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At the age of 16, when Tony Kofi was an apprentice builder living in Nottingham, he fell from the third storey of a building. Time seemed to slow down massively, and he saw a complex series of images flash before his eyes.

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As he described it, “In my mind’s eye I saw many, many things: children that I hadn’t even had yet, friends that I had never seen but are now my friends. The thing that really stuck in my mind was playing an instrument”. Then Tony landed on his head and lost consciousness.

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When he came to the hospital, he felt like a different person and didn’t want to return to his previous life. Over the following weeks, the images kept flashing back into his mind. He felt that he was “being shown something” and that the images represented his future.

Later, Tony saw a picture of a saxophone and recognised it as the instrument he’d seen himself playing. He used his compensation money from the accident to buy one. Now, Tony Kofi is one of the UK’s most successful jazz musicians, having won the BBC Jazz awards twice, in 2005 and 2008.

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Though Tony’s belief that he saw into his future is uncommon, it’s by no means uncommon for people to report witnessing multiple scenes from their past during split-second emergency situations. After all, this is where the phrase “my life flashed before my eyes” comes from.

But what explains this phenomenon? Psychologists have proposed a number of explanations, but I’d argue the key to understanding Tony’s experience lies in a different interpretation of time itself.

When life flashes before our eyes

The experience of life flashing before one’s eyes has been reported for well over a century. In 1892, a Swiss geologist named Albert Heim fell from a precipice while mountain climbing. In his account of the fall, he wrote is was “as if on a distant stage, my whole past life [was] playing itself out in numerous scenes”.

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More recently, in July 2005, a young woman called Gill Hicks was sitting near one of the bombs that exploded on the London Underground. In the minutes after the accident, she hovered on the brink of death where, as she describes it: “my life was flashing before my eyes, flickering through every scene, every happy and sad moment, everything I have ever done, said, experienced”.

In some cases, people don’t see a review of their whole lives, but a series of past experiences and events that have special significance to them.

Explaining life reviews

Perhaps surprisingly, given how common it is, the “life review experience” has been studied very little. A handful of theories have been put forward, but they’re understandably tentative and rather vague.

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For example, a group of Israeli researchers suggested in 2017 that our life events may exist as a continuum in our minds, and may come to the forefront in extreme conditions of psychological and physiological stress.

Another theory is that, when we’re close to death, our memories suddenly “unload” themselves, like the contents of a skip being dumped. This could be related to “cortical disinhibition” – a breaking down of the normal regulatory processes of the brain – in highly stressful or dangerous situations, causing a “cascade” of mental impressions.

But the life review is usually reported as a serene and ordered experience, completely unlike the kind of chaotic cascade of experiences associated with cortical disinhibition. And none of these theories explain how it’s possible for such a vast amount of information – in many cases, all the events of a person’s life – to manifest themselves in a period of a few seconds, and often far less.

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Thinking in ‘spatial’ time

An alternative explanation is to think of time in a “spatial” sense. Our commonsense view of time is as an arrow that moves from the past through the present towards the future, in which we only have direct access to the present. But modern physics has cast doubt on this simple linear view of time.

Indeed, since Einstein’s theory of relativity, some physicists have adopted a “spatial” view of time. They argue we live in a static “block universe” in which time is spread out in a kind of panorama where the past, the present and the future co-exist simultaneously.

The modern physicist Carlo Rovelli – author of the best-selling The Order of Time – also holds the view that linear time doesn’t exist as a universal fact. This idea reflects the view of the philosopher Immanuel Kant, who argued that time is not an objectively real phenomenon, but a construct of the human mind.

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This could explain why some people are able to review the events of their whole lives in an instant. A good deal of previous research – including my own – has suggested that our normal perception of time is simply a product of our normal state of consciousness.

In many altered states of consciousness, time slows down so dramatically that seconds seem to stretch out into minutes. This is a common feature of emergency situations, as well as states of deep meditation, experiences on psychedelic drugs and when athletes are “in the zone”.

