Planning the Perfect MDMA Trip: A Beginner's Guide

If you've never taken MDMA before, you're in for a treat.  You probably have an idea of the drug's effects based on stock video footage played ad nauseam on the news or various documentaries:  the dancing, smiling, sweating and incessant desire to form cuddle puddles.  While my days of rolling on E are behind me, I still look back fondly on them.  MDMA in its pure form is one of the most enjoyable drugs a person can experience.  It shines in both therapeutic and recreational settings, enhancing one's sense of empathy as well as bodily sensations like touch and hearing.  

This article is for new users who are thinking of taking the drug for the first time as well as those looking to plan the perfect trip.  It is not a harm reduction article:  the internet is full of scare stories and safety tips on how to avoid dying on MDMA.  Please do your research before taking this or any drug.  

I think of MDMA as a sensory enhancer... a sensual drug rather than a sexual one.  Therefore, to plan a great MDMA experience you should focus on the 5 senses.  Here's a quick guide to get you started:

Sight:  MDMA dilates the pupils, letting in more light than usual.  Therefore you'll probably prefer a dimmer setting than somewhere bright.  However don't plan on sitting in the dark.  There's a reason people are entranced by light shows at raves.  So dim those bulbs & put on some Christmas lights or other colorful/sparkly lights!  Glow sticks are also fun.  A bubble or fog machine can add to the ambiance as well.  Just make sure not to light a bunch of candles or other actual fire sources that can be hazardous.  Stick to safer options that you won't have to attend to while high, like colorful neon or LED lights.  You'll thank me later.  

Smell:  This one is interesting.  All kinds of aromatherapy are nice on MDMA, but menthol is a favorite among ravers.  Vicks inhalers (which incidentally contain levmetamfetamine, the levo isomer of methamphetamine) and other off-brand menthol inhalers send a tingly rush of mint to the brain that's said to reinvigorate the MDMA high.  Wear it around your neck for easy access.  Scented lotions & oils are also nice if you're doing massages, as are essential oils.  But again, don't use anything that has to be plugged in or lit on fire while you're intoxicated.

Sound:  This is probably the most essential part of an MDMA experience:  Music.  Uptempo, spaced-out, funky, electronic.  Doesn't matter.  Any genre you normally like will sound infinitely better, but try to branch out and mix in some new artists with your standard faves.  Make a long playlist and have it ready to go.  Better yet, attend a live music show or play your own.  Just stay away from anything depressing, somber or angry.  You'll likely want to dance spontaneously so keep that in mind when planning.  The MDMA high is not like psychedelics where you'll want to meditate in silence or get lost in your thoughts; it specifically enhances music & makes it sound amazing, so go big & get creative with your choice of tunes.  

Touch:  After music, touch is probably the second most vital part of a good MDMA trip.  Ecstasy turns up the sensitivity to touch in a way that's hard to put into words.  Everything feels SO GOOD.  Soft things.  Cool water.  Human touch.  Stretching your muscles like a cat.  Feathers, fur, beads.  A cool breeze.  I like to keep a spray bottle & spritz myself randomly or, better yet, spray it into my floor fan & let it blow back into my face.  Massages & cuddling are also otherworldly.  As long as the touch is consensual it's all good.  

Taste:  You probably won't be particularly hungry while on MDMA as it has appetite suppressing effects, but sweet things like Gatorade & suckers taste yummy.  Pop Rocks & sour candy are also fun.  MDMA tends to cause the jaw to tense up and trigger an effect called "gurning," so have some gum nearby to prevent tooth grinding.  Fruit flavored sweets like Skittles or actual fruit are another a good choice.  Whatever you pick, make sure to have plenty of cold water on hand to prevent dehydration.  Add a twist of lemon or lime to your water to make it taste amazing.  

