Science Savvy

In this episode of Science Savvy, we speak with Pablo Otero, who holds a PhD from Imperial College London and has been involved with the organisation Drugs and Me, about harm reduction and the science behind recreational substances. We discuss how these substances affect the body, why and how mixing them can increase your risk, and practical, evidence-based ways to make safer decisions in party settings.

Disclaimer: This episode does not encourage or endorse recreational drug use. In fact, much of the conversation focuses on why avoiding these substances is the safest option. However, because some people may still choose to take them, this episode aims to provide factual, science-based information that may help reduce the risk of harm.

Bibliography (readings I used to prep for this interview; they may not be comprehensive of everything discussed):

Applying the Consolidated Framework for Implementation Research (CFIR) to understand college health administrator perceptions on adopting and implementing opioid overdose education and naloxone distribution (OEND) programs among universities nationally. PubMed. 2026 Mar 7.

The mediating role of anxiety and depression symptoms in the relationship between ADHD symptoms and polysubstance use among French university students: the i-share study. PubMed. 2025 Dec 13.
Prevalence of Illicit Drug Detection in 5 US Cities Among Out-of-Treatment People Who Inject Drugs. PubMed. 2026 Feb 5.

The scientific basis of synergy in traditional Chinese medicine: physicochemical, pharmacokinetic, and pharmacodynamic perspectives. PubMed. 2026 Jan 8.
Pharmacological and Pharmacokinetic Profile of Cannabidiol in Human Epilepsy: A Review of Metabolism, Therapeutic Drug Monitoring, and Interactions with Antiseizure Medications. PubMed. 2025 Nov 30.

Alcohol and drug interactions. PubMed. 2026 Jan 30.

Stereoselective, sex-dependent 5-HT2A receptor modulation of cortical plasticity by MDMA in mice. PubMed. 2026 Feb 2.

Safety and Efficacy of Monoamine Oxidase Inhibitors in Patients Who Use Psychoactive Substances: Potential Drug Interactions and Substance Use Disorder Treatment Data. PubMed. 2026 Jan 17.

Differentiation of Therapeutic and Illicit Drug Use via Metabolite Profiling. PubMed. 2025 Nov 17.

Disruption of Dopamine Homeostasis by Psychostimulants. PubMed. 2026 Mar 5.
Psychedelics as a Therapeutic Opportunity or Threat: A Narrative Review. PubMed. 2025 Dec 23.

Predicting drug-drug interactions between ayahuasca alkaloids and SSRIs using physiologically based pharmacokinetic modeling. PubMed. 2026 Feb 18.

Serotonin syndrome: understanding pathophysiological bases and managing a growing clinical challenge. PubMed. 2025 Nov 20.

Serotonin syndrome presenting as severe reversible cerebral vasoconstriction syndrome. PubMed. 2026 Feb 13.

Risk of heat-related illnesses and preventive measures at mass gathering rock festivals in the summer of 2023 in Japan. PubMed. 2026 Jan 22.

JSA guideline for management of malignant hyperthermia in 2025. PubMed. 2026 Jan 8.

Wastewater Analyses for Psychoactive Substances at Music Festivals: A Systematic Review. PubMed. 2025 Dec 3.

Exploring the impact of drug decriminalization and legalization policies on mental health outcomes: A scoping review. PubMed. 2025 Oct 15.

Predicting the prognosis of primary and substance-associated psychoses using urine drug screens: A 5-year retrospective longitudinal study using medical records. PubMed. 2026 Feb 4.

Hospital-based care for hallucinogens and risk of mania and bipolar disorder: A population-based cohort study. PubMed. 2025 Dec 2.

Sensory Processing in People Experiencing Homelessness in Spain: A Pilot Study. PubMed. 2025 Dec 18.

Harm reduction and pharmacy practice: a scoping review of services for people who use drugs provided by pharmacy staff. PubMed. 2026 Mar 2.