The limits of understanding

But what about Tony Kofi’s apparent visions of his future? Did he really glimpse scenes from his future life? Did he see himself playing the saxophone because somehow his future as a musician was already established?

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There are obviously some mundane interpretations of Tony’s experience. Perhaps, for instance, he became a saxophone player simply because he saw himself playing it in his vision. But I don’t think it’s impossible that Tony did glimpse future events.

If time really does exist in a spatial sense – and if it’s true that time is a construct of the human mind – then perhaps in some way future events may already be present, just as past events are still present.

Admittedly, this is very difficult to make sense of. But why should everything make sense to us? As I have suggested in a recent book, there must be some aspects of reality that are beyond our comprehension. After all, we’re just animals, with a limited awareness of reality. And perhaps more than any other phenomenon, this is especially true of time.

Steve Taylor, Senior Lecturer in Psychology, Leeds Beckett University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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You might have seen online or heard about “binaural beats”, which have been described as “digital drugs”.

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Listening to binaural beats has been claimed to help with sleep, stress, anxiety and cognition, and there’s much discussion online about whether or not they can cause a “high” similar to drugs.

But what actually are they? And what’s the evidence for beneficial or mood-altering effects?

What are binaural beats?

The perceptual phenomenon of binaural beats was discovered by Heinrich Wilhelm Dove in 1841 and first described in scientific literature in 1973.

The perceptual auditory illusion created by binaural beats occurs when two pure tones of slightly different frequencies are presented to each ear. These two tones are then processed within our brains to sound like a third frequency. This third frequency is thought to produce a range of effects, including relaxation and attentiveness.

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Academic research has focused on two main uses for binaural beats:

1) as a medical treatment or therapy

2) as a substitute for or complement to psychoactive drug use (drugs that affect the nervous system and alter perception, mood, cognition or behaviour).

Binaural beats as therapy

Research investigating binaural beats has found positive effects for pain alleviation, anxiety reduction, and memory. However, there have been conflicting findings around its effects on concentration.

For example, a meta-analysis that included 22 studies on the effect of binaural beats on memory, attention, anxiety and pain relief found across all studies a statistically significant and consistent effect. A dose-response effect was found, meaning greater exposure to the sounds increased their effectiveness as a therapy.

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Studies using high-quality designs have also consistently shown effects: using a double-blinded randomised control cross-over trial (the gold standard of clinical study), binaural beats reduced pain intensity, stress and use of analgesic drugs in chronic pain patients, compared with a placebo stimulation.

Studies looking at improving attention haven’t found evidence of an effect.

Binaural beats can be positioned within a range of other commonly used digital sound-based therapies such as ASMR (Autonomous Sensory Meridian Response). Emerging research indicates ASMR may have therapeutic benefits for mental health, which highlights the broader potential of digital sounds.

Binaural beats as digital pleasures

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Binaural beats have also been incorporated into music, soundscapes and other consumer-facing products, including meditation tracks.

Some of these soundscapes have been marketed via mobile phone apps as digital drugs. Binaural beat tracks available to download are sometimes named after specific drugs, for example “Molly Rave Riot” (reference to MDMA) or “Roofie Enhanced calm” (reference to Rohypnol).

There is limited literature concerning digital drugs as substitutes for, or used in combination with, psychoactive substances. For example, binaural beats were mentioned in a paper investigating drug combinations on a public internet forum. Participants “frequently described listening to binaural beats while using substances to enhance the experience”.

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Our paper, released today, surveyed over 30,000 respondents via the Global Drug Survey, finding 5% reported binaural beat use in the last 12 months.

Supporting the idea these binaural beat tracks are used to enhance drug use experiences, we found respondents who had recently used cannabis, psychedelics or novel drugs were more likely to also report use of binaural beats.