What To Do/Where To Do It

As for activities to do on MDMA, the possibilities are endless.  You don't have to take it at some crowded dance party or festival, though it complements those events nicely--it's also great in more intimate settings.  Many of my rolls were with just me and my (now) ex at home by ourselves.  It can affect some people a bit differently.  I always got the typical euphoric energy rush while she fell asleep shortly after dosing.  But the effects are pretty predictable for the most part, unlike LSD or other hallucinogens that can cause panic, ego death & uncomfortable bodyloads.  Set and setting are less important with MDMA as freakout potential is lower.  It's the next-day comedown that's rough for some folks. 

My ideal MDMA trip setting, minus the heat and fire.

I can imagine it being ideal in many settings including a Fall camping trip, date night with your spouse, concerts, holiday parties (New Year's Eve or 4th of July come to mind), a pool party*, Vegas-type shows or at an arcade.  Anywhere with lots of sensory stimulation that's not too hot.  Personally, my dream MDMA experience would be taking it with my crush with some music playing while we chill in a heated pool at sunset... alone, of course.  I can't imagine anything better than the combined highs of this drug plus the natural endorphin rush of being with someone you like romantically.  The feeling would probably be on par with winning the lottery, honestly.  

This isn't an experience to "waste" by taking it alone or while nobody else is rolling in my opinion.  It's definitely more special if other people are on your level, chemically speaking.  This is likely due to the drug's effect on empathy.  There's a bittersweet feeling to MDMA:  you know it's an artificial high that will eventually end, so you want to maximize the pleasure as much as possible & make memories that will last forever.  And again, the comedown can be harsh for some so it's not something to re-dose or take every weekend.  3 months between doses is the recommended waiting period.  

*Safety first!  Only enter the water if you can swim, feel safe doing so and have sober trip sitters present.  Do not combine MDMA with alcohol or other intoxicants as this increases the risk of self-injury. The main risks of this drug are overheating and dehydration, so be aware of the ambient temperature & drink plenty of water.  Always test your MDMA with fentanyl test strips prior to dosing & start with half a pill to avoid overdosing.  

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Serial Killers & Military Service: The Strongest Link You've Never Heard Of

Trigger warning:  Violence.  

What makes a serial killer or mass murderer?  This question is often posed with lots of pontificating on things like nature vs. nurture, childhood trauma and the like.  Indeed, a few standout risk factors have been identified:  autism spectrum disorder, head trauma and child abuse being the Big 3.  But there's one that often goes unmentioned, either out of ignorance or because it's not politically correct to discuss it.  This single factor is so overwhelmingly omnipresent in serial killers that it's almost unbelievable that the world's leading psychologists would overlook it by chance, which leads me to believe it's the latter.  That risk factor is a history of service in the U.S. military.

If you were to Google any well-known serial killer in U.S. history right now, chances are you'd find that they've got a history of military service prior to committing their crimes.  Try it.  David "Son of Sam" Berkowitz?  Honed his expert rifle shooting skills in the military.  Gary Heidnik?  Received high marks in service & attended military school.  Joseph DeAngelo, the Golden State Killer?  Joined the U.S. Navy in 1964 & served in Vietnam for 22 months before becoming a police officer in California, where he committed his brutal series of rapes & murders.  The one exception I can think of is Night Stalker Richard Ramirez, but alas, he was directly influenced by his older cousin Miguel who served in Vietnam & shared horrific stories of raping the body-less heads of women he'd decapitated in the war.  He also shot his girlfriend in the face in front of young Richard, cementing the marriage of sex and violent gore in his mind.  

In my own life I know several vets who went in relatively normal and came out to commit horrific crimes--one raped a girl in my town while she was unconscious (drunk) and another committed suicide after getting addicted to meth & going AWOL from the Marines.  The worst of the group killed his infant son and then committed suicide before he could be charged.  It later came out that he ran over a child in Iraq due to instructions by a commander to never slow down for fear of being blown up by an IED.  The cries of his baby boy must've caused flashbacks that triggered a rage.  When he returned home, he was told by a superior never to speak of the incident so he was unable to truly get help for the trauma.  One has to wonder how common this is with vets returning home from war zones.  

