Support our Kickstarter

Off-Label Ethics

Jedunnigan
happypills.jpg

The illegal and research chemical markets are flooded with new compounds all the time: substances like 2C-I and 4-MMC invade drug communities before they are put through any sort of testing environment.  This presents quite the moral dilemma for researchers like David Nichols who have made the discovery of new substances their life's work: “"You try to work for something good, and it's subverted in a way.”

Some might argue (a la the work of the ethnobotanist, Sasha Shulgin) that the off-label uses of these psychoactive compounds are not all bad, but the fact remains that people do experience negative consequences from improper use of these compounds.  In Nichols' case, his work inadvertently led to the deaths of at least two people over 20 years ago when one of his discoveries managed to escape the lab and be reproduced illicitly:

“He published his study, found little interest from pharmaceutical companies in his chemical, called MTA, and moved on…People [tried it]. They took too much. Their brains were flooded with serotonin, and they died.”

Despite Nichol's regret, it would seem that the problem resides in the system, not the compounds or the researchers who design them. The illegality of these substances prevents proper testing, oversight, and distribution of these chemicals in the public arena.

 

Image by formatbrain on Flickr Courtesy of Creative Commons Licensing.

Tags:

Comments

Nichols should stop whining

Submitted by Jedi Mind Traveler on Thu, 01/13/2011 - 12:41.
and call for legalization and testing, and yes also proper distribution. 

What is this? Editor?

Submitted by Lunk Rat on Thu, 01/13/2011 - 13:24.

Is this supposed to be an article?

"What’s clear is that the problem resides in the system, not the compounds or the researchers who design them. The illegality of these substances prevents proper testing, oversight, and distribution of these chemicals in the public arena."

How is this "clear"? Do you have more arguments/sources/discussion to back up this claim? The substances in question are not even illegal, so it is difficult to swallow your cry that "illegality of these substances prevents proper testing, oversight, and distribution . . . "

If you had bothered to read the essay that Nichols himself wrote for Nature, then you might understand that he was feeling remorse over the misuse of his research and wanted to share this with the broader scientific community. Nowhere in his essay do we find claims that drug laws are to blame for the harmful use of his research publications. If you have a good argument for this I would be interested to hear it.

Ahh, sorry everybody, I was

Submitted by Lunk Rat on Thu, 01/13/2011 - 18:31.

Ahh, sorry everybody, I was a bit assholistic with my first comment. I just expected more supportive explanation after the editorial possibility that was posed. Jennifer provided just the type of supportive reasoning that I felt was missing. While I personally agree that drug laws cause more harm than they prevent, other readers may not immediately understand the reasons why this is the case; it is not enough to say "it is clear" (and I see that you have now edited the post and softened the language to address my criticism). 

I was mostly annoyed by the way that the author's "editorial possibility" ignores the original focus of Nichols' essay--the ethical responsibility that he feels knowing that the drugs he creates might end up causing great harm--and shifts the focus to claiming that "the system" is to blame for the harm related to certain chemicals.

I would like to hear what other readers think about the "guilt trip" that Nichols describes in his essay. If you created a chemical that people began reproducing and distributing, would you feel responsible if it caused harm and suffering? You don't have to be a fancy Purdue psychedelic pharmacologist to have a taste of this type of ethical responsibility: inagine that you hand out MDMA to some friends and one of them has a medical emergency. Would you feel partially responsible? Or maybe you buy someone a lot of drinks and they wreck their car. Or you are an LSD dealer and people are freaking out a lot more from your latest batch. Do you get that gut feeling that feels responsible for their safety?

Should we feel responsible if we invent, or sell, drugs that turn out to be used without proper caution and lead to harm? Is Nichols whining too much about his losing sleep over the misuse of his publications?

ab[use]

Submitted by Chonnykins on Thu, 01/13/2011 - 21:36.
I wonder how many pharmacists feel guilty when they read about the amassing addiction and deaths related to prescription drugs? Or if they have a moment of contemplation as they hand the pills over to their patient? There spectrum of use/abuse will always apply as humanity is driven to find ways to alter his/her consciousness, for whatever reason. It is important we continue to push for mental health care, addiction treatment and prevention services so that we may compassionately address the ripple effect any compound produces. We are all in this together, of course, so we must keep each other in check and informed so as to wake up each day to live a little more radiantly.

