Some may have been surprised to read recently that the US Food and Drug Administration has approved three trials of MDMA to treat post-traumatic stress disorder – the final phase of validation required to turn the “dance drug” into a legal medicine. Surprised, probably, because we have been repeatedly told for over two decades that MDMA is a very dangerous drug and that “there is no such thing as a ‘safe dose’”. Doctors would surely never give a dangerous drug with no safe dose to someone just to aid therapy, so what’s going on here?
It has been known since the 1970s that MDMA had some potential in psychotherapy, but almost all research and testing on the drug was halted when it was globally criminalised in the mid-1980s. But the story of how we got to a place where MDMA is “Class A” (the most dangerous drugs) is a sorry story of misleading experiments, politicised research, biased scientific endeavour, wilful distortion of facts, and – most importantly – the silence of the scientific and medical establishments in the face of obvious manipulation of the truth.
Nearly all research on MDMA since the 1980s has been funded by the US National Institute on Drug Abuse (NIDA) or its predecessors. Its very name – “drug abuse” – gives away the goal of the organisation, which is to provide the evidence backing for politicians to promote the “War on Drugs”. In that goal it has been hugely influential.
In a perplexing twist, almost none of the research testing on MDMA safety used actual therapeutic or recreational doses to measure effects of use on health – almost all used tens to hundreds of typical doses at once. Quite often, the most surprising result from an objective point of view was that any of the test subjects (monkeys/rats/etc) even survived the test, as equivalent doses of many everyday drugs like paracetamol would easily be fatal. A sceptic would point out this lack of realistic experiments was probably because it was hard or impossible to detect harm with typical doses, and we must consider that a biased organisation like NIDA was giving the grant and might not be granting money for experiments that were unlikely to produce the headlines that it wanted.
But if the experiments were misleading, the conclusions drawn were worse distortions. What if a researcher said, “I injected test subjects with the alcohol from 400 pints of beer at once, and they all suffered serious harm as a result. On this basis I conclude that alcohol is a very dangerous drug with no safe dose”? Well, people would fall about laughing and that researcher would find it difficult to be taken seriously in future. And yet, this is exactly what was pushed in the realm of MDMA research during the 90s and early 00s; and not only did it not get called out (except on embryonic counter-culture internet forums) for being obviously misleading, medically irrelevant, and scientifically unsound, but usually rigorous news outlets like the BBC simply regurgitated and propagated it without any critique.
Even medical magazines – who should really have known much better – didn’t call this out this abuse of medical research, perhaps because putting your head above the parapet to “defend the drug that killed Leah Betts” was at that time a career-harming action (because of the hysterical climate that had been allowed to develop), but also probably because most people saw no reason to call-out misinformation that matched what they broadly believed anyway (i.e. that MDMA was bad).
Now, only 40 years later, is MDMA being finally properly tested to see if it can treat people. This delay may have prevented many millions of people from being helped or cured of their PTSD problems, which is a pretty shameful fact or us to consider.
In the “post truth” world, this has serious implications for us all in our efforts to bring a factual basis for political debate back to the fore. It is our job as liberals to shoot down biased or misleading stories, research, news, or any other information…*even if we happen to agree with the cause it aids*. Too often, we have allowed obviously misleading information to go unchallenged because it supported our message – whether that be on policy, crime statistics, Brexit, or whatever. This has to stop, even if it annoys our colleagues. For example, despite being a non-smoker, a few years ago in a Lib Dem Voice article I called-out obvious misinformation about shisha smoke. The re-imposition of political rigour has to start in our own camp, and it has to start now.
* Dr Mark Wright is a councillor in Bristol and was the 2015 general election Parliamentary candidate for Bristol South.
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13 Comments
Excellent piece.
“It is our job as liberals to shoot down biased or misleading stories, research, news, or any other information…*even if we happen to agree with the cause it aids*.”
Too often Neo-puritanism appears to drive policy (including as a basis for some peoples arguments on here).
Mark
Good to have you writing in the field, and from the perspective, you know best ,and exhibit such excellent qualities. It is as someone trained and knowledgeable in the science area ,that you bring a methodology and exactitude to our debate .
I of course bring my own qualities from the perspective of the arts and yet on this topic I cannot therefore claim any knowledge at all.
I am very interested in and concerned about these issues though. I do believe as with much we do , things must be evidence based. Do you not think there is room also for gut feelings or instincts as well ?
As a suggestion I would say all of us have a tendency on a subject . I am tough on crime if you mean on the violence of criminals with direct victims . I probably would find more common cause with John Reid than a bleeding heart liberal.
But on “victimless ” so called crimes , privacy , understanding , tolerance , are my tendencies and I am very much of a piece with the most ultra liberal at times.
One thing I know . You mention the 80s and America. We now need , as ever we did , more than “just say no !”
Thanks for this Mark, it’s a subject close to my heart. No, not MDNA (although I did hear a fascinating talk on it by a medical toxicologist a number of years ago), but the use and abuse of evidence in policy making and medical decisions.
There was a book out a couple of years ago called “The Geek Manifesto” which called on us to call on politicians to take more of an evidence-based approach to deciding policy, with the associated TedTalk here:
https://www.youtube.com/watch?v=qKg0qI_l7FA
The author warns of the perils of politicians finding evidence to fit their theories, rather than the other way around, although I think he fell into the trap of some selective story-telling to fit his own political prejudices.
A better book, but more about actual science and especially the world of medicine, is “Bad Science” by Ben Goldacre. If you are interested in the subject, I’d read this book first for a better explanation of the important concepts and to get you extra angry about the irresponsible behaviour of the media when it comes to things like MMR.