When Violence Abroad Comes Home

Soldiers are given intense training in marksmanship & survival before leaving for war.  This training is harsh, unkind and downright cruel at times but is necessary to prepare them for what's coming.  When war is over, they're sent right back into the "civilian" community without any kind of de-escalation or therapy to help reacclimate them to life outside a warzone.  This often makes it extremely difficult to reintegrate into society as the fight-or-flight response and adrenaline are still running high.  These mechanisms literally kept them alive for months or years abroad except now they serve no purpose other than causing nightmares, flashbacks, depression & other symptoms of PTSD.  

When people think of PTSD they usually only consider how horrific it is for the person afflicted, but if not treated properly it can also result in domestic violence and, in extreme instances, violent crime in the community.  See:  the case of Chris Kyle, who was killed by a fellow veteran he had taken on a "shooting therapy" excursion as a form of (dangerous & ineffective) PTSD treatment.  Another well-known example is the D.C. Sniper, who went on a multi-state shooting spree with a child he was molesting.  Both killers had a history of military service prior to committing their crimes, but there are many less well-known cases.  

Beer is Cheaper Than Therapy documentary

These war wounds can also blossom into homegrown terrorism.  OKC bomber Timothy McVeigh served in the Gulf War & became jaded to the military's mission halfway through, returning home to unemployment & disillusionment with the ATF's behavior at Waco, prompting him to become radicalized & commit the Oklahoma City Bombing 2 years to the day after the Waco siege on April 19, 1995.  McVeigh was every bit the terrorist that Mohammad Atta or Ramzi Yousef were but his path to terrorism is less comfortable to discuss since he was a white American militiaman with a history of military service.  So they executed him in record time before he could say too much about his motivations.  Problem solved.  If the OKC bombing happened today, there's no doubt that FOX News, OANN and similar networks would praise McVeigh's politics & views, if not his methods.  Just look how many people fawned over Kyle Rittenhouse.  

Timothy McVeigh during the Gulf War

There's no question that our government is failing to provide our veterans with adequate housing, mental health care & treatment for specific ailments such as Gulf War Illness & Agent Orange poisoning.  But few media outlets are willing to touch on what that failure might mean for the rest of us.  It's abhorrent to hang your soldiers out to dry after they've served their country; we can all agree on that.  It's this secondary effect that needs discussion because there seems to be a conspiracy of silence about the effects of war-induced PTSD on American society as a whole.  When the military fails to de-escalate returning soldiers after war, we all pay.  

Caring for our vets is often left entirely up to private organizations like Wounded Warrior Project, which is disgraceful.  These orgs shouldn't even have to exist!  If our military and government did what they were supposed to by providing for these people, they wouldn't have to rely on charity, which is beyond insulting.  If you risk your life for this country, you should be set for life--not discarded when you're no longer physically capable of fighting.  When you consider that these traumatized soldiers are also highly trained with weapons & often left to self-medicate with alcohol or other substances, it can become a volatile situation.  

Soldiers in Hiding documentary

Obviously correlation doesn't equal causation.  Perhaps people who enlist in the military already have a higher propensity to commit violent acts for some reason, such as lower socioeconomic status or education.  Military recruiters flock to impoverished high schools so this has to be taken into consideration.  Also, there's a possibility we have the cause and effect backwards:  maybe people willing to kill in the first place are just joining the military because they already have that tendency and the military service itself isn't "causing" anything.  It's sort of like the link between football and domestic violence:  is the head trauma making players violent, or are they already violent as evidenced by their behavior on the field every day?

Either way, sweeping this risk factor of military service under the rug because it's uncomfortable to talk about doesn't do anyone any favors.  Our government doesn't have the right to put us all in danger because they refuse to care for our vets.  We should all be livid that this is happening because it's preventable.  Every war since WWII has been unnecessary & based on lies rather than protecting our nation.  But if they're going to send our troops to war, the least they can do is provide them with housing, healthcare (including adequate mental healthcare) & employment opportunities upon return.  And that includes allowing and encouraging soldiers to talk about WHATEVER horrific things they've seen and done at war with a licensed therapist, not burying it deep inside where it will surface later in a horrific way.  