Clinical Approach to Acute Recreational Drug Intoxication in the Emergency Setting: A Practical Guide Based on Swiss Experience. PubMed. 2025 Nov 29.

Why do some women feel bloated, emotional, or irritable before their period, while others feel like they become a completely different person? In this episode of Science Savvy Podcast, Professor Rossella Nappi (gynecologist, endocrinologist, and sexologist) breaks down the crucial difference between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), and why PMDD is far more than “just bad PMS.” Together, we explore what is really happening in the brain and body, from altered sensitivity to normal hormonal changes to the roles of serotonin, GABA, stress, trauma, and even the gut-brain axis.

Professor Nappi also explains how PMDD is diagnosed, why symptom tracking is important for those seeking help from a physician, as well as the treatments that can actually help (from natural lifestyle changes to hormonal contraception and intermittent use of antidepressants). Most importantly, this episode is a reminder that severe premenstrual symptoms are real, treatable, and never something women should have to just “put up with.”

As this was an interview, we do not have a "formal" bibliography. However, here are the papers I read to prepare:

Tiranini L, Nappi RE. Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome. Fac Rev. 2022 Apr 28;11:11. doi:10.12703/r/11-11. PMID: 35574174.

Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991 Aug;78(2):177-181. PMID: 2067759.

Verri A, Nappi RE, Vallero E, Galli C, Sances G, Martignoni E. Premenstrual dysphoric disorder and eating disorders. Cephalalgia. 1997 Dec;17 Suppl 20:25-28. doi:10.1177/0333102497017S2008. PMID: 9496774.

Nappi RE, Petraglia F, Luisi S, Polatti F, Farina C, Genazzani AR. Serum allopregnanolone in women with postpartum "blues". Obstet Gynecol. 2001 Jan;97(1):77-80. doi:10.1016/S0029-7844(00)01112-1. PMID: 11152912.

Studd J, Nappi RE. Reproductive depression. Gynecol Endocrinol. 2012 Mar;28 Suppl 1:42-45. doi:10.3109/09513590.2012.651932. PMID: 22394303.

Lete I, Häusler G, Pintiaux A, Jamin C, Nappi RE, Fiala C, Chabbert-Buffet N, Lobo P. The inconvenience due to women's monthly bleeding (ISY) survey: a study of premenstrual symptoms among 5728 women in Europe. Eur J Contracept Reprod Health Care. 2017 Oct;22(5):354-359. doi:10.1080/13625187.2017.1400001. PMID: 29157023.

This episode explores how pain is not just a bodily signal but a brain-made experience shaped by context, expectations, and emotions. It covers top-down modulation (stress or adrenaline can suppress pain; mood can amplify it), the role of placebo and endogenous opioids, and surprising findings sugar pill placebo effects.

It also summarizes practical, non-pharmacological strategies like cognitive behavioral therapy, exercise, mindfulness, pain education, and social support, that engage the brain’s own analgesic systems to reduce pain or improve coping.

Bibliography / references used to write the episode:

Wang et al. (2025). The effect of music therapy for patients with chronic pain: systematic review and meta-analysis. Medicine (Baltimore).

Garza-Villarreal et al. (2017). Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis. Pain Physician.

IsHak et al. (2018). Pain and Depression: A Systematic Review. Harv Rev Psychiatry.

Lunde et al. (2024). Role of Expectations in Placebo Analgesia: Systematic Review and Meta-Analysis. Psychosom Med.

Hohenschurz-Schmidt et al. (2024). Placebo analgesia in physical and psychological interventions: systematic review and meta-analysis. Eur J Pain.

Borg et al. (2025). Open-label placebo effects in chronic musculoskeletal pain: systematic review and meta-analysis. Sci Rep.

Morley et al. (1999). Meta-analysis of CBT for chronic pain. Pain.

Maglione et al. (2016). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Rand Health Q.