The most common reported reasons for use of binaural beats in this sample included to relax or fall asleep, to change mood-state and to get a similar effect to that of other drugs. Qualitative responses also indicate use for pain relief for common ailments such as headaches and migraines.

In this survey sample, binaural beats were accessed primarily through video streaming sites on mobile phones.

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Are binaural beats psychoactive?

Currently it’s unclear whether binaural beats are similar in effect to the psychoactive drugs they are promoted to simulate.

Given there are studies showing some effects of reducing anxiety and relieving perceptions of pain in medical contexts, it may also be possible binaural beats marketed as producing psychoactive drug effects could be perceived by consumers as providing similar sensations.

Controlled laboratory studies comparing ingestible psychoactive drug effects with those of binaural beat substitutes would be useful to answer this question.

Our research demonstrates some people who responded to our survey, and already consume drugs, are also using binaural beats to augment or substitute psychoactive substances.

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Depending on their actual efficacy, a future where drug experiences can be downloaded (or streamed), rather than obtained from illegal markets, is intriguing, and poses questions that will traverse legal, clinical, and social domains.

Monica Barratt, Vice Chancellor’s Senior Research Fellow, Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University; Alexia Maddox, Research Fellow, Blockchain Innovation Hub, RMIT, RMIT University; Jenny L. Davis, Senior Lecturer in the School of Sociology, Australian National University; and Naomi Smith, Lecturer in Sociology, Federation University Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Consider the statements below. What do they describe? A trip on psychedelics? A dream?

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I felt I could reach through the screen to get to another place.

Lasers became entire fans of light sweeping around, and then it felt as if the screen began to expand.

I saw old stone buildings … like a castle … I was flying above it.

In reality, they are statements that different people reported after viewing the “Ganzflicker” on their computers – an intense full-screen, red-and-black flicker that anyone can access online and that we use in our experiments. In less than 10 minutes, it creates altered states of consciousness, with no lasting effects for the brain. Visual experiences set in almost as soon as you start looking at it.

But our new study, published in Cortex, shows that while some people see castles or fractals in the Ganzflicker, others see nothing. We have come up with a theory of where those individual differences come from.

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Like a computer screen, the part of your brain that processes visual information (the visual cortex) has a refresh “button” which helps it sample the environment – taking snapshots of the world in quick succession. In other words, your brain collects sensory information with a certain frequency. Yet you see the world as continuous and dynamic, thanks to your brain’s sophisticated ability to fill in the blanks.

For example, your eyes have a blind spot right outside the centre of vision, but you don’t see a patch of blackness everywhere you look. Your visual cortex extrapolates from the surrounding visual information so that your whole field of view appears to be complete. If the sensory information being processed is the Ganzflicker, this will interact with your brain’s own rhythms to alter how you fill in or interpret what you are seeing.

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Ganzflicker is known to elicit the experience of anomalous sensory information in the external environment, called pseudo-hallucinations. “Simple” experiences – like seeing lasers or illusory colours – have previously been explained as your brain reacting to clashes between Ganzflicker and the brain’s rhythms. But how do some people see complex pseudo-hallucinations such as “old stone castles”?

Capacity for mental images

The brain is composed of many different regions interacting with each other, including “low-level” sensory regions and regions that correspond to “high-level” cognitive processes. Discriminating whether a line is vertical or horizontal, for example, is considered a low-level sensory process, whereas determining whether a face is friendly or annoyed is a high-level cognitive process. The latter is more open to interpretation.

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Visual mental imagery, or the mental simulation of sensory information – the “mind’s eye” – is one of these high-level cognitive processes. High-level processes can interact with low-level processes to shape your brain’s interpretation of what you are seeing. If someone sees simple pseudo-hallucinations in the Ganzflicker, their brains may automatically interpret that information as more meaningful or realistic with help from their mind’s eye.