Again, there are a couple of excellent TedTalks by Goldacre.
https://www.youtube.com/watch?v=h4MhbkWJzKk
https://www.youtube.com/watch?v=RKmxL8VYy0M
I really do think we could save a lot of money in the NHS especially if we dropped the dogma and put more effort into listening to experts (sorry Michael), and evaluating the data.
@Psi & Fiona – thanks both!
@Lorenzo – The issue of whether we should be guided by “gut instinct” is complex. Take, for example, the Middle East refugee issue, which I think tugged at many people’s gut instincts. Many liberals felt a strong gut instinct that we should help those fleeing the fighting, and I think that’s right and there’s no problem with that.
But the next step was: how to help? Some said the best way to help was to pour money into aid and refugee camps – as the UK did. But I think many liberals had gut instinct that the best way to help was to simply say “You can all come here” – as Angela Merkel did. It is a noble and generous gut instinct. But there are consequences. The perception that much more wealthy countries were opening their borders inevitably encouraged a great many more people to use international people-smuggling networks of organised criminals to make a chaotic, dangerous journey over thousands of miles of sea and mountains, with the probably predictable result that near 10,000 unfortunate have died on that journey so far in the last 2 years. I think if Merkel had done an objective analysis of likely outcomes, two years ago, she might have come to a different conclusion of the best way to help.
I would advise anyone wishing to read a short history and where we are at the moment should google ( sorry link not working)
Making a medicine out of MDMA Ben Sessa. David Nutt. British Journal of Psychiatry, Jan 2015
I think there is a broader issue here too which is the Referendum rejection of experts. It has become almost impossible for the ordinary person in the street to determine what is evidence based from what is biased. Add this to the financial experts failure to predict the last crash and the opinion “what do they really know?” is easy to arrive at, leaving a large proportion of the population open to persuasion by those like Trump and Farage who deal with emotion rather than facts.
We almost need a civil service branch who’s sole purpose is to tell us what is the truth, but that’ll never happen, of course. Democracy does depend on the population having a certain amount of knowledge but the pursuit of truth has become like a game of mirrors in a mist.
Sue,
“We almost need a civil service branch who’s sole purpose is to tell us what is the truth” – Would that by any chance be Orwell’s Ministry of Truth?
I remember reading in William Manchester’s biography as to how Churchill’s assessed the news of his day. Disdaining the front page news as a jumble of facts, he instead turned to the opinion pages of the daily papers to get a broad cross-section of interpretations of key issues from differing standpoints.
Mark’s article raises important issues around academic research that has wide ranging implications. We rely to a large extent on the rigour of University research departments in maintaining objectivity and a scientific approach to research in providing the ‘evidence base’ that we need for policy development.
When research is allowed to develop a systematic bias or another Orwellian characteristic ‘group-think’ becomes the norm for cultural or career development reasons then that evidence base is corrupted.
This is perhaps most evident in the field of macro-economics that has morphed from a broad study of political economy in the 19th century into a highly quantitative discipline that is based on the seemingly dubious empirical foundations.
Approaching received wisdom with a questioning attitude and a healthy degree of scepticism, when facts do not appear to match experienced reality, is how mankind achieves progress. I agree with the premise of the article that this most be done even when (perhaps especially when) it is politically inconvenient and does not support the message we may wish to convey.
@Joseph – Very good points, thanks!
@ Sue Sutherland,
In my view, I think the issue is that research into Cannabis for medical use may have been delayed because it too has been used as a recreational drug.
I think that the paragraph on Safety and Risks in Professor Nutt and Ben Sessor’s article should give pause for thought.
@ Joe Bourke,
This is not America and we are now 40 years more advanced.
One of the first questions one asks when reading a piece of research is, who produced it what were the motivations for this research coming into existence, what biases might there be. There is also a hierarchy of research methodologies and a hierarchy of scientific journals, the best ones where the quality of a submission such before any research paper is accepted. There is also peer review.
Any scientist worth their salt recognises that there are limitations to any research, but if one is capable of higher order thinking, one understands that the more one knows, the more there is to know, i.e there is an awareness of one’s own ignorance. I have yet to meet a medical researcher who lacks humility and a recognition of the possibility of their own conscious and unconscious bias which they try to minimise. Rather, because medical researchers tend to have clinical responsibilities as well as research interests, they are driven by a thirst to extend the boundaries of medical knowledge and this requires scientific integrity.
A big issue for me regarding research in general, is that it is now an academic requirement to have a CV with a list of research papers under one’s belt if one wants career advancement, and in some subjects this leads to rushed, poor quality research. These papers are sometimes picked up by newspapers because it suits the agenda of the newspaper, even though there has been no peer review and no quality journal would touch them.
Regarding the comment “there is no such thing as a ‘safe dose’”, this is an unscientific lie perpetrated by the US Government (and likely others) in the War On Drugs. I am disappointed that it is so widely believed. Anyone familiar with toxicity knows the saying “the dose makes the poison.” Any good test of effects would use a range of doses, and with any drug, poison or substance there’s a dose below which there is no effect.
Cracking article by former Guardian journalist Glenn Greenwood, criticising fella news at The Guardian newspaper:
“The Guardian’s Summary of Julian Assange’s Interview Went Viral and Was Completely False”
https://theintercept.com/2016/12/29/the-guardians-summary-of-julian-assanges-interview-went-viral-and-was-completely-false/
“fella” = “false”
@Cllr Mark Wright
I’m not sure Glenn Greenwald (aka Greenwood) is the man to save us from the scourge of false news.
I recall in particular one of his many Twitter spats with Richard Dawkins a year or so ago, when Greenwald claimed (falsely) that Dawkins had refused to be interviewed by a journalist because they were Muslim. When conclusive proof was provided that Greenwald’s story was false, he refused point blank to apologise – presumably on the grounds that he hates Dawkins, hence “false news” which portrays Dawkins in a bad light is somehow justifiable.