Twenty years, one Saturday

If you’re in the UK this Saturday, London’s Institute of Cognitive Neuroscience is celebrating 20 years of peering into the brain with an all-day £5 conference that gathers leading researchers to cover everything from the neuroscience of cannabis to embodied cognition.

By looking at the talks (warning: pdf format programme), it seems they’re pitched half way between BBC documentary and academic talk, so if you are suitably caffeinated, they should perfectly hit the spot.

You can buy tickets online but if you’re not walking through central London trying to pipe energy drinks directly into your bloodstream at 9.30am on Saturday, you can watch it via a livestream which is being hosted on the information superhighway.

Can’t wait.

 

Link to Mind the Brain conference details.

The science of the Psychoactive Drugs Act

The world’s stupidest drugs law, the Psychoactive Drugs Act, has come into effect in the UK last week and it claims to prohibit the creation and supply of all psychoactive substances not already covered by pre-existing drugs laws.

Apart from taking us further down the futile road of prohibition it is premised on something that’s scientifically impossible – testing if a seized drug is psychoactive from looking at its chemical structure.

The government claimed that they had ‘solved’ this problem and they’ve just released their forensic strategy document which, unsurprisingly, doesn’t actually solve it.

What it does do, however, is worthy of attention as it likely raises a whole new set of problems.

We learn from the forensic strategy that the test for ‘psychoactivity’ is to submit mystery substances to receptor binding assays – a lab test where the substance is added to cells ‘in a dish’ which have receptors for certain neurotransmitters to see if substances bind to and activate the receptors.

Your brain has many, many different forms of receptors, so the government has defined a list that will supposedly indicate whether a substance is ‘psychoactive’ based on whether a substance binds to and activates one of the following:

  • CB1 (targeted by cannabis and synthetic cannabinoid type drugs)
  • GABAA (targeted by benzodiazepine type drugs)
  • 5HT2A (targeted by hallucinogenic type drugs – these can be from a number of different types of drugs)
  • NMDA (targeted by dissociative/hallucinogenic drugs e.g. ketamine)
  • µ-opioid (targeted by opioid drugs e.g. heroin) and
  • monoamine transporters (targeted by stimulant drugs e.g. MDMA, cocaine).

These are indeed receptors that facilitate some of the major recreational drug groups but this is not an adequate definition of ‘psychoactivity’ not least because there are several psychoactive substances that don’t affect these receptors.

Most notable is long-running ‘legal high’ salvia divinorum which is wildly hallucinogenic but has its effect through the non-listed κ-opioid receptor.

So produce a lab-based tweak on the salvinorin A molecule, the ‘active ingredient’ in Salvia, and you have something that won’t be picked up by government tests.

The main problem though, is likely to be that these tests will be over-inclusive. Lots of substances will activate these receptors without having a psychoactive effect.

For example, epinastine is a drug in eye drops that strongly activates the 5HT2A in the lab but which doesn’t have a psychoactive effect because it doesn’t cross the blood-brain barrier.

Acamprosate is a drug used to treat alcoholism, not typically considered to be psychoactive, and yet activates GABAA receptors.

There are many more examples and they’re not hard to track down – mainly because we now have several open databases of drugs and receptor interactions so you can easily find psychoactive drugs that will screen negative or non psychoactive ones that will be falsely detected as mind-altering.

In practice, what this means is that lots of substances – chemicals from the home, the workshop, the lab, and the pharmacy – may screen for ‘psychoactivity’ but not be psychoactive. False positives, in other words.

But this approach also shows that the Psychoactive Drugs Act fails at solving the problem it is meant to overcome: underground labs producing new substances faster than they can be added to a list of banned drugs.

The Act just complements a fixed list of banned drugs with a fixed list of banned drug effects – making it just another target for grey market labs to innovate around.

What’s also interesting from the list is what drug effects are not proscribed – and we can probably expect underground innovation in pure D2 dopamine agonists that don’t affect monoamine transporters for uppers, and antihistamines as downers, among others. Although to be honest, most will likely just keep on using the same substances.

But considering that the biggest take home from ‘legal highs’ is that they were much worse for your health than ‘illegal highs’ – perhaps the best public health result we can hope for is that the Psychoactive Drugs Act pushes recreational drug users back to using the less harmful classics – speed, MDMA, weed and so on.

And when that’s the best you can hope for, you really know that your drug laws are in a dismal state.

World’s stupidest drugs laws enacted by Britain

Yesterday, the UK Parliament approved the Psychoactive Drugs Bill which will become law in April. New Scientist pulls no punches in an uncharacteristically direct article and tells it like it is:

It’s official – the UK ban on legal highs that will begin in April is going to be one of the stupidest, most dangerous and unscientific pieces of drugs legislation ever conceived.

Watching MPs debate the Psychoactive Substances Bill yesterday, it was clear most of them hadn’t a clue. They misunderstood medical evidence, mispronounced drug names, and generally floundered as they debated the choices and lifestyles of people who are in most cases decades younger than themselves.

