The second semester of my work at the lab is coming to a close, and so I feel like a sort of "wrapping up" might be wanted. However, this time point is more of a construction of my academic life and doesn't really affect my experience at the lab so much. The experiments are year-round, and we are in the middle of preparing participants for the next round of an inpatient/outpatient cycle. I'll continue working as usual in the summer (I might take a little bit of a break so that I can live full-time in the library during finals). In the summer, I will be spending a bit more time in the lab, probably around 4-5 days of the week, while balancing a few other jobs around the city (managing a department at WKCR, doing some music research, tutoring, and receptionist job). With all of this extra time, I hope I can take on a more in-depth project at the lab, maybe something that will occupy me for most of the summer. Maybe this can range from something like reorganizing the lab (which seems menial, but is actually really crucial to making everything more efficient and functional around here), to updating the mass of data that needs to be input into our computers. There is also the possibility of lending a hand in some of the neighboring labs, especially those that do a lot of TSSTs (see my post a bit below to learn about the thrilling experience of making participants feel very awkward...for science!). The cocaine lab is also doing a bit of work with rats and fMRIs I believe, which would be a great chance to learn a few more skill sets over the summer. I think I even heard that the lab is a bit more relaxed over the summer in terms of running experimental cycles. This gives the researchers a bit of a break to maintain records and analyze data. I'll do what I can to lend a hand in these things, so I hope this will be a productive and busy summer.
As my academic year comes to a close, the lab keeps running as usual, churning out more data for the researchers to include in their analysis. I loved the opportunity to balance these two worlds, and as my school life constantly changes, I feel like my own experience of the lab changes with it. I learned a ton about neuroscience and drugs over the last year in my classes, and that has drastically changed my understanding of the lab and of the topics that we are dealing with. Next year, I hope my experience in Biology, Physics, and Organic Chemistry can continue to shift my perspective, leading me deeper and deeper into the rabbit hole of drug research.
Tuesday, April 29, 2014
On Security
One of the most impressive aspects of the lab is the sophisticated system of security. I definitely won't be going too into details, since I'm sure even the vague details that I know are enough to get me into trouble with the lab and the DEA.
However, I'll talk about the general idea of security, and what it means for the research lab of an illegal drug. Marijuana is a schedule I drug, as part of the five schedule system that rates drugs based on their accepted medical use and abuse potential. Obviously many people contest both aspects of this categorization: marijuana has been shown to have very clear medical use, and the abuse potential has been shown to be much lower than previously believed. With the recent spotlight on reviewing the illegality of marijuana (and almost all other drugs of abuse), this will inevitably change in the coming years, a change that will affect the research of these drugs significantly.
However, in the meantime, the research center and the DEA have to work extremely carefully together to make sure that this research is within the bounds of the lawful activity. In order to make an exception for the researchers, the DEA must ensure that the drugs being delivered to the facility are only being used for research. This means absolute measurements on marijuana used, as well as an extremely powerful safe, with multiple levels of security. The center is also subject to random DEA inspections (one of which I have been able to witness).
Clearly this is a very stressful topic of all of those who work in the lab. We must make sure that we can maintain our privilege of studying an illegal, so all must be done to convince the government that this exception is for research, and research only.
Monday, April 28, 2014
Horizons: Pseudo-Science and Religiosity in the Realm of Drug Research
I wrote this small essay outlining my experience at the Horizons Psychedelic Conference. The Conference was really fun! However, parts of it left me a bit unsatisfied, as I explain in the paper.
In downtown New York, scientists,
philosophers, spiritualists, and curious minds congregated in Judson Memorial
Church for the Horizons conference. The Horizons Conference
focuses on providing “a forum that examines the role of psychedelics in
science, healing, culture, and spirituality.” By setting up a platform for
intelligent discussion, the conference organizers aim to help establish
psychedelic drugs as a legitimate topic of interest.
Psychedelic drugs have long been plagued
by the stigma of the 1960’s, where hallucinogens fueled the often incoherent
spiritual ravings of the free-love era. Long after the burnout of the hippies,
LSD and other hallucinogens continue to be disregarded as a trivial
recreational drug for those seeking a fun, colorful experience. However, a
vocal community of supporters have been advocating for the benefits of
psychedelic drugs, especially in the fields of science and medicine. In the
1950’s, before the explosion of recreational use, LSD and psilocybin were
frequently researched at major universities. Stanford and Harvard were leaders
in the field, and researchers such as Doctors Timothy Leary, Ralph Metzner, and
Richard Alpert performed a large body of psychological experiments on these
drugs. This research was rigorous but short-lived. After several controversies regarding
psychedelic drugs appeared in universities and the media, research was soon
defunded, and the government was quick to label these drugs as restricted
substances (later as Schedule I substances after the Controlled Substances Act
of 1970). However, over the last 20 years, there has been somewhat of a
“psychedelic renaissance,” a renewed interest in studying psychedelics in a
research setting. Organizations such as the Multidisciplinary Association for
Psychedelic Studies (MAPS) have pushed for a widespread acceptance of the
potential benefits of psychedelic drugs, which range from substance abuse
therapy to treating PTSD. By promoting research, encouraging drug education,
and working with government substance regulatory authorities, MAPS hopes to
push the field of psychedelics past the stigma of recreational use and into the
world of science.
