"You'll never think about drug addiction the same way again"
July 1, 2017 5:20 AM   Subscribe

 


Nontrivial number of failed replications, I don't know how many failures of replication have been published.

Get Alexander's book, "The Globalization of Addiction", if only for the China chapter. His critiques of capitalism are pretty stale and standard Naomi Klein sort of stuff, but the China and maybe the Orkneymen chapters are great.

His reasoning for saying his theory of addiction applies to China:

1. China during the Maoist period ending in Deng Xiaoping's reforms had the only instance of a state-sponsored antidrug campaign succeeding
2. This isn't from the dire punishments meted out to smugglers, since the dire punishments were in place before Mao and after him, but opium and other drug usage was incredibly high before and after Mao
3. It may have been lying, but we have records from anti-PRC orgs who corroborate
4. It may have been the huge cultural campaigns and the meetings and slogans and shit - but we do that in the west, too, although he doesn't rule it out
5. Iron rice bowl and the stability of employment and shit is his answer, if I recall correctly. Soviets failed at getting this because they destroyed traditional social organizations but Mao was like, "villages are fine"
6. Alexander ain't no apologist, this huge opium addiction reduction was literally at the same time as the massacres and famines and things
posted by hleehowon at 5:50 AM on July 1, 2017 [4 favorites]


Notably lacking in that list: like, controlled experiments and shit

Man's a better historian than scientist, tbh
posted by hleehowon at 5:51 AM on July 1, 2017 [1 favorite]


McMillen previously.
posted by Obscure Reference at 6:07 AM on July 1, 2017


Hmmm, I've always thought the drug researcher should study folks like, well, me. I've had many opportunities in my life to take on all the varieties, but, to be obstreperously simplistic, I went to the library. (or bookshop or mifi) which seems to have some correlation with the last frame of the cartoon.

Is there any actual research about populations or sub-populations that do not get addicted?
posted by sammyo at 6:57 AM on July 1, 2017 [3 favorites]


Frankly (and you might as well start the hooting and hollering now) I'm not even convinced addiction itself exists. See Dalrymple, Theodore.
posted by adam hominem at 7:17 AM on July 1, 2017 [6 favorites]


I don't think Alexander does clinical anything. And he has a pretty idiosyncratic definition of addiction, which he shares with his friend G. Mate. Try the intro to In the Realm of Hungry Ghosts, which is Mate's book
posted by hleehowon at 7:24 AM on July 1, 2017


From experience, I'd say the distinctions between physical and psychological addiction and addictive potential are very real, and like some clinical evidence suggests, those with a genetic predisposition aren't necessarily likelier to develop psychological addiction, just more prone to having and struggling with getting over dependencies on substances with a physically addictive potential.

Tough love and shunning definitely don't help with addiction. My mom might have recovered fully from her own heroin addiction years earlier with more understanding and compassionate social support. You definitely don't want to kidnap a recovering addict's child while they're in an intensive rehab program, because, duh, when they find out how much they've lost while making a genuine effort to recover, they experience that as punishment for the effort and are more prone to relapse. Also, as noted, isolating anyone increases their compulsive/addictive potential.
posted by saulgoodman at 8:27 AM on July 1, 2017 [12 favorites]


I would not argue that feeling "caged" in one sense or another may lead further into addiction. Or maybe, the rats were seeing stimulation they did not find in cages. Maybe it was a social factor. I am thinking about the other factors because there is addiction rampant among the high social classes to which the world is theirs to roam. I would not argue, as well, rich people never feel "caged", but addiction definitely has more than one factor.
posted by thetoken at 8:42 AM on July 1, 2017 [1 favorite]


I recall Alexander's argument against physical addiction being incredibly consequential to the actuality of addiction is his experiences dealing with Vancouver heroin junkies. The supply chain of Vancouver heroin is often bad to the point where there was no heroin in the 'heroin', but the people kept shooting up.

A completely valid critique of the actual experiment is one posed by Feynman to all of rodent-to-clinical translation biology: the variables are fucked, so the replicability will be fucked. Who the fuck knows about rat social dynamics? Certainly in a state of ostensible freedom in even small societies there will come to be people susceptible to addiction
posted by hleehowon at 8:46 AM on July 1, 2017 [1 favorite]


Who the fuck knows about rat social dynamics?

*grimly* if people would pay behavioral ecologists like me, that'd be our job. It drives me absolutely bug-fuck nuts that rat and mouse specialists in the lab who are trying to use rats and mice as model systems to understand human neurological issues often seem to totally fail that these species have a context outside the lab that we need to understand and keep in mind as we devise these experiments.