Note:  This is a critique of our government, not our troops.  In no way do I mean to imply that all veterans are violent or have the potential to harm others.  It's clearly a tiny minority who go on to commit violent acts upon returning from war.  I deeply appreciate the sacrifice our troops make by enlisting voluntarily.  Caring for our vets for their own sake should be priority #1.  I just wish our government felt the same.  

Resources:

American Journal of Arcane & Obscure Research:  Murderers Who Have Served in the U.S. Military: A Database

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SUNDAYS ARE FOR DISCOVERING NEW MUSIC.

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Cannabis "Allergy": Why Did Weed Turn On Me?

If you've been in the cannabis community for any length of time, you've probably heard the story before:  dude or dudette starts smoking weed, usually in their teens, and loves the stuff.  Said dude(tte) becomes a casual smoker for several years with no issues.  Then, around 3-7 years down the line, the weed starts causing sudden and unexpected side effects that were never present before:  anxiety, paranoia, rapid heartbeat, dizziness or shortness of breath.  Less commonly, severe adverse effects like Cannabinoid Hyperemesis Syndrome can develop in long-term users, forcing them to give up the good weed altogether.  This can be majorly depressing or even life-altering if said stoner was a medical marijuana patient.

The question is:  WHY is this happening?

For all we know about this ancient plant, we still don't know why it can seemingly turn on long-term users in such dramatic fashion.  This happened to me when I was in college.  I started smoking when I was 16 occasionally and became a daily user by age 19.  By age 23 I'd developed negative side effects like anxiety and paranoia, especially when in public after toking.  But even in high school, I had friends who claimed they'd become "allergic" to weed and could no longer smoke for similar reasons.  Needless to say I was skeptical.  This was before I was an internet nerd and had read countless reports of the same online.  Here are a few:

Weed is making me feel bad all of a sudden.

Why am I all of a sudden anxious after smoking weed?

I get severe anxiety every time I smoke weed now.

The CHS stories are even more brutal:  tales of smokers of 10-30+ years suddenly being afflicted with non-stop vomiting & stomach pain triggered by smoking their favorite plant--a plant that's famous in the medical world for it's nausea-fighting effects.  The CHS subreddit is full of personal horror stories that prove this is more than just media hype despite how scary & bizarre the symptoms sound.  

Cannabis Side Effects:  A Closer Look

More of this, scientists.

So what the hell is going on here?  

Drug users tend to fall back on the old "set and setting" explanation, but there's only so far set and setting go in this instance.  Sometimes a drug's direct effects on the body are truly to blame, and that's definitely what's happening here.  It's too common an experience for it to be anything else.  In my case, I had absolutely zero anxiety about smoking under my authoritarian dad's nose when weed was 100% illegal & I had everything to lose vs. now when it's legal & I'm a consenting adult.  I had no paranoia when trying to function high in public back then either.  In fact, it was FUN.  So it's nonsensical to blame it on my mindset when the stigma has been erased along with the legal penalties.  It's the weed causing the anxiety & paranoia, not the legal status.  

I suspect the potency of today's weed plays a role, but only a small one since my side effects started back in the Mexican brickweed days of the early 2000's.  THC being stored in the body's fat cells might offer a clue: perhaps it builds up in the body and causes an "overdose" of some sort of metabolite with chronic heavy use?  (Most CHS sufferers are long-term users who smoke multiple times a day & have THC built up in their bodies).  Or maybe the teenage brain reacts differently to weed than the adult brain and starting too young somehow (mis)shapes the cannabinoid receptors during brain development?  These are all wild guesses on my part as I'm clearly no scientist.  

That's why I'm calling on scientists to tackle this problem before it snowballs any bigger.  Our hospitals are already overloaded with COVID patients--if and when that problem resolves itself, there will be a backlog of people with other diseases who neglected their health due to the pandemic.  The last thing we need are people with weed-induced freakouts or "scromiting" further taxing our overburdened healthcare system.  There are also people with chronic diseases like Dravet Syndrome, Multiple Sclerosis & glaucoma who rely on cannabis as a first-line medicine; if it becomes worthless to them because they suddenly develop adverse effects, what then?  