Although I am already interested
in the field of psychedelic research, I still maintain a great amount of
skepticism when it comes to psychedelics in science. My experience with
learning about psychedelic drugs has often been frustrating, since the field is
plagued with many pseudo-scientific and mystical interpretations of the drug
experience. Although spiritual and mystical writings have a place in their
respective fields, this approach is often presented in lieu of scientific fact in
order to offer an understanding of these drugs that always falls short of the
rigor that is possible in research. I understand that the psychedelic
experience can be very emotional and moving, but when these passionate
interpretations are presented as fact, the true potential of psychedelic
science is disregarded.
Thus, I went into Horizons with
skepticism. I had never attended the conference before, and I did not know
whether the atmosphere would be rigorous and scientific, or if the talks would
be shrouded with mysticism and pseudo-scientific assertions. Additionally,
since I am interested in the scientific side of psychedelics – psychology,
neuroscience, and chemistry – I hoped that these talks would be valuable sources
of information, not simplified and made accessible for the general audience and
the media.
However, once the conference
began, I was extremely impressed by the intelligent and informative nature of the
talks. The first speakers at the conference were Earth and Fire Erowid, the
founders of the massive online drug information resource, erowid.org. Although
I knew about the website beforehand, I did not know much about the famous
founders, the Erowid couple. Prejudicially, I felt like I expected some sort of
vague spiritual talk from two people with names such as Earth and Fire. To the
contrary, they presented one of the most insightful and conscious talks of the
weekend. Their lecture, entitled “State of the Stone 2013: New Drugs, New Laws,
and a New Generation Wisdom Cycle,” focused on giving the audience a debriefing
of the rapidly evolving drug scene, both in the US and around the world. The
Erowids track the trends and developments of the drug landscape, which is
constantly changing with advances in the fields of chemistry and
communications, as well as law enforcement efforts to keep up. One of the main
focuses was on the many new psychoactive drugs that are legally being sold
stores across the US. As new drugs are constantly being synthesized and sold in
obscure packaging (methoxetamine is one example), law enforcements struggle to
learn about and ban the sale of these substances (in 2013 alone, the DEA has
identified 80-100 new substances). These drugs are usually untested, and thus,
the health effects are widely unknown and potentially dangerous. Additionally,
the labels on these drugs are often not correctly, as Erowid had proven with
legal synthetic drugs (although the packaging had specifically said the drug
did not contain a certain illegal chemicals, the Erowid lab found that the drug
was primarily made up of this specific chemical!). Overall, the Erowids proved
that they were keenly aware of the complex, shifting drug environment.
Another talk that interested me
greatly was the update from the Johns Hopkins University MDMA-assisted tobacco
cessation research. This research especially caught my attention because of its
adherence to the rigorous standards of experimental psychology. With data obtained
from his research, Dr. Garcia-Romero made an argument about the potential benefits
of MDMA with authority and precision. The experimental setup consists of 15
otherwise-healthy adults who are addicted to nicotine, have tried to quit, and
currently want to quit. The mean age of the smokers was 51 years old, and the
mean years smoking was 30 years. The experiment consists of a combination of
regular and MDMA-assisted therapy sessions, during which a patient would
attempt to stop smoking cigarettes. After the sessions are over, there are
several follow-ups with the patients in order to gauge the lasting effect of
this research. The first round of this study has shown an incredible 80%
success rate in terms smoking secession, with 20% of the patients relapsing
into their smoking addiction. Dr. Garcia-Romero expressed his goal to replicate
these promising results in phase two of this experiment.
Although these two talks
demonstrated the legitimate nature of the conference, the overwhelmingly
positive attitudes about psychedelic drugs hinted towards a bias in the
presentation of the material. All of the speakers expressed optimism and success
in the field of psychedelics, promising that the field would soon blossom.
