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For some reason, there's a creature that gets high off of acne medication, as per the title.

Specifically, when it ingests a certain quantity of clindamycin phosphate 1 % topical solution - an antibacterial agent used to fight bacteria that cause acne-related skin lesions - it experiences psychoactive symptoms similar to those caused in a human who has imbibed a small (relative to their weight) quantity of cannabis.

Why? What biochemical mechanism could cause this to happen?

Bonus points for answers that can exist within the laws of Earth-based biochemistry.

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  • $\begingroup$ Suppositories. It takes them in the form of suppositories. $\endgroup$
    – John O
    Commented Dec 29, 2021 at 15:09
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    $\begingroup$ Because handwavium? $\endgroup$ Commented Dec 29, 2021 at 21:43
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    $\begingroup$ This is one of the most weirdly specific questions I've seen in some time, good job! $\endgroup$
    – Hearth
    Commented Dec 30, 2021 at 1:37

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Clindamycin is an antibiotic, which already have observed neuropsychiatric side effects. More in the line of confusion, anxiety and depression than a high, but it's a start. Look into lincomycin, which clindamycin is a derivative of. Their mechanism of action is similar to macrolides, so you can back things up by analogy.

Another mechanism of action could be natural gut bacterial flora that have continuous neurosuppresive effect on your creature. In that case, most antibiotics that can make it through intestine would result in a high via suppressing this bacteria. The obvious candidate for this would be vancomycin because of its property of not being absorbed by the intestine. Which means that when taken orally it hardly affects the host al all, delivering full power against the host's contents instead. Clindamycin doesn't "pass through" humans - but hey, it's your creature, and you can give it clindamycin-impermeable guts in addition to downer bacteria. I'd make this bacteria essential, like koalas - so if they go too far with the antibiotics, they'll die of malnutrition soon.

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  • $\begingroup$ "would result in a high via suppressing this bacteria" Funny to see two answers reaching a 180 degrees different conclusion, proposing the same mechanism. The outcome may actually be opinion based. You used more biochemistry terms than I did, you're probably more of an expert on this, but in essence it's the same idea... as your answer is later, I have to vote it down, sorry. I normally don't vote answers where I gave an answer myself, but in this case.. $\endgroup$
    – Goodies
    Commented Dec 29, 2021 at 13:45
  • $\begingroup$ I'm no expert, I've just read in the document I've linked about positive (unfortunately temporary) effect of vancomycin on autistic children and that gut bacteria are the suspect. The gut microbiome is much wider known and therefore more plausible than brain microbiome. Also, my answer is 2 parts. $\endgroup$
    – Agent_L
    Commented Dec 29, 2021 at 13:51
  • $\begingroup$ Well @Agent_L to be honest I don't understand large parts of your text, let alone the articles you cite there. The bottom line of both answers is: this high occurs, because earth bacteria were in the creature's brain, now removed. The second part states specific assumptions about the creature's physiology, to avoid the bacteria, or the high to be the main player, and blame the antibiotic for some other pathology. But the question states, only the creature's state of mind is changing. There is no illness, or casualties. $\endgroup$
    – Goodies
    Commented Dec 29, 2021 at 14:18
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    $\begingroup$ @Goodies 1) There is no brain bacteria in my answer. 2) The bottom line of my answer is that antibiotics are psychoactive on their own. $\endgroup$
    – Agent_L
    Commented Dec 29, 2021 at 14:40
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Central American Fruit Bats

That ache medicine is only 1% Clindamycin phosphate, but 50% isopropyl alcohol. Isopropyl alcohol has a very similar intoxicating effect as ethanol; however, it is considered far more dangerous for humans to consume because it is metabolized so much faster increasing the risk of alcohol poisoning. Human alcoholics are known to switch to drinking isopropyl alcohol in part because of its more potent intoxicating effects.

So, to answer your question, you just need an animal that likes to get drunk, but has a higher tolerance for alcohol than your average human. That is where American Bats come in. Many species of American Bats are known to eat fermented fruits containing copious amounts of alcohol; so, they have evolved to have naturally high resistance. One study showed that these bats could still fly though an obstacle course with a BAC over 3 times the legal driving limit for humans. This suggests that these bats may have the resistances necessary to survive recreational isopropyl alcohol abuse. Getting drunk is not exactly the same as getting high, but the effects should be close enough depending on the needs of your story.

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Doesn't happen the same with alcohol for humans and other organisms? It has antiseptic properties, yet it makes users high.

Same goes for chocolate, caffeine and other alcaloids, or the secretion of the notorius toad, they were developed by the producing organism as defense mechanism, not as leisure substances. But somehow biochemistry messed up, making them not so defensive.

Apparently these creatures have receptors in the brain that are activated by the specific binding of clindamycin phosphate, and not in way that uses the antibiotic properties of the molecule.

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  • $\begingroup$ In addition it could be like overreactions like allergies (see peanut)/wrongful reaction in breaking it down or trying to remove it/binding to some receptors causing negative/positive feedback loops that result in the high state. $\endgroup$
    – Trioxidane
    Commented Dec 29, 2021 at 10:16
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Earth bacteria affecting their brain

You may be just in time.

I think we can help these creatures. You say they get high. when they take this antibiotic.

This indicates the presence of inhibiting bacteria in their brain, probably of Earth-origin.

Kill the bacteria, they will feel better, less stressed and probably be more social ?

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The oldest known treatment for the negative symptoms of schizophrenia is minocycline, an antibiotic. However, its mechanism is still not understood.

Likewise a random trial of drugs on ebola found that the best were an anti-anxiety drug and one for high blood pressure.

To just say it has that effect works. Cite other mysterious interaction for plausibility.

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