Most drug reactions happen instantly, or at least very soon after a person starts using a substance.  In fact I'm not aware of any other medication that causes a person to react positively for years and then suddenly start feeling like they're going insane or puking their guts out from it.  We need more research into this phenomenon, and fast.  With the rise of legal cannabis we'll keep seeing higher potency products in more forms ranging from edibles to topicals to concentrates, though these reactions appear to be just as likely with flower smoked the old fashion way.  

The dearth of information on cannabis is entirely due to the 80-year prohibition on it--I know that will take time to remedy.  But that's precisely why we need to legalize ALL drugs.  The exact same thing is happening with research on LSD, MDMA, heroin, mescaline, khat, psilocybin mushrooms and other Schedule I drugs as we speak.  The result is that science is stalled & real people suffer. 

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[Review] - Cannabis Edibles: Green Hornet Trifecta 1:1:1 Gummies (Mixed Fruit)

 

These "Good Mood" gummies were a welcome gift from a friend who picked them up at a local mmj dispensary for $15.  Green Hornet is a trusted brand made by parent company Cheeba Chew, one of the best known in the edible industry.  While not as rich in CBD as the Simple Cure 3:1 gummies I love so much, they're much tamer than the current DOSD Nano Bites I'm eating which contain 25mg THC & CBD per candy.  And they taste better too.  

Green Hornet Trifecta gummies contain a 1:1:1 formulation of CBD, CBN & THC totaling 100mg per bag (10mg of each ingredient per piece).  The mixed fruit flavor is really yummy and makes you want to eat the whole bag, which you shouldn't if your tolerance is on the floor like mine.  They're the perfect mix of sweet and tart, and you can't tell they're low-calorie/low-fat at all.  They're also gluten-free for all my Celiacs out there.  Green Hornet sells a variety of gummies & flavors including Goodnight grape (CBN/THC), Black Cherry (CBD/THC) & Blue Raspberry (Sativa).  

Green Hornet gummies inside package

The effects are quite similar to the 3:1 gummies, which is probably accounted for by the double dose of CBD + CBN to the single dose of THC.  I much prefer these to the DOSD gummies for their ease of dosing (read: lower potency) & taste.  The only drawback is the packaging which is clearly not meant for re-closing hundreds of times like I intend to do.  My gummies were slightly melted after the car ride home but nothing horrible.  Granted, it's mid-October.  Can't imagine how they would've fared in the heat of the summer.  My premenstrual cramps were easily wiped out by nibbling the corners off these bad boys all afternoon, though they did give me extreme munchies.  

Overall I give Green Hornet Trifecta 1:1:1 Mixed Fruit Gummies 4.8 of 5 stars for flavor, effects & price.  The only thing I'd change is the integrity of the packaging by making it more easily resealable for those of us who don't plan on taking the whole 100mg at once.  It's good to see CBN get some love in the edible world and I appreciate the inclusion of gluten-free, low-calorie options that taste great too.

The FDA's War on Supplements

As a long-term user of N-Acetylcysteine, I started having a hard time finding it in stock around Spring 2021.  Assuming the shortage was COVID related, I never looked into it too much and figured it would sort itself out in time.  I take it daily in large amounts to (hopefully) offset acetaminophen-induced liver toxicity from the large doses of Tylenol I take every day.  So far it's working according to my liver enzyme tests.  It's not marketed for that use by the manufacturer to be clear, but that's how I use it.  And I've never had a single side effect from it.

So imagine my shock when I clicked on a random Youtube video about NAC the other day and found out that the reason for the shortage is that the FDA has begun a coordinated crackdown on the sale of it on Amazon that's likely to become a total ban of the manufacture and sale of NAC in the U.S!  This is a dietary supplement that's been on the market for over 30 years and has an incredible safety profile, with zero risk of abuse or addiction and no psychoactive properties whatsoever.  Not one person is using this to get "high" and it's killed no one.  