However, none of the presenters displayed skepticism about psychedelic science,
whether that is in the effectiveness of the treatments, the potential harm of
using the drugs, or the legitimacy of the research. The unchallenged positive
attitude at Horizons made the general sentiment of the conference less
persuasive, since the solely positive attitude made the general atmosphere seem
almost like a pep rally for those who are already convinced of the benefits of
the drugs.
Given the state of psychedelics
in mainstream science and media, this sort of attitude is understandable. The
pioneers of the field know that psychedelic science is still in its infancy,
and there is a long road ahead before the subject attains widespread
acceptance. Many people have a negative opinion of psychedelics and have not
been convinced towards any potential benefits of using psychedelic drugs. These
people are already armed to the teeth with arguments and facts that the media
has been communicating about the dangers of psychedelic drugs. At this point,
it may be safest to promote the subject with upmost optimism, in order to avoid
giving the opposition more reasons to be concerned. Thus, solely broadcasting
the positive aspects of the field and its research would help inspire people to
keep pushing the field forward until the field gets to the point where critical
evaluation of the drugs are more valid. From an educational perspective, I am
disappointed that this approach was taken. I would have loved to get a better
understanding of the totality of psychedelic drug use, which not only includes
its benefits, but also its dangers. Before psychedelics can go on towards
becoming a legitimate field of science, these scientists must overcome their
fear of rejection. By allowing a free dialogue of what the full implications of
psychedelic drugs, the field will be taken as legitimately and seriously as a
topic of science and medicine.
Sunday, April 27, 2014
The Lying Participant
A topic that I have mentioned before is the possibility of participants lying. This is a very important issue that researchers must face when dealing with human subjects, and it can have severe consequences on the results of the study. Through the various interviews, surveys, and self-reports, we often rely on the information given to us by the participants. It is very important to know about the participants' prior behavior in order to guage the effects of our experiment on them. Additionally, we hope that we can trust the participants' reports during the experiment so that we can have subjective information about the experiment. This information is analyzed along all of the other data that we collect in the study in order to fully evaluate the experimental effects.
However, the largest question is: how can we trust our participants? How do we know that the participants aren't lying, that they aren't exaggerating or changing their answers so that they seem like a "better" participant (although the best participant is the honest one)?
We cannot! The simple answer is that scientists just have to take their word for it. Any lies or exaggerations due significantly impact the results of the study, which is unfortunate. However, human self-reports are extremely important in this sort of study, so we must be able to work around potential fallacy. I'll leave it up to the senior researchers to figure out how to make their evaluation flexible enough to account for data that is incorrect.
However, the largest question is: how can we trust our participants? How do we know that the participants aren't lying, that they aren't exaggerating or changing their answers so that they seem like a "better" participant (although the best participant is the honest one)?
We cannot! The simple answer is that scientists just have to take their word for it. Any lies or exaggerations due significantly impact the results of the study, which is unfortunate. However, human self-reports are extremely important in this sort of study, so we must be able to work around potential fallacy. I'll leave it up to the senior researchers to figure out how to make their evaluation flexible enough to account for data that is incorrect.
Friday, April 25, 2014
The Pains of Pills
Here's a little write-up of an article from Nature Neuroscience from my Behavioral Neuroscience class. It's supposed to be in the style of a "pop science" article for the masses, which pretty much meant paraphrasing the more technical stuff into digestible prose. Enjoy!
Taking a Look at Painkillers
New evidence shows that opioids could potentially disturb activity in
some of the learning areas of the brain in the long-term
By Gabriel Ibagon
---
Engulfed in the depths of pill
culture, Americans are in the depths of a love affair with prescription pain
killers. Whether these pills are prescribed to help handle physical pain, or
whether people abuse them for their euphoric effects, many people take
prescription pain killers without much concern for their long term effects. Brady
K. Atwood, David A. Kupferschmidt, and David M. Lovinger have just released a
study investigating how opioids, a common form of painkillers, may have
long-term consequences on the brain, in the hope that this information can
better help us deal with problems surrounding opioid use and abuse.
The National
Survey on Drug Use and Health estimates that 1.9 million Americans are
currently abusing opioids. Experts believe that the increasing trend of painkiller
abuse has come about because of the continuously increasing amount of
prescriptions handed out by doctors (from about 75.5 to 209.5 million in the
last 20 years), as well as the trend of misperceptions of the dangers of these
drugs (National Institute of Drug Abuse). Many people may assume that drugs
handed out by doctors would be less harmful than other sorts of illicit
recreational drugs. However, prescription painkillers carry just as much
potential for harm as many other drugs that are misused. Research efforts have
been embarked to further understand what exactly happens to your brain when you
take these drugs, and how we can then translate this information to the public
to inform them about any adverse effects.
