Posted by In the wake of some recent deaths in Edmonton of teenagers who took Ecstasy, DrugMonkey gets irritated with a doctor who made some proclamation to the press:
I’m particularly exercised over an article which quotes Charles Grob, M.D. (UCLA page):
Charles Grob believes there is a strong chance that a deadly batch of adulterated pills is making the rounds in and around Edmonton, though health officials and law-enforcement groups have issued no such public warning.
Dr. Grob, a professor of psychiatry at UCLA, was the first U. S. researcher to conduct human tests of methylenedioxymethamphetamine, or MDMA, the technical name for Ecstasy, since it was outlawed in the U. S. in 1984. It is rare for anyone to “overdose” on the drug in its pure form, he said.
There are but a few dozen deaths linked annually with Ecstasy in North America; mostly, they arise from complications, such as pre-existing heart problems or hyperthermia that occurs when high, frenetic raver kids overheat themselves.
But three girls, all within a few weeks of each other, in the same vicinity, and none of whom were observed exercising hyper-actively, he says, is too unusual to be MDMA-caused. “I think there’s something else in those pills,” Dr. Grob says. “It would be awfully coincidental if all three of these teenage girls had congenital heart problems that had not been identified earlier. I’d put my money on a drug substitute.”
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Here’s my take. We don’t bloody well know. Period. Until we have a comprehensive tox report showing what was and what was not in these kids’ bodies when they died. It is quite possible, however, that MDMA is indeed the primary cause.
DrugMonkey then proceeds to lay down some reasons — grounded in research — that Dr. Grob shouldn’t be dismissing the possibility of MDMA overdose out of hand.
You should go read the whole DrugMonkey post. Here, I’m going to use it to highlight an issue we’ve discussed before: If you’re speaking to the public as a scientist (including speaking to the public through a journalist), you have some responsibilities.
Get the facts right.
Take account of the current relevant research, rather than assuming that it all falls in line with your results. (Don’t speak to journalists until you’ve acquainted yourself with that research.)
If you’re going to make a claim that outstrips the empirical evidence, flag it as a hunch rather than a well-supported conclusion.
Underline not just what is known, but also areas where uncertainty remains — especially in understanding particular cases where crucial data (like toxicological reports) is not yet in.
Think about why getting good scientific information matters to the public and about the ways the public could use the information you’re providing — not just how it could be helpful, but how it could be harmful if people don’t appreciate the complexities of the point you’re making, or if you’re wrong.
On this last point, DrugMonkey suggests that the part of the public inclined to take Ecstasy at parties is better served by a more accurate account of what the existing body of research says could have happened in the Edmonton cases than by one researcher’s hunch in the absence of conclusive toxicology results:
As I say fairly frequently, the Ecstasy user is comparatively sensitive to information on the likely risks of the drug. No, I’m not being naive. You can look at many, many user practices which are promulgated on advocacy/harm reduction websites and forums online and talk to your local users (do you talk with your undergraduates, professors?). Chill out rooms, tryptophan loading, various vitamin prescriptions, cautions on dose and frequency….you can draw direct links to available knowledge from Case Reports of medical emergency/death, on-site experience of harm reduction outfits and the preclinical research literature. Now, I’m not saying that stuff necessarily is helpful to avoid all potential adverse consequences, I’m just saying that the target audience is…receptive. And in the absence of information to the contrary, this population is going to go to the mat denying that it could possibly be MDMA itself that is the root cause of fatality.
Given that scientists complain that the public just doesn’t pay attention to scientific information even when scientists are making an effort to convey it to them clearly, scientists need to take responsibility for conveying accurate information — in case the public actually does pay attention.
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