So why would they suddenly decide to ban its sale as a supplement?

The 'official' reason is that it was approved as a medication first, which is flimsy as there are many other supplements that are sold as both prescription drugs and supplements.  (See:  fish oil, Vitamin C prescribed as "Ascorb" & l-methylfolate prescribed as "Deplin" for depression).  More importantly, why is this only coming up NOW when NAC has been sold without issue for 30+ years on the supplement market?  

One popular theory is that studies have recently come out showing its effectiveness in improving outcomes in COVID patients.  I like this theory because it explains both the timing & the reasoning of the FDA, which is in line with some of their previous ban attempts.  To be more clear:  this cheap, effective supplement is competing with pharma's ability to create an expensive version of NAC that's available by prescription only.  They did this with cannabis by keeping it illegal for decades (see:  Marinol, Nabilone, Epidiolex) and undoubtedly want to do it with kratom.  No one's going to buy an expensive prescription version of NAC if it's available OTC for pennies per dose, so the only logical move is for the FDA to ban the supplement version.  

Implications of a Ban

From Brazilian study on Therapeutic uses of NAC (source)

NAC is vital for making the antioxidant glutathione, which neutralizes free radicals & fights cellular damage.  Not only is it not addictive, it might actually be beneficial for treating addictive behavior & mental illnesses like OCD & schizophrenia.  Its most well-known use is in hospitals to treat acetaminophen overdose, but it's also used clinically to treat serious lung diseases like COPD and cystic fibrosis due to its mucolytic effects.  Others use it to improve kidney, immune system & heart health.  As with kratom, one of the main benefits of NAC in its current form is that it's dirt cheap, meaning anyone can afford and access it, and the side effect profile is magnificent.  The most severe side effects tend to include nausea, diarrhea & allergic rash.  

If the FDA bans over-the-counter NAC, millions of people will lose access to this affordable & versatile supplement.  AND THERE'S NO RATIONAL REASON TO DO SO.  Americans should have the right to access vitamins, minerals, herbs & other supplements as long as they're not adulterated or promoted to treat/cure diseases they haven't been proven to cure.  And NAC isn't even one of the supplements that's been caught in an adulteration scandal like many of the various weight loss, sexual enhancement & detox supplements on the market.  The only reason I can fathom for this move is pharmaceutical companies' greed.  If a prescription COVID drug comes out that contains NAC or a derivative of it after this ban, there'd better be a lawsuit & mass protest at FDA headquarters.  The pharmaceutical industry should NOT have a monopoly on nutritional supplements & antioxidants. 

Furthermore, we shouldn't have to form lobbying groups like the American Kratom Association for every substance on the chopping block just to keep them legal.  This corporate fascism is getting way out of hand.   I'm not into conspiracy theories or demonizing "Big Pharma," but it's not hard to see why so many people are distrusting of corporations & government institutions when they do shit like this every few months.  There's a clear conflict of interest at the FDA when they pull stunts like this while rushing approval of drugs like Aduhelm which has practically zero proof of efficacy (and causes actual harm) in patients with Alzheimer's disease.  I've seen this movie before and the villain is often our own regulatory agencies, which are coincidentally run by a revolving door of ex-pharma fat cats & stock market profiteers like Scott Gottlieb, former Cephalon fentanyl procurer.  

(Yeah, I'm never letting that go.  Maybe I should do a copy/paste of the evidence on my own blog before it disappears down the memory hole forever).  

Now What?

Money talks at the FDA

What's next?  Is the FDA gonna ban Xylitol nasal spray because it's been shown to shorten COVID infection in clinical trials?  I'm all for innovation & ending this pandemic, but not at the expense of my right to access harmless supplements I've been taking for years.  And not when we still don't have affordable, accessible healthcare that would allow all people to obtain these supplements-cum-drugs should they be made prescription-only.  Nobody should have to pay to see a doctor & wait in line at the pharmacy for a supplement like NAC.