Atwood et al. have investigated the effects of opioid abuse on specific
aspects of the brain, which may hint us towards the negative effects people may
experience after several years of opioid abuse.
Published in Nature Neuroscience under the title, “Opioids
induce dissociable forms of long-term depression of excitatory inputs to the dorsal
striatum,” this study reports that opioids caused several connections in the
brains of rats to be less efficient in the aftermath of opioid administration.
The researchers used oxycodone, a common prescription painkiller, to see how
the dorsal striatum in rats is modified – understanding the “plasticity” of the
dorsal striatum after drug use. These rats were then killed and had their
brains examined to search for neurological changes, which revealed that several
of the opioid receptors in the dorsal striatum part of the brain experienced
opioid-induced long-term depression (OP-LTD), which means that the synapses
connecting to the striatum became less active. The overall effect of these
changes are not known, but by looking at similar studies conducted with
alcohol- and marijuana-induced disruptions to the dorsal striatum, scientists
suspect that this may affect learning (especially helping us establish habits).
Although this may
sound like a grim warning to stop taking your pain prescriptions, we should
take a moment to consider what the implications of this research study are. The
research has only been done on rats, so while these critters do serve as a good
model to begin to understand how opioids work on the brain, we can’t necessarily
generalize these findings to the human brain. The dosage used for the rats also
seemed extraordinarily high; the rats were given 1mg of oxycodone per kg of
body weight, where the usual human dose is around 0.2mg per kg of body weight.
The rats were also only examined a few hours to a few days after a dose, which
would probably show a different result than someone who takes pain medication
every day for a few years. Lastly, the authors expressed their uncertainty
about the cognitive and behavioral effects that opioids depression on the
striatum would cause.
However, these
findings are still significant in that they hint us towards the importance of
further understanding the long-term effect of opioids on the brain. Not only
are the prescription rates of opioid drugs skyrocketing, the abuse of these
drugs is also following suit. As we struggle to find ways to prevent people
from misusing these drugs in a potentially harmful manner, we must also try to
extend our knowledge in order to understand and treat these potentially harmful
effects. Furthermore, science can provide people with tools to educate the
public about these drugs, to make our society much more informed and
responsible when it comes to using substances. With the health of the public in
mind, we must urge that science do all it can to understand the intricacies of
opioid use.
References
Atwood, Brady K.,
Kupferschmidt, David A., and Lovinger, David M. (2014). Opioids induce
dissociable forms of long-term depression of excitatory inputs to the dorsal
striatum. Nature Neuroscience, 17.4.
Retrieved from http://www.nature.com/neuro/journal/v17/n4/pdf/nn.3652.pdf.
National
Institute on Drug Abuse. (2011). Prescription
Drug Abuse: A Research Update from the National Institute on Drug Abuse. Retrieved
from http://www.drugabuse.gov/sites/default/files/prescription_1.pdf.
U.S Department of
Health and Human Services. (2012). National
Survey on Drug Use and Health: Summary of National Findings [Data file].
Retrieved from http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm.
Monday, April 21, 2014
What Makes A Bad Participant?
What makes a bad participant?
Over the course of conducting our study, we encounter hundreds of hopeful applicants, and then scores of participants who make it through the screening. However, there is always one, or two, or a few participants in a round of the study who exemplify someone who is difficult to work with in these circumstances.
The worst thing one can do during the outpatient portion of the study is to not show up. During the outpatient segment, participants are commuting to the lab from their homes several times a week. Once the participants are scheduled for outpatients, many things from physical examinations to drug dosages are carefully scheduled. A missed drug dose can put our schedule in jeopardy, or at least cause inconvenience for the researchers when trying to analyze the data. Being late is another big issue; since the day is scheduled very strictly, being late will cause inconvenience in having to reschedule all of the time points.
Learning ability is also another factor. There are quite a few tasks that the participants must do during the study, and while they aren't incredibly complicated, they still take some learning and understanding. We sometimes run into some difficulty with participants who do not have a strong math or literary background, and thus have a hard time completing some of the math battery tasks or understanding some of the surveys. We try our best to get these participants caught up and understanding, but we often run into patients who are simply unable to understand or complete the tasks. If this causes too much of a problem, we would have to let the patients go.
Another issue is attitude. It is almost unavoidable for the participants to be in a terrible mood when they're at the height of their cigarette and marijuana withdrawal. In monitoring the participant's conversations (which we do with obvious cameras and microphones in the social area. This seems to be a fact that they seem to forget, at least judging by some of the things they say...), we often encounter negative attitudes that may be harmful to the study. If one participant is talking about how terrible the study is, it may bring down the overall morale, which in turn may incite participants to stop cooperating. Additionally, sometimes rumors are started between the participants about something we may have said to them (or at least what they think we said to them), which may spread misinformation among the participants, interfering with the study.
