Drugs

So a week back or so, a number of friends read an article about death by rectal eel and immediately thought of me. For those of you who missed the story, it went a little something like this: * Chinese man gets drunk with friends and passes out * Friends think it would be hilarious to insert a large living swamp eel into the man's butt while he is unconscious * Hilarity does not ensue. In fact, the man dies. Chinese doctor says the eel "consumed the man's bowels" The article was widely reported in major news outlets like CNN and the Times, but I am linking instead to the UK edition of…
In the sixties one of the suggested exist strategies for the War in Vietnam was "to declare victory and get out." Alas, it was the road not taken, increasing the length and depth of the tragedy for all concerned. For the War on Drugs, there is an even simpler solution: stop calling it a war. According to Obama's drug chief, that's the attitude of his administration and it's about time: President Barack Obama’s plan to fight drug abuse and trafficking proposes spending $15.5 billion next year and shifting the emphasis from fighting a war on drugs to treating the problem as a national health…
Just because a company got it right once doesn't mean they'll get it right all the time. Back in the day, one of the great crisis management success stories was was Johnson & Johnson's handling of a case where someone intentionally introduced cynanide into on the shelf bottles of Tylenol in the fall of 1982 in the Chicago area. Seven people died. If you ever have trouble opening your over the counter or prescription drug bottles, you can thank the creep who did it -- whoever that is. No one was ever caught. Here's a concise summary of the 1982 poisonings, courtesy Wikipedia: Wednesday…
If you take or are close to someone who takes antidepressant medication, you're probably aware that one class, the SSRIs, is particularly prone to causing sexual side effects. These effects can run the gamut from inhibition of libido, to erectile dysfunction, to a diminished or complete inability to achieve orgasm. It's that last one that we take a look at today - a SSRI went on sale in Britain this week that is touted as inhibiting orgasm - on purpose! This SSRI, dapoxetine, is marketed to treat premature ejaculation. Previously sold in a few European countries, it has just gone on the…
Self medicating for mood disorders is well known. It is often quite harmful, with the chief culprits being ethyl alcohol and nicotine. But there are others. One that comes up often is chocolate as an antidote to feelings of depression. Not everyone who eats chocolate is depressed, of course. Probably most of us who do it do it because we like chocolate. When I was in elementary school I used to eat a lot of Hershey bars after school. They cam in six-packs and one memorable day I found two whole packs and one pack with a single bar missing. I ate all 17 in one sitting. Two hours later I ate…
tags: Sex, Drugs and HIV -- Let's Get Rational, behavior, disease, prostitution, gay men, drug addicts, sex, STD, HIV, AIDS, poverty, medicine, public health, Compassion Conundrum, Elizabeth Pisani, TEDTalks, streaming video Armed with bracing logic, wit and her "public-health nerd" glasses, Elizabeth Pisani reveals the myriad of inconsistencies in today's political systems that prevent our dollars from effectively fighting the spread of HIV. Her research with at-risk populations -- from junkies in prison to sex workers on the street in Cambodia -- demonstrates the sometimes counter-intuitive…
Cellularity is a new project by James King, a speculative designer working on biotechnology and interaction design. The project focuses on the potential future of smart pharmaceuticals, drug molecules surrounded by membranes that over time as technology advances may come to more and more closely resemble actually living things. He proposes a cellularity scale from totally non-living to really alive artificial cells. This quantification of "aliveness" in a way is something that may need to be done if some of the proposals of synthetic biology come to fruition. When does a membrane surrounding…
If there's one thing I have a zero tolerance policy for, it's zero tolerance policies. We see too many incredibly stupid implementations of rigid and mandatory policies (including mandatory sentencing), no matter how reasonable they sound when first advocated, to believe there should ever be policies that provide absolutely no flexibility. The world is a messy place and not everything fits into pre-envisioned boxes. The latest miscarriage of common sense and humane behavior comes to us from those good people at WalMart, who fired a long time, loyal and effective employee because he failed a…
I've had occasion to remark a number of times how much of what is reported as "science news" is just warmed over press releases from university media departments or company flacks. I read them anyway, often sucked in my a headline that turns out to oversell the case. Now I'm becoming aware headlines can also (deliberately) undersell the case. Consider two press releases that came out on virtually the same day, one from Big Pharma Pfizer, the other from biotech player, Genentech, owned by Big Pharma's Roche (maker of Tamiflu). Pfizer, first. The headline pretty much tells the whole story, as…
Apparently, if the high-profile, exhaustively peer-reviewed journal Men's Health [/snark] is to be believed, Boston is the least boozy city in the country (italics mine): Fresno, Calif., tops Men's Health magazine's list of America's "drunkest" cities while Boston, home to the "Cheers" bar where everyone knows your name, was deemed the "least drunk," besting even Salt Lake City. The magazine, which will publish the list of 100 major cities in i's March edition, drew upon such data as death rates from alcoholic liver disease, booze-fueled car crashes, frequency of binge-drinking in the past…