What most people don’t realize is that everyone’s imagery is different. Some people have imagery that is as vivid as actually seeing something in front of them. A small proportion of people have a “blind mind’s eye” and cannot even visualize the faces of their friends or family. This condition is called aphantasia, and has attracted an increasing amount of attention in the last few years. Many people are, of course, somewhere in between these extremes.

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The power of Ganzflicker

It is very difficult to describe and compare imagery experiences, since they are private, internal, subjective events. But it turns out that the Ganzflicker can help.

We discovered that imagery ability can be reflected in an individual’s description of a ten-minute experience with Ganzflicker. Almost half of people with aphantasia see absolutely nothing in the Ganzflicker. The other half see mostly simple patterns like geometric shapes or illusory colours. Compare that to people with visual mental imagery, for whom the majority see meaningful complex objects, such as animals and faces. Some even see entire pseudo-hallucinatory environments, like a stormy beach or a medieval castle.

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Going back to the idea of brain rhythms, it’s possible that people who see imagery have naturally lower-frequency rhythms in visual cortex – closer to the Ganzflicker frequency – which makes them susceptible to experiencing pseudo-hallucinations. People with aphantasia, on the other hand, have naturally higher-frequency rhythms in the visual cortex – which may give them a buffer against the effects of the Ganzflicker.

Our theory is that mental imagery and pseudo-hallucinations elicited by Ganzflicker are tapping into the same processes in the brain. This means that Ganzflicker captures a dynamic projection of people’s imagined experiences, like opening a window to the mind’s eye.

Ganzflicker is therefore a promising tool for understanding individual differences in mental imagery and its interaction with the visual environment.

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The experiment can help people share their unique experiences with each other – ultimately bringing subjective experience into the real world.

Reshanne Reeder, Senior Lecturer in Psychology, Edge Hill University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Over 150 people in Illinois started bleeding uncontrollably after using synthetic cannabis-based products – including fake marijuana, Spice and K2 – that contained the rat poison brodifacoum in March and April 2018. By the end of July 2021, these banned products were still being sold in 10 states and the District of Columbia, resulting in hundreds of severe bleeds and several deaths.

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Illicit drug use was responsible for an estimated 166,613 deaths worldwide in 2017 due to overdose. The increased risk of disease and injury associated with illicit drug use caused an additional estimated 585,348 premature deaths. And it’s impossible to tease out whether people were harmed by the drugs themselves or by the myriad impurities added to them.

I am a clinical pharmacologist and guest editor for a special supplement in the Journal of Clinical Pharmacology on commonly abused substances. I also surveyed the research in 2021 on what’s known about illicit drug adulteration. The research is clear: Adding impurities to, or adulterating, illicit drugs is a longstanding and widespread practice with harmful consequences.

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You seldom get what you pay for

Drugmakers include other ingredients for a few reasons, whether to cut costs by bulking up their product with cheaper nonactive ingredients or to achieve particular effects by adding other drugs to mask poor product quality or imitate the desired effect of the drug itself.

Prior to the 2000s, drugs including cocaine and heroin were being “cut,” or diluted, with inactive ingredients like sugars to enlarge supply and increase profits. Since then, buyers of cocaine and heroin products frequently receive a cocktail of adulterants that mimic the product’s intended effects or mask side effects due to poor quality.

For example, the active ingredient of ecstasy, MDMA, is what produces the product’s intended effects. However, a 2004 study assessing ecstasy tablets from drug seizures at raves found that 20% of the products contained no MDMA, and dosage varied widely in products that did. Cheaper and more dangerous stimulants and psychedelics like synthetic bath salts and LSD are frequently swapped for MDMA without alerting the buyer.

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Drugs added to intensify effects

Over 70% of cocaine products contain levamisole, a drug for worm infections that increases the intensity and duration of stimulant effects. It was banned in the U.S. in 1999 because it suppresses red and white blood cell production and increases the risk of life-threatening infections and anemia. These side effects are seen at doses over 150 milligrams, and 35% of seized cocaine products in the U.S. exceed that level.