Lying about information is another very big issue, an issue that raises some questions about how to go about human clinical trials. That may be a subject for a future post.
Many participants have shown some of these traits in one way or another. I suppose that our job as researchers is to minimize the damage that uncooperative behavior may cause.
Over the course of conducting our study, we encounter hundreds of hopeful applicants, and then scores of participants who make it through the screening. However, there is always one, or two, or a few participants in a round of the study who exemplify someone who is difficult to work with in these circumstances.
The worst thing one can do during the outpatient portion of the study is to not show up. During the outpatient segment, participants are commuting to the lab from their homes several times a week. Once the participants are scheduled for outpatients, many things from physical examinations to drug dosages are carefully scheduled. A missed drug dose can put our schedule in jeopardy, or at least cause inconvenience for the researchers when trying to analyze the data. Being late is another big issue; since the day is scheduled very strictly, being late will cause inconvenience in having to reschedule all of the time points.
Learning ability is also another factor. There are quite a few tasks that the participants must do during the study, and while they aren't incredibly complicated, they still take some learning and understanding. We sometimes run into some difficulty with participants who do not have a strong math or literary background, and thus have a hard time completing some of the math battery tasks or understanding some of the surveys. We try our best to get these participants caught up and understanding, but we often run into patients who are simply unable to understand or complete the tasks. If this causes too much of a problem, we would have to let the patients go.
Another issue is attitude. It is almost unavoidable for the participants to be in a terrible mood when they're at the height of their cigarette and marijuana withdrawal. In monitoring the participant's conversations (which we do with obvious cameras and microphones in the social area. This seems to be a fact that they seem to forget, at least judging by some of the things they say...), we often encounter negative attitudes that may be harmful to the study. If one participant is talking about how terrible the study is, it may bring down the overall morale, which in turn may incite participants to stop cooperating. Additionally, sometimes rumors are started between the participants about something we may have said to them (or at least what they think we said to them), which may spread misinformation among the participants, interfering with the study.
Lying about information is another very big issue, an issue that raises some questions about how to go about human clinical trials. That may be a subject for a future post.
Many participants have shown some of these traits in one way or another. I suppose that our job as researchers is to minimize the damage that uncooperative behavior may cause.
Friday, April 18, 2014
On the Dearth of Participants
Too good to be true.
The appeal of marijuana research is undeniable. For marijuana users, the prospect of being paid to smoke their favorite indulgence all day seems almost too good to be true. Interviewing applicants on the phone constantly reaffirms this fact; people are always surprised that they are getting free, legal marijuana, even asking me to repeat that fact over to them as if I what I was saying is almost inconceivable. So, if this seems too good to be true, why does our lab frequently face the struggle to recruit participants for our studies?
During our initial screening process, we get hundreds of responses from callers all over the New York City area. After seeing our ads in the newspaper or on the Internet, many marijuana smokes jump at the opportunity to take part in our study. Those screening weeks are truly some of the most busy weeks at the lab, and all of our staff are huddled over the phone conducting interviews and keeping up with the pace of the mounting pile of applicants.
However, when it comes to accepting participants for our study, the outlook is much more bleak. The participant requirements for our study are quite strict, and many participants are knocked off the first round of screening simply because they are not fit for our study. On the outset, participants have to be in the NYC area, between the ages of 21 and 50, and current marijuana and cigarette smokers. After they pass these preliminary requirements, they also have to be willing to take part in our 32-day study, which consists of a full 16 day inpatient segment. Many people simply do not feel comfortable spending 16 days cut off from the outside world, confined to a small, windowless space (with no Internet! Cruel and unusual!). Furthermore, the requirement to quit smoking cigarettes for three weeks is daunting, and sometimes turns participants off the study completely. Once the participants know what they're getting into, they must then go through a phone interview, where we scrutinize their past drug use, their legal history, and their medical condition. Many participants who get to this stage end up having at least one factor that is outside of our study requirements.
At the end of it all, our hundreds of applicants dwindle down to just a handful of possible participants. We feel the most comfortable with at least 6-8 applicants for the outpatient segment of the study, so that we can safely count on 4 for the inpatient segment of the study.
The point of this all is that no matter how attractive and in-demand participating in this study is, participants must pass through many many requirements in order to be a fit subject. While we wish we could make the requirements more lenient to allow more participants to participate, science demands that we keep our requirements strict, so that we can best study the question at hand.
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