This isn't everyone, mind--there's some pretty cool work going on actually about how social context changes all kinds of interesting things in the brain and also in the way individuals respond to stress. But you have to do that contextual work, and ideally you have to do it in both your wild and your domestic strains of the species you're interested in. And for rats in particular that's difficult, because rats are more expensive than mice although they're also significantly more behaviorally complex and socially complex, and since their genome was not sequenced as quickly as the mouse genome was, they're only now beginning to catch up in terms of neurological technique. Which means we have a fuckton of older rat behavioral work (like this study) and then rat work suddenly dropped quite a bit as everyone favored mouse work, and now we're starting to see rat work come back into vogue again.

Anyway, this is why I'm a behavioral ecologist and not an animal cognition specialist: context matters and you have to understand that context before you can apply generally relevant information to a different context.
posted by sciatrix at 8:56 AM on July 1, 2017 [50 favorites]


::applause please for sciatrix::

Brava brava, encore!
posted by infini at 9:22 AM on July 1, 2017 [3 favorites]


Oh, this is clever, nice find, infini.
posted by clavdivs at 10:32 AM on July 1, 2017


I was aware of Alexander's earlier work back in 1974 when I started my research career as coordinator and statistical analyst for a study of...the Drug Control Amendments of 1970. It was funded by NIDA, NIMH, and DEA, the organization created by the law, and they were convinced that the findings of our research would be favorable to them. We looked at four classes of scheduled drugs (barbiturates, benzodiazepines, opiates, and amphetamines). The question was whether scheduling had an impact on licit and illicit use of these pharmaceuticals. To prepare myself, I read a lot of the literature on drug use and abuse, including much of the sociology of drug use. Even though I was familiar with the area from a personal *ahem* perspective, I was surprised by what I read. Back then, researchers had found not only what Alexander was initially finding before his light-bulb moment, but sociologists were finding that there were a lot, the majority, of heroin users who were not, by any definition, addicted. They would use on weekends, like social drinkers, and the rest of the time lead pretty normal lives. Only about 10% were addicted by the usual definition, and those people often had problems related to their use. In addition, about 90% of those addicts would mature out of their addiction by the time they reached their 30s. I know there has been a lot of research since then and these earlier findings may have been as much a product of their time as of any eternal scientific truths, but even then what the anti-drug people were saying was completely contradicted by what the scientists studying the problem were saying.

Oh, and by the way, the results of our research found no effect of the new laws on illicit use of the scheduled drugs. We looked at emergency room admissions, death certificates, the Drug Abuse aWareness Networkd (DAWN) data, street drug analysis lab data, reported diversions from manufacturers, distributors, and pharmacies, the National Prescription Audit done by IMS, America, and the DEA's own arrest and seizure data. Trends that existed before the law's schedules took effect continued uninterrupted, except for two. The number of prescriptions that could be renewed went down (mandated by the law) and the size of the prescriptions went up to compensate. So the net effect of the law was to increase the amount of abusable drugs in the hands of the citizenry at any given time, an effect I'm sure was not intended by the good folks of the DEA. The DEA screamed bloody murder when we reported our findings, threatening to blackball the University from further federal funding. Of course, we had the facts on our side, but they buried the report. I've made it a policy since to never accept research funding where I didn't have the right to publish what I wanted to.

As for research, I was hooked.
posted by Mental Wimp at 2:36 PM on July 1, 2017 [9 favorites]


these species have a context outside the lab that we need to understand

No study of addiction in rats will ever be adequate if it does not include the alternative of giving them pizza.
posted by oneswellfoop at 2:45 PM on July 1, 2017


The tradition of intensive research into drug use that gets overridden by moral panic goes back at least a century.
posted by Devonian at 3:07 PM on July 1, 2017 [2 favorites]


Sciatrix: just because you have more understanding of the ethology than a clinician (a low bar) does not mean the variables aren't fucked and replications are also often fucked, because even the understood variables are damn hard to manipulate. How do you reliably get a social group of rats to not ostracise some specific rat? What's the procedure for that?
How good is the replicability?
posted by hleehowon at 3:25 PM on July 1, 2017


An excellent mental image: rats playing the ball passing rejection game, two confederate rats passing around a ball, rejecting the fuck out of a third rat
posted by hleehowon at 3:29 PM on July 1, 2017 [1 favorite]


The science is a lot more complicated than that, hleehowon. Sometimes a pharmacological/neurological procedure can cause behaviours that deviate from normal. For example, the novelty test. A rat is presented with two objects/two rats. If the rat has seen one before, it will spend more time exploring the novel object/rat. This kind of test is used to judge experimental perturbations.