Other additives are commonly added to cocaine to intensify effects. Aminorex, a stimulant and appetite suppressant, was withdrawn by the FDA in 1972 after it caused a number of pulmonary hypertension cases that resulted in heart failure and death. Similarly, caffeine is frequently added to intensify the adrenaline rush. While safe when taken alone in lower doses, higher doses of caffeine in combination with other stimulants can induce seizures and heart rhythm problems.

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For heroin, veterinary anesthetic xylazine is commonly added to intensify its relaxing effect. And fentanyl is increasingly being used as a substitute. Because fentanyl is 50 times more potent than heroin, a smaller amount of total product can produce similar effects. But adding even just a slightly larger amount of fentanyl than expected can easily result in an overdose.

Covering up adulteration and poor manufacturing quality

Manufacturers also add impurities to compensate for lost effects due to adulteration. Anesthetics like lidocaine and benzocaine are added to adulterated products to reproduce the tingling sensation on the gums or tongue that drug dealers look for to assess cocaine quality. While these anesthetics are FDA approved, they can cause seizures and heart rhythm problems with the wrong dose.

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A similar technique is used for heroin. Manufacturers commonly add malaria drug quinine to mimic heroin’s bitter taste and the initial drop in blood pressure when it’s administered.

Poor heroin production also creates a lot of impurities that can cause severe chills and pain at the injection site. To get around these side effects, manufacturers frequently add antihistamines like Benadryl and pain relievers like Tylenol. The pain reliever metamizole, which was recalled in 1977 for health risks, is sometimes used instead of Tylenol.

The double-edged sword of field testing

Adulterants can lead to dangerous side effects. But because additives aren’t disclosed to the buyer and most of them have been banned by the FDA, clinicians might not recognize or even suspect that an adulterant is the cause of a patient’s symptoms.

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While consumer-based methods to test for drug impurities may help, they aren’t foolproof. Volunteers at music festivals in the 2010s offered MDMA purity testing so attendees could decide whether they wanted to use the drugs they had. If they were injured, attendees could alert emergency personnel about potential adulterants they were exposed to. Unfortunately, over 40% of the adulterated samples were missed by those field testing kits and discovered days later only with sophisticated laboratory equipment.

With illicit drugs, the difference between what you believe you are buying and what is actually in the product can be the difference between life and death. If you are suffering from drug addiction, resources are available to help you manage your addiction and achieve sobriety.

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Poisons today typically evoke notions of harm and danger – the opposite of medicines for healing. Yet traditional Chinese medicine, which has been in practice for over two millennia, used a large number of poisons to treat a variety of illnesses. Chinese doctors knew that what makes a drug therapeutic isn’t just its active ingredient – it depends on how you use it.

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Biomedical researchers skeptical of the safety and efficacy of traditional Chinese medicine might not be surprised that Chinese doctors historically prescribed poisons. Some believe that the drugs used in traditional Chinese medicine often contain hidden toxic ingredients detrimental to health.

But this blurred boundary between poison and medicine is not unique to traditional Chinese medicine. Chemotherapy uses toxic drugs to treat cancer. And the U.S. opioid epidemic offers a sobering reminder of how a class of FDA-approved medicines used to treat chronic pain became lethal poisons through improper administration. Conversely, certain psychedelics deemed illegal today have ignited new interest in the medical community as potential treatments for anxiety, addiction and depression.

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I am a medical historian who examined the therapeutic use of poisons in Chinese medicine in my recent book. Based on my research, I believe that Chinese doctors in the past recognized the healing capacity of poisons while being fully aware of their potential to kill. Understanding this practice compels modern biomedicine to reconsider how “medicine” is defined today.

What is an active ingredient?

The debate on the safety and efficacy of traditional Chinese medicine often centers on the active ingredient of a drug. The U.S. Food and Drug Administration defines an active ingredient as “any component that provides pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment, or prevention of disease, or to affect the structure or any function of the body of man or animals.”