It would have been funny except the decisions made will harm people’s lives and liberty.

Parliament has just demonstrated you can invent nonsensical bullshit in place of science and get it passed as law as long as you claim it’s to ‘protect people’ from drugs.

Quite frankly, it’s an embarrassment.
 

Link to New Sci piece on “one of the worst laws ever passed”.

An inner beauty of neurosurgery

The New York Times has an excellent profile of British neurosurgeon Henry Marsh that manages to be an indiscreet but humane look at the medic now famous for his autobiography Do No Harm

It follows Marsh as he operates with colleagues in Albania and recounts both his work and personal style. It is written by the Norwegian novelist Karl Ove Knausgård and reads like downbeat gonzo journalism that hits some perfect notes along the way.

Could Marsh, this brilliant neurosurgeon, be troubled by a constant need to call attention to himself? Weren’t his extraordinary qualities, so obvious to everyone around him, fixed securely in his own image of himself?

I thought of what he said the night before, about keeping the wolf from the door. I had thought he meant something big. But perhaps, to the contrary, it was something very small?

I looked at him, there at the end of the table, seated at the place of honor, his strong fingers distractedly holding the stem of his wineglass as he talked, the round spectacles in his round, lined face, the lively eyes, which, as soon as he stopped talking, turned mournful.

I would also recommend an interview with Marsh in this week’s edition of BBC Hardtalk where he expands beyond his views on brain surgery to discuss healthcare in general. Well worth a listen.

 
Link to NYT article ‘The Terrible Beauty of Brain Surgery’
Link to stream / podcast of BBC interview.

The underground smart drug amendment

CC Licensed Image from Flickr user e-Magine Art. Click for source.Last week, some amendments were quietly slipped into the disastrous Psychoactive Substances Bill that’s currently going through parliament. Surprisingly, a new list of permitted substances has been added. Almost all are poorly evidenced substances used informally as ‘smart drugs’.

The bill is an embarrassingly bad piece of legislation that aims to ban all psychoactive substances by relying on the scientific impossibility of adequately defining ‘psychoactive’. It allows for a ‘whitelist’ of approved drugs which until last week, only included alcohol, nicotine and caffeine.

On December 15th, an amendment was added that greatly increases that list. It now includes:

Racetams
Pramiracetam, Oxiracetam, N-phenylacetyl-L-prolylglycine ethyl ester, Phenylpiracetam, Nefiracetam

Cholinergics
L-Alpha glycerylphosphorylcholine, Citicoline, Meclofenoxate

Miscellaneous
L-Theanine, Oxitriptan, Tongkat Ali, Resveratol, Trans-resveratol, Sulbutiamine

The list is followed by a note which says:

The substances in this amendment are commonly used to improve individuals’ cognitive performance and have been found to have positive effects in a number of academic studies.

The list almost entirely consists of drugs that are widely used by smart drug or nootropics enthusiasts. But to imply that there is good evidence that they have ‘positive effects’ on cognition is entirely misleading.

While some studies have claimed these effects we simply do not have the quality of evidence needed to demonstrate this. Most of the studies that have shown benefits are small and poorly designed.

We know that some of the substances are likely to be low risk in small doses. Oxitriptan, for example, is better known as 5-HTP and is a precursor to the neurotransmitter serotonin and is present in, among other things, bananas. Sulbutiamine is essentially a slightly tweaked version of vitamin B1.

But several of the others are actually quite poorly researched in terms of safety. Typically, few side-effects were reported in the not-very-good-quality studies, but we really know very little about their long-term effects.

What is most striking about this sudden addition to the bill is how odd it is. Suddenly, a list of poorly tested and little understood drugs have been exempted from a ban if the bill becomes law.

The backers of the bill claim that it is needed to protect us from an influx of new poorly tested substances from grey market labs, and then have just exempted a bunch of them based on poorly evidenced claim that they improve cognition.

It’s like someone read the pop-up banner ads for a dodgy internet ‘smart drug’ store and decided to change the proposed law as a result.

The Psychoactive Substances Bill has gone from bizarre to baffling.
 

Link to December 15th bill amendments (via @JonBuchan)

The Peer Reviewers’ Openness Initiative

pro_lockThe Peer Reviewers’ Openness Initiative” is a grassroots attempt to promote open science by organising academics’ work as reviewers. All academics spend countless hours on peer review, a task which is unpaid, often pretty thankless, and yet employs their unique and hard-won skills as scholars. We do this, despite misgivings about the current state of scholarly publishing, because we know that good science depends on review and criticism.

Often this work is hampered because papers don’t disclose the data upon which the conclusions were drawn, or even share the materials used in the experiments. When journal articles only appeared in print and space was limited this was excusable. It no longer is.

The Peer Reviewers’ Openness Initiative is a pledge scholars can take, saying that they will not recommend for publication any article which does