For actual social isolation experiments, rats are social creatures and are typically group cages (and to save money). Removing a rat of a certain gender at a certain developmental time and individually housing it (within sight/sound/smell of other rats, caged individually or group housed - or not) creates all kinds of different behavioural responses.

WRT addiction studies, most studies aren't dosing correctly; "addictive" appearing behaviour may very likely be a physical response to acute withdrawal symptoms. Not enough studies do good washout periods and re-exposure. Some really interesting research being done on what factors, such as stress and the timing of such stressors, contributes to re-acquisition of addictive-like behaviour.

Also, importantly, many models of drug abuse are intravenous and the context is administration is highly weird. It's like aliens beaming a super drug into you randomly - this is an extremely different context than you cutting a rail and snorting it when you feel like it.

Interestingly, IV administered psychoactive cannabinoids are very aversive to rats/mice, not to mention that naturalistic injestion of cannabinoids is done with a mix of many different cannabinoids, not just THC or CBD or simple ratios of THC/CBD. A lot human patients benefit from "whole Cannabis" don't tolerate sativex (semi-synthetic THC/CBD at a simple ratio) very well.

I was at a conference recently where the researchers acknowledged this problem and set up a vapourization system where the experimental animal can self-administer (or whatever, lots of different conditions can be probed with experimental systems like this) that produced a cloud of vapourized whole extracts from drug-type Cannabis.

In this system, psychoactive cannabinoids are no longer aversive - quite the opposite. However there are some really interesting behaviours that are beginning to be teased out. It's not yet published data so I can't share specifics, but the gist from this group and many others is that there's a whole lot more solid scientific evidence coming down the pipeline that marijuana really isn't the Devil Weed.

Incidentally, there is a really strong study underway supporting a previous highly powered twin study suggesting very strongly that any neurological/behavioural deficits from early/youth use of drug-type Cannabis is purely from confounds that hadn't been addressed. The summary of the twin study is that when one twin used, but the other did, both twins looked like they had neurological/behavioural deficits compared to the control non-use group.
posted by porpoise at 4:38 PM on July 2, 2017 [1 favorite]


Ioannidis jokes that we really only know about 7 things in medicine, because the variables are so much worse than in physics. I mean, at some level we have to be resigned at that, but at some level maybe not.
posted by hleehowon at 5:20 PM on July 2, 2017


hleehowon, my experience with rat studies has actually been with singly housed animals specifically to eliminate that variable... but then you wind up in the whole "holy fuckballs this is an artificial situation" soup again. There is no good answer for this; all there is for biologists and especially anyone working on behavior, neurology, or psychology is to attack the problem from as many angles as possible and do their best to understand what is going on.

As I speak, I am sitting here trying to understand how leptin interacts with social stimuli in the mind of a singing mouse as it decides whether to sing. I'm using male individuals who were group housed with one to three other males from weaning to the time I used them. I'm randomly assigning individuals to each treatment and assigning socially relevant stimuli in a randomly assigned order, and that's about the best I can do with respect to teasing the variables of dominance interactions among mice or order effects on these things--I'm hoping order effects will wash out some with the noise. I'm hoping mice will naturally sing more if they suddenly feel they own a territory for the first time in their lives. I'm hoping that intra-peritoneal leptin will get to the brain and that singing mice will respond well to the leptin produced by a mouse that hasn't shared an ancestor with my guys since the Oligocene.

I am hoping all of these things very fervently, because I am entering my sixth year of my PhD, I would like to have enough financial stability to have a kid in the nearish future, and my degree program wanted us out by the end of fifth year and I would very much like to acquire enough data that I can trust to graduate. I am less intimidated by the neurological and genetic work I have planned on the docket than this, the behavioral side of the coin. My job depends on coming up with results that challenge accepted wisdom enough to have my biological peers tut happily to themselves and feel I have expanded knowledge significantly, but not challenging them enough to write off my applications for grant money and support as a waste of time and effort before I can get started.