Last year, I wrote about a scientific controversy over the structure of the influenza M2 proton channel, particularly over the protein's binding site for adamantane type anti-flu drugs. The Schnell/Chou model, based on solution NMR, had the drug binding to the outside of the channel, within the membrane (at a 4:1 drug:protein ratio). On the other hand, the Stouffer/DeGrado model had the drug binding inside the channel (1:1 ratio), based on X-ray crystallography studies. A new study was recently published in Nature (the same journal that published the original two competing papers), based this…
We've written quite a bit about statins because there is evidence that these plentiful and cheap drugs may be useful in treating or preventing the innate immune system's catastrophic dysregulation sometimes called "cytokine storm" (see here, here, here, here, here for a few examples). A new study now suggests that daily statin use by people under 75 may also lead to a significant (40%) reduction in cataracts. This from a study in Epidemiology of 180,000 patients seen between 1998 and 2007 in Israel: Dr. [Gabriel] Chodick and his colleague Dr. Varda Shalev found that men aged 45 to 54 who took…
[Previous installments: here, here, here, here] We'd like to continue this series on randomized versus observational studies by discussing randomization, but upon reviewing comments and our previous post we decided to come at it from a slightly different direction. So we want to circle back and discuss counterfactuals a little more, clarifying and adapting some of what we said for the coming randomization discussion. Let me change the example to a more recent controversy, screening mammography for breast cancer. Should women under 40 get routine screening given that there is said (on the…
Continuing our discussion of causation and what it might mean (this is still a controverted question in philosophy and should be in science), let me address an issue brought up by David Rind in his discussion of our challenge. He discussed three cases where a rational person wouldn't wait for an RCT before taking action, even though there remained uncertainty. The first was a single case report of rabies survival after applying an ad hoc protocol. The next was use of parachutes while sky diving. The third was the first reports of antiretroviral therapy for AIDS. Here's what Rind said in his…
I've noticed that whenever I have the temerity to suggest (e.g., here and here) that maybe the word of the Cochrane Collaboration isn't quite the "last word" on the subject and indeed might be seriously flowed, I hear from commenters and see on other sites quelle horreur reactions and implications this blogger doesn't believe in the scientific method. Why? Because "everyone knows" that a randomized controlled trial (RCT) automatically beats out any other kind of medical evidence and any Cochrane review that systematically summarizes extant RCTs on a subject like flu vaccines is therefore a…
With medical marijuana now legal in thirteen states, and President Obama's Attorney General advising Feds not to waste resources on users in compliance with state law, the tide of tetrahydrocannabinol seems to be on the rise. On The Scientific Activist, Nick Anthis reports that the American Medical Association has recently altered its view of the drug, calling for a revised federal classification and more research into its potential medical benefits. PalMD for one will wait and see, writing that "the available clinical data do not give a doctor a clear way to evaluate the risk/benefit…
Last month, lawmakers in Ontario, Canada introduced legislation that would award prescription rights to graduates of two naturopathic schools. Should students subject to different educational standards be granted the same powers of prescription? On Terra Sigillata, Abel Pharmboy calls it inconsistent for the naturopathic community to "want the right to prescribe regulated medicines while simultaneously decrying medicine and science-based investigative methods," adding that "homeopathy is diametrically opposed to dose-response pharmacology." You can learn more about homeopathy here. Then…
This is not a needle exchange program center (from here) I've written before about the needle exchange legislation which is very good...in an imaginary world lacking parks, schools, and other places where children congregate. From Maine, we find out what this legislation really means: Such a position could conceivably pave the way for additional federal money for needle exchange -- with one catch. Bill McColl is the political director at AIDS Action in Washington D.C., who's been following the needle exchange debate in Congress. "They did accept an amendment that would ban the use of federal…
Any concerns about the current swine flu vaccine inevitably bring up the swine flu episode of 1976. This is not 1976. For starters, this year we have a bona fide pandemic and in 1976 the virus never got out of Fort Dix, NJ. That in itself is a game changer. If there are any risks from a vaccine (and there are usually some risks, even though they are much safer than most over the counter drugs) and they are for a disease no one is at risk for, the risk - benefit equation has nothing on one side and if there is anything, no matter how rare, on the other, it makes it unfavorable for the vaccine…
Yesterday, the influential AMA (American Medical Association) announced that it would cease its opposition to the concept of medical marijuana and instead advocate for a change in federal classification of the drug. From the LA Times: The American Medical Assn. on Tuesday urged the federal government to reconsider its classification of marijuana as a dangerous drug with no accepted medical use, a significant shift that puts the prestigious group behind calls for more research. The nation's largest physicians organization, with about 250,000 member doctors, the AMA has maintained since 1997…