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In other words, the active ingredient is a specific chemical considered to make up the essence of a drug. Because it carries the responsibility of curing a target disease, it’s used as the gold standard to evaluate the utility of a drug in modern pharmaceutics.

There is value in identifying active ingredients in drug discovery, including those in traditional Chinese medicine. Scientist Tu Youyou won the 2015 Nobel Prize in Physiology or Medicine for isolating malaria drug artemisinin from an herb used in traditional Chinese medicine. In the same vein, medical researcher Zhang Tingdong and his team identified arsenic trioxide as an effective treatment for leukemia by studying drug formulas in traditional Chinese medicine.

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Despite these success stories, reducing a medicine to a single molecule is rather limited. This reductionist approach ignores the context in which a drug is used, which plays a crucial role in its end effects. To appreciate this perspective, it is necessary to go back in history to see how poisons were understood and used in premodern China.

Poisons in traditional Chinese medicine

The Chinese word for poison is “du” (毒). Unlike its negative meaning today, ancient texts written 2,000 years ago used the word to denote potency, or the ability to both harm and heal. There was no categorical distinction between poisons and nonpoisons in traditional Chinese medicine – they acted in a continuum defined by level of potency.

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The dual potential of poisons laid the foundation for their use in medicine. Chinese doctors strategically deployed potent poisons to cure everything from blood clots to abdominal pain to epidemic diseases. For example, aconite (“fuzi” 附子), a highly poisonous herb grown in southwest China, was one of the most often prescribed medicines in the medieval era. Mercury was another poison used regularly in both medicine and alchemy to eliminate worms and prolong life. Overall, poisons consistently made up about 20% of the drugs in the ever-expanding Chinese pharmacopeia throughout the imperial era, speaking to their crucial role in healing.

One way Chinese doctors used poisons for healing was through the principle of using poison to attack poison (“yi du gong du” 以毒攻毒). In their eyes, these powerful substances could target and eliminate specific disease entities like worms inside the body. They believed the strong sensations induced by poisons marked a process of purifying the body of its harmful burdens.

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The context in which a drug is used matters

Chinese doctors in the past were not looking for an active ingredient that defined the usefulness of any given substance. Rather, they considered the effect of each drug highly malleable. No better example illustrates this way of thinking than the medical use of poisons.

Doctors in China were keenly aware of how the effect of a poison varied greatly depending on how it was prepared and administered. Accordingly, they developed a variety of methods – such as dosage control, mixing with other ingredients and other drug processing techniques – to mitigate a poison’s potency but still preserve its efficacy.

Chinese doctors were also aware that poisons worked differently from person to person. The same drug could have different effects depending on the patient’s gender, age, setting, emotional status and lifestyle. For example, eminent 7th-century physician Sun Simiao (孫思邈) offered remedies specific to women and the elderly.

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Using a poison outside of its prescription often proved deadly. For instance, Five-Stone Powder, or “Wushi San” (五石散), a psychedelic drug that contains arsenic, was one of the most popular medicines in medieval China. Despite medical recommendation that it be used only as a last resort to treat emergencies, many at the time regularly consumed it to invigorate their bodies and illuminate their minds. Unsurprisingly, this misuse led to numerous deaths. Going beyond its restricted usage, a poison could easily kill.

Beyond the active ingredient

The paradox of healing with poisons in traditional Chinese medicine reveals a key message: There is no essential, absolute or unchanging core that characterizes a medicine. Instead, the effect of any given drug is always relational – it is contingent on how the drug is used, how it interacts with a particular body and its intended effects.

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Medicines are fluid substances that defy stable categorization. Looking beyond the biomedical standard of the active ingredient could help doctors and researchers pay more attention to the context of how medicines are used. This will allow for a more nuanced understanding of healing.

Ultimately, there is more to a medicine than its active ingredient. Poisons in traditional Chinese medicine, I hope, teach a compelling lesson.

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