If you had any doubt that the FDA's kratom, CBD & Benzedrex ban attempts had NOTHING to do with keeping the public safe, here it is.  They're now trying to ban a supplement with a long & flawless safety record; a substance found in foods like eggs, cheese & turkey.  A frickin' antioxidant.  Whether you've ever used NAC or not, you should be very concerned about this development.  Write a letter to your representative or simply tag them @US_FDA on social media asking what their reasoning is for this ban.  This is a dark predictor of things to come & we can't allow it to go unchallenged.  

I'd love for an FDA representative to respond to this article & offer their reasoning for this suspiciously-timed ban of N-Acetylcysteine.  But I highly doubt that'll happen.  They answer to no one (except drug company CEOs and investors).  Here's your invitation anyway:  Please make this make sense.  

Update 1/12/22:  The makers of Xlear nasal spray have been sued by the FTC for citing a study which found that their product shortened the duration of COVID infection in subjects on their website.  They believe they were unfairly targeted and have responded to the lawsuit.  

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My Arduous Journey Quitting Proton Pump Inhibitors

I've used and abused many classes of drugs over the years:  stimulants, depressants (benzos, alcohol), opiates, empathogens (MDMA, 4-FA, methylone) & psychedelics.  I've also tried and quit a vast array of psychiatric medications, many of which were terrible to come off of.  For some reason I never thought a stomach medication would be in the same league as meds that affect the mind in terms of withdrawal symptoms, but boy was I wrong.

I've suffered from severe GERD and gastritis since about 2015 when I developed a hiatal hernia.  To treat it, I was put on proton pump inhibitors like Prilosec, Protonix and eventually Dexilant, the most expensive and "first-class" drug in this family.  The gastro doctor acted like I was lucky to even be able to afford or access this drug because of its high cost.  The only difference between it and the over-the-counter options like Prilosec is its time-release function.  She said it should "fix me right up".  Imagine my disappointment when it didn't.  

By this point nothing had helped whatsoever & I was at the end of my rope.  A woman in her 30s who's not overweight should not be this disabled by acid reflux.  Not only is my diet severely restricted (I survive on rice and crackers at times), I also can't lift, bend or sleep on my left side due to the gnawing pain in my stomach and the hot acid that comes up in my throat.  This is a problem that runs in my family and one person has already developed esophageal cancer from it.  I even talked to a stomach surgeon about repairing the hernia, but he seemed unbothered and advised that I just stay on the medications as surgery carries its own risks and doesn't guarantee improvement.  In some cases it can cause problems of its own that are actually worse than the reflux.  Yeah, no.

Risks of Long-Term Use

Dexilant 60 mg

So here I am, three plus years later and still taking proton pump inhibitors.  At the time I started taking them, I was unaware that they weren't meant to be taken long-term.  Turns out this class of drugs is intended to be taken for a maximum of 8 weeks.  Studies have come out that are extremely disturbing in the the past couple decades showing links to everything from "major cardiac events" to pneumonia to dementia in long-term PPI users.  But if you dig deeper there's a loooooong and worrying list of possible links to diseases ranging from B-cell lymphoma, liver cancer, stroke & heart attack as well as more well-proven maladies like C. diff & bone fractures in long-term proton-pump inhibitor users.  

What the actual FUCK.

Of course my doctors have never mentioned a word of this to me when recommending the medications over surgery or other options.  To make matters worse, PPI's have been shown to CAUSE rebound acid reflux in patients who never had heartburn or reflux a day in their lives when given to test subjects and then stopped cold turkey.  For those who don't know, rebound reflux (or rebound ANYTHING) is far worse than your original symptoms.  So for someone like me who has actual stomach problems attempting to quit these meds, the hellish withdrawal symptoms are almost unbearable.  I know because I quit my Dexilant a few years ago to undergo an endoscopy.  For 7 days I endured the worst reflux of my LIFE.  I could barely sit up and wanted to cry.  If I forget to take the pill for a day, I feel awful the following day.  At this point I don't know how many of my symptoms are caused by the meds vs. my actual stomach problems.