off point

Submitted by Jedunnigan on Sat, 01/15/2011 - 10:05.
@LunkRat: friend, you seem to have misread me. Forgive me for not making my point more clear. However, you are quite wrong in saying these substances are not illegal. If you read the Analogue Act you will see that a significant majority of the substances Nichols create (and even before he creates them!) are illegal via structural similarity, intention for human consumption, and 'similar' psychoactive activity. And even if these chemicals were completely legal, to get proper funding for human testing would be neigh-impossible on any consistent basis. As for your second question: I honestly don't feel that Nichols should feel guilty at all. The end-users have the responsibility to know what risks are involved--as goes for any product you might consume/use--iand should practice harm reduction to the best of their ability. However, I find myself again at my point in the original post: users don't know proper harm reduction, safe consumption techniques, etc... thanks to an overall lack of drug education in this country. The negative precipitates of drug illegality are rampant--whether in the ghetto, rich suburbia or a science lab: people don't know how to safely consume drugs or how to teach people how to use them. What does this lead to: I'll let you fill in the blanks since you read the article.

Ah yes—good call—the

Submitted by Lunk Rat on Mon, 01/17/2011 - 21:59.
Ah yes—good call—the amazingly vague Analogue Act does indeed declare many new drugs to be illegal before they are even invented. And yes, you make a good point, this law “dooms” many molecules right from the get-go! How can we expect to establish safety practices, dosage guidelines, or phenomenological data on a new drug when said drug is illegal for human consumption before it is even invented in the lab? Like you said, fat chance at harm reduction when it is impossible to properly establish any facts about how the molecule operates in the human organism.

The ethical questions around new psychoactive compounds, “designer drugs,” involve more than just the absurdities of the Analogue Act. Let's imagine for a moment that there is no Analogue Act, and that new legal psychedelic drugs are being created and tested on human subjects in research clinics and universities worldwide. Imagine also there is a universal system for creating safety profiles for new psychedelic substances, and that people in general are educated on harm reduction and drug use best practices.

Now in our imaginary world where designer psychedelics are legal and accurate drug education proliferates, let's think about the Nichols situation. He describes how his research on MTA, an analogue of MDMA, inspired clandestine entrepreneurial chemists to distribute the drug for human consumption under the name “flatliners.” Eventually people actually flatlined on flatliners—that is, they died. Is it less likely that this would happen in our imaginary world of legal psychedelics and drug education? Probably not. Greedy people would still produce and push dangerous research drugs for profit with a disregard for safety; probably even more so if designer psychedelics were widely used and accepted. And drug consumers would still be careless and dumb, dosing and dancing themselves to death, even if accurate drug safety information was widely available. Sure, overall people would be much safer if these drugs were legal, but there would still be plenty of new “flatliners” to try out, with plenty of careless buyers, plenty of hospitalizations, and plenty of deaths.

Nichols ends with a situation to consider: “what if a substance that seems innocuous is marketed and becomes wildly popular on the dance scene, but then millions of users develop an unusual type of kidney damage that proves irreversible and difficult to treat, or even life-threatening or fatal? That would be a disaster of immense proportions.” This example is still possible and likely even in a world where there is sanctioned “distribution of these chemicals in the public arena,” as you put it. Legalizing the drugs would not eliminate this ethical concern from chemists.

Continuing with our fantasy world of legal designer psychedelics, we must ask, Who will sell these drugs on the legal market? Corporations. Probably the same corporations that sell all the other drugs: pharmaceutical companies. New chemists will constantly develop new psychedelics and companies will patent them and hurry them to market, just like they do with all the other legal drugs. And while public corporations do have more accountability than renegade black market chemists, they also have more legal protection when their products cause harm. I can't imagine Pfizer executives writing a letter to Nature because they are feeling bad that some drug or another that they patented is hurting people.

Lots of science leads to human harm and death. New research is constantly published that leads to the creation of more weapons, more pollution, more accidents, and more death. So what? That's science. As Nichols says “There really is no way to change the way we publish things . . .” This makes us ask, Why is Nichols compelled to publish his fears and guilt about the misuse of his work? Would he have felt the need to publish that essay in our pretend world of sanctioned entheogens? Maybe not, because he would be just like any other scientist publishing work that might lead to destructive events. It's the cultural stigma—and the legal status—around these drugs that makes his work seem to require repentance when somebody else uses it for ill.

So when psychedelics are widely accepted and new designer drugs are being legally rolled out to the masses, chemists will still have the same ethical quandaries when they unleash novel compounds through their research. They just might not feel the need to publicly voice those fears “for the record” because they will be just like any other scientist publishing work that could lead to harm.

So in essence I agree with you that drug laws make drugs more dangerous. But legalizing them does not eliminate the risks of designing and experimenting with and distributing new compounds. I also agree that legal status and the anti-drug hysteria of the public should not influence scientists to be regretful of their important work. 

Even if we didn't have restrictive laws, there is still a lot more that can be discussed about "off-label ethics."