Part two of this Science Savvy pain series explains how common painkillers work, why many provide limited relief, and how pain is shaped by nerves, the spinal cord, the brain, and emotion!! (emotion?!?!)... we even talk about porn, sexual arousal, and its impact on pain... the ffff

The episode covers common drugs like ibuprofen, paracetamol, local anesthetics (at your dentist office) through to not-so-common drugs like opioids. We also talk about why expectations, social support, and non-drug approaches matter - a little bit of hope man, please.

As always, the full bibliography below:
1. None, M., None, A. A. & None, S. A. (2025). Pharmacological Agents Targeting Pain Pathways: A Systematic Review of Analgesic Efficacy and Physiological Correlates. Journal of Contemporary Clinical Practice, 11(9), 683-691.

2. Mallet C, Desmeules J, Pegahi R, Eschalier A. An Updated Review on the Metabolite (AM404)-Mediated Central Mechanism of Action of Paracetamol (Acetaminophen): Experimental Evidence and Potential Clinical Impact. J Pain Res. 2023;16:1081-1094
https://doi.org/10.2147/JPR.S393809

3. Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Sep 28;2015(9):CD008659. doi: 10.1002/14651858.CD008659.pub3. PMID: 26414123; PMCID: PMC6485441.

4. Mourkojannis, C., Wolf, MI., Wittkamp, C.A. et al. Pain modulation by self-generated expectations. Sci Rep 15, 31588 (2025). https://doi.org/10.1038/s41598-025-17276-8

5. Ghlichloo I, Gerriets V. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/

6. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. Does heightened subjective sexual arousal lower pain in women? PLOS ONE. 2025;20(??):e0323095. doi:10.1371/journal.pone.0323095

7. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. The influence of sexual arousal on subjective pain intensity during a cold pressor test in women. PLOS ONE. 2022;17(10):e0274331. doi:10.1371/journal.pone.0274331

8. Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women. Pain. 1985;21(4):357–367.

9. Hambach A, Evers S, Summ O. The impact of sexual activity on idiopathic headaches: An observational study. Cephalalgia. 2013;33(6):384–389. doi:10.1177/0333102413476374

Pain is weird. You only feel it in your brain… yet your brain has no pain receptors.

In part 1 of this 3-episode series, we unpack why pain is less a “signal” and more a decision your nervous system makes to feel it, shaped by reflexes, memory, mood, and context. You will learn why a hot stove makes you yank your foot back before you even feel anything, how “sharp” and “throbbing” travel on different nerve highways, and why chronic pain can become a disease of its own.

We discuss mind-bending paradoxes like phantom limb pain, referred pain (why heart attacks can hurt in your arm/jaw rather than your heart), and why two people with the same injury can rate pain totally differently.

 

Bibliography:

Greenwald BD (2012). Can the Brain Itself Feel Pain? BrainLine.

Derderian C, Shumway KR, Tadi P (2023). Physiology, Withdrawal Response. StatPearls.

Nicholas M et al. (2019). The IASP classification of chronic pain for ICD-11: chronic primary pain. PAIN 160(1): 19–27pmc.ncbi.nlm.nih.gov.

de Almeida KPO et al. (2020). Chronic Facial Pain: Trigeminal Neuralgia… Int J Environ Res Public Health 17(19):7012mdpi.com.

Mills SEE et al. (2019). Chronic pain: a review of its epidemiology… Br J Anaesth 123(2): e273–e283pmc.ncbi.nlm.nih.gov.

Limakatso K et al. (2020). The prevalence and risk factors for phantom limb pain… PLoS ONE 15(10):e0240431journals.plos.org.

Venda Nova C et al. (2020). Treatment outcomes in trigeminal neuralgia – a systematic review. World Neurosurg X 6:100070pubmed.ncbi.nlm.nih.gov.

Melzack R (1975). The McGill Pain Questionnaire: major properties and scoring methods. Pain 1(3):277–299sralab.org.