I'm so mad I wasn't warned about a single one of these risks by any of my doctors who advised me to basically take them for the rest of my life.  Short term use is fine; I'd have no issue taking them for a couple weeks for ulcer healing in the future if need be as that's how they're intended to be used.  But telling someone my age to take drugs that cause calcium deficiency without even warning me to supplement with calcium is borderline malpractice.  These medications are known to cause fractures of the wrist, hip and spine among other serious diseases like C. diff.  

To be clear, severe GERD also carries its own risks:  gastritis, esophageal damage resulting in Barrett's esophagus (a precancerous condition) & even esophageal cancer in the most severe cases.  It can also cause damage to your teeth, adult-onset asthma(!), narrowing of the esophagus & sinusitis.  So it's important to treat it.  But not like this.  

The Long Process of Withdrawal

lol.  I feel ya little buddy.

Now I'm attempting to taper down from my daily 60 mg of Dexilant for good due to fears about the long-term health risks.  Needless to say I'm seriously concerned about how bad the withdrawal is going to be.  My plan is to take one pill every other day for a month and then switch to every 2 days next month, sprinkling some Dexilant beads into my mouth as needed for severe symptoms as needed on the 'off' days.  If this proves too hard, I can always go back to the old every-other-day dose for a while.  I'll be supplementing with lots of Tagamet, Carafate & chewable calcium carbonate antacids which don't really do much but are better than nothing.  

I'm three days into the taper and already feeling the increase in stomach acid.  Any little stressor causes my stomach to fill with acid noticeably, as do most foods.  This is not going to be pleasant but it will ultimately be better than a broken spine or cancer.  I'll update this article as I go.  One study said the patients with no pre-existing reflux endured up to three MONTHS of rebound reflux after quitting the medications.  😳

Update 10/20/21:  I've successfully tapered to my "every 2 days" plan and things are going a little better than expected, at least compared to the time I cold turkey'd for 7 days.  My reflux is not good by any stretch of the imagination, but it's tolerable.  I've even been eating some trigger foods like Wasabi peas & spicy soup without spending my days doubled over in agony.  There was one "off" day where I had to chew up some Dexilant beads to hold me over until my scheduled dose the following day, but now I'm successfully able to wait the full 2 days.  What's interesting is that, at least right now, my overall GERD symptoms are not worse than before I started the Dexilant.  This leads me to believe the medication may not have been helping me all that much, though I'll have to completely taper off for a while before I can make that call.  More updates to follow.  

Update 11/18/21:  I'm now down to "every 3rd day" dosing and, while my reflux is not as terrible as I had predicted, I've been dealing with some troubling mood symptoms.  Anxiety & depression in particular.  I know this is a stomach medication that's not known for affecting the brain but I've been feeling REALLY out of sorts lately and am wondering if Dexilant withdrawal could be contributing.  Granted, my life is especially stressful right now but even so, it's not like me to feel this depressed for such a long time.  I can only find a few reports in the literature about the drugs causing mental side effects but nothing about their withdrawal making people feel this way.  To be continued...   

Update 5/26/23:  I managed to taper all the way off the meds and STAY off for several months without any increased stomach pain or reflux.  Tapering is 100% the way to go here.  Everything was great until I was faced with a housing crisis that caused a dramatic increase in my GERD.  I was then forced to go back on the Dexilant just to keep the caustic acid out of my throat/mouth & prevent it from wearing down my tooth enamel more than it already has.  (My dentist commented on this at a recent visit which terrified me).  Just like with the codeine, life situations forced my hand.  I'd prefer to be off both meds but stress takes such a physical toll on my body it's not feasible.  Blah.   

Do you have experience quitting proton pump inhibitors?  Any tips or tricks are appreciated; leave them in the comments below.  As always, be sure to talk to your doctor before quitting any prescription medication.  But I would also advise any newbies to GERD to avoid getting started on these medications unless it's for short-term use only.  The long-term risks just aren't worth it.

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