease in Hamilton's depression rating system on the day three follow up of the study the ketamine-induced mood change had returned back to the patient's baseline.

Zarate et Al replicated this experiment in 2006 and found that; ‘ketamine was shown to produce rapid and robust antidepressant effects in patients with treatment-resistant major depressive disorder and bipolar depression'

Therefore Zarate et al's study was said to suggest the following, ‘that inhibitors of glutamate could have antidepressant-like effects' that Ketamine's effects on glutamate signalling is proficient reducing this within hours.

CONCLUSION

Health should be at the centre of any and all debates regarding the decriminalisation of drugs and these would certainly need to include professional healthcare workers and those working in the field with social/economic deprivation.

According to a report by the Global Commission on Drug Policy (panel includes former UN secretary-general Kofi Annan, British businessman Richard Branson and the former presidents of Switzerland, Colombia, Mexico and Brazil the prohibition of drugs has had "little or no impact" on the rate of drug use with the number of drug users increasing by almost 20 per cent between 2006 and 2013 to 246 million people.

The report warns prohibition of drugs fuels mass incarceration and executions in contravention of international law and drives human rights abuses by those who supply them. It claims prohibition laws have failed to curb either supply or demand, reduce addiction, cut violence or reduce profits for organised crime, claiming the so-called 'War on Drugs' had been a failure.

The British Medical Journal called for the legalisation of illicit drugs for the first time in 2016. The editors called for doctors to be at the centre of the debate on alternative policies to promote health and respect people's dignity.

The paper's editor-in-chief, Dr Fiona Godlee, and features and debates editor, Richard Hurley, pointed to the fact drug use has grown substantially worldwide, with a quarter of a billion adults

worldwide having potentially taken illegal drugs such as cannabis, cocaine or heroin in 2014.

Parliamentarians also called for an end to criminal sanctions for the personal possession and use of all drugs. “British politicians should seriously consider introducing a version of the Portuguese model in the UK, involving a significant transfer of resources from criminal justice to treatment services,” they said. They added that steps towards decriminalisation in the UK have already begun, with the Psychoactive Substances Act 2016, and argued changes to drug prohibition “could be good for the UK".

Former Liberal Democrat leader Nick Clegg and Baroness Molly Meacher claimed the UK's drug policy has been irrational for 55 years and argued this was the right time to establish a wider review of drug policy. and argued this was the right time to establish a wider review of drug policy. They urged the Government to reschedule cannabis for medical use and review policy on heroin-assisted treatment, which they said had shown positive results in Switzerland, such as a decline in drug use and crime and improvements in health and rehabilitation.

Ruth Dreifuss, former President of Switzerland and chair of the Global Commission on Drug Policy, said ever. She argued the idealised notion of a “society without drugs” was an unattainable fantasy and said reforms must prioritise issues of public health, social integration and security, while respecting human rights and judicial process.

Decriminalisation can and must go further, she added. In an upcoming report, the Global Commission will call for governments to regulate all illicit drugs, which it says would curb a massive revenue for organised crime worth an estimated $320bn.

Cannabis has been used through the centuries as a painkiller however recently there is a risk in the use of cannabis predominately down to a strain named, ‘Skunk” a highly potent strain which is used as a recreational drug to produce an intense high rather than its medicinal value. The medicinal use of drugs can be seen like this by using marijuana for example by legalizing marijuana the user is allowed a choice they can choose to have a much softer strain to deal with their pain or something stronger as decided by their doctor (who is qualified to diagnose eliminating self diagnosis) instead of having to use a high THC concentrated strain. By allowing the patient a safer option to get the drugs that the doctor can prescribe to them it eliminates the dealer's business reducing crime and makes usage a lot safer as it gives the user a chance to make an informed choice on which strain they want to use.

THC has been proven to have its medical values to certain individuals however, The usage of this drug carries extensive risks, research in labs has shown that cannabis can also cause extensive damage to important blood vessels and in some situations even promote cancer cells to grow and multiply. THC is the chemical that results in a user experiences a high, so treating a disease using THC will cause the patient to suffer from side effects such as dizziness, hallucinations and a general feeling of tiredness.  CBD on the other hand has no recorded side effects when being used to treat seizures in comparison with benzodiazepines, which are highly addictive, and the patient can suffer from extreme side effects, such as seizures, vomiting blood and insomnia these symptoms can prove life threatening. Therefore it can be deemed that CBD is a much safer alternative for the prevention of seizures. Therefore drugs are being prescribed with detrimental side effects when safer alternatives are available however banned.

In regards to LSD being used to treat depression, it's use in clinical trials has produced the results that the drug causes the patient to have less fear regarding matters and in consequence can deal with more difficult emotions and talk about tough times without feeling afraid which therefore results in a more successful therap. However, LSD has also been found to, ‘impair the identification of complex emotions' which can prove to make therapy considerably less effective as the patient cannot specify how they are actually feeling due to the patient only feeling a general feeling rather than a specific feeling. Therefore it has benefits when the therapy requires the patient to talk about difficult situations for them. LSD is impractical in therapy when it requires the patient to pinpoint specific feelings.

Consequently to the impact LSD has on the brain the conventional method for treating depression, SSRI's are a much safer option for the treatment of the symptoms of depression as they do not alter the brain's functions/neurotransmitter levels as drastically as LSD, however, they are slower at treating the symptoms. They take 4-8 weeks as a base level of the neurotransmitter serotonin has to be reached in order for the patient to feel ‘happier.' Treatment with SSRI's also doesn't help solve the actual problem at hand they just help to prevent the symptoms by dulling out your current emotions with serotonin leading to a ‘higher mood' Whereas LSD has a more appropriate use to deal with the actual issue rather than eradicate the symptoms.

Both treatment will require side therapy. SSRI's produce a base mood level higher than the patient's the previous mood when not taking SSRI's. By producing a ‘higher mood' it is easier to work with in therapy whereas, LSD provides an alternative mindset to work with which in therapy is more flexible and open to new ideas. This provides an unconventional refreshing method for the therapist to work with which is useful if the patient is struggling with the symptoms associated with depression such as the inability to get out of a ‘rigid mindset'.

Although ketamine had promising results from previous clincal trials, it cannot be overlooked when assessing whether the drug has medical value that the drug has psychotropic effects. The drug alters people's perspectives of themselves/others and their environment as it fragments our reality, which can lead to the general public being put in harm's way due to the patients actions. Through excessive use of ketamine, the user is  also put at danger of experiencing a psychotic episode. Ketamine has other disadvantages such as it has to be administered intravenously and it can have side effects which require close monitoring for many hours after. The effects of ketamine misuse on the bladder are significant. It causes ketamine cystitis which is where the bladder suffers irreversible damage by ketamine killing the bladder cells it causes the cells to become cytostatic where they stop growing and eventually die with continued use which ultimately can result in death.

. Therefore with further research these ‘Class A' drugs absolutely have the potential to become an effective treatment for diseases and effective and safer replacements for already invented treatments. The risks of administering these drugs however must not be overlooked; tougher storage and more safety measures must be put in place for the administering of these drugs to everyday patients. By allowing them to everyday patients more research can be done on them, as research can be done on a much wider scale allowing doctors to create regulations and rules in order to keep patients safe. Further research may also lead to new discoveries on how the effects could be useful in different

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