My current experiment requires me to come in every single day to move animals or run them through the experiment, and I am running out of break time. Our system for funding science is a fucked-up mess that requires young scientists to give up any dream of career or geographical stability for close to a decade (or more, depending) and as these young scientists are the people doing the bulk of the actual research, they tend to want to design experiments with an eye towards convenience as well as accuracy. I would probably be more relaxed about my design if it did not require me to adjust my animals to a very slightly different light cycle shifted an hour ahead; however, my PI felt strongly that they had to be run in the dark, and not shifting them would require that I get up at 430am each morning rather than 615am in order to give up the ability to ride to a closer bus stop in my wife's car on her way to work. I get home at 7pm most nights, and that schedule would result in either permanent sleep deprivation or loss of what passes for my social life or both. It's not happening.

I can't quite tell if you are being critical because you'd like to get biology and behavior to act like physics or not, but if it's the former you're doomed to disappointment--biological systems are nearly always chaotic in that very very small perturbations in your starting conditions can drastically change the outcomes within the system. Because of this, we are restricted to doing our best with what we can do, which tends to either be running experiments with high control over variability in intensely unrealistic scenarios, or attempting to create more biologically relevant scenarios at the expense of control.

There aren't good answers, except perhaps brute forcing it--and that's damn hard to do, given that we're people too, and given limited resources. If that is something you are not comfortable with, physics and Feynman will await you with open arms, I suppose. In the meantime, I love trying to pull some kind of information from the delicate chaos about how variables respond to specific perturbations, so I will be continuing to try to work out what is going on with the flawed tools available to me.
posted by sciatrix at 10:04 AM on July 3, 2017 [1 favorite]


(and dammit, Ionnadis has a good point as far as it goes, but it's a point that is not going to be solved by anyone without massive systemic structural changes in the way scientists are recruited and incentivized, including much more financial support for science in a political climate that is uncertain and critical at best. Criticizing the results of the science we can do on the grounds of a fundamentally broken worldwide system seems unlikely to result in a less punishing system that might produce better data, so I'm trying to get by without being crushed under the weight of the system we do have.

I'm a practical woman. Now if you'll excuse me, I need to go take some brains.)
posted by sciatrix at 10:07 AM on July 3, 2017


chaos theory was made by and for physicists, you know? quite sophisticated chaotic analyses exist esp of heart rate variability
posted by hleehowon at 7:06 PM on July 5, 2017


dude, if you think physicists can come in and solve every problem of biology if only they cared enough, well, you're welcome to try. we trade specialists often enough, but for every Lord Robert May I've seen a dozen physicists and computer engineers wade into my field, proclaim they know how to tackle every complex problem with their amazing physics knowledge, and make massive fundamental errors because they don't bother to actually comprehend the existing knowledge in the field they're dealing with first. When they do work out well, they tend to be in ecology and cell biology--as you mention, heartbeat theory, fucking heartbeat theory--not in behavior. Which is orders of magnitude more sensitive to subtle perturbation than tissue dynamics. There's a place for computer scientists and physicists in behavior work, but it's a collaborative place, not the patronizing "let me explain science for the plebes" patronizing stance that many physicists take when writing about or contemplating biological sciences. I'm down with neural networks and the psychophysics of sensory modalities and modeling in general. I use that shit and borrow the theory happily enough, which is by the way the case with most of the behavioral ecologists/neurologists/whatever the fuck you call us I know these days; we borrow techniques and ideas from other fields with a cheery hand while we work out what might be useful and what not be.

jesus, save us from engineers' disease. this is why I hate dealing with physicists. no other discipline would generate the sheer number of arrogant assholes who try to explain complex behavior by reducing and oversimplifying it, generating models that a) incorporate flawed assumptions and b) reduce the phenomenon under study to a series of spherical cows as they try to understand the actual problems at hand. there's a delightful level of misogyny flavoring the whole interaction, too, like those "softer" sciences (which mysteriously lost all their respect when women gained parity in them, historically speaking) are just noodling along on their own waiting for a real scientist to explain things to them.

go on though. explain my field to me some more, bro. if you think I've got a chip on my shoulder about this, hey! you're exactly the reason why.
posted by sciatrix at 9:09 AM on July 6, 2017 [4 favorites]


I mean, statistics was invented for and by evolutionary biologists, but mysteriously we don't spend all our fucking time explaining that physicists using statistics to analyze their experimental results could probably do their fields better if they just invoked expertise from a trained evolutionary biologist more frequently.
posted by sciatrix at 9:14 AM on July 6, 2017 [3 favorites]


I mean, statistics was invented for and by evolutionary biologists

Wut?
posted by Mental Wimp at 9:11 PM on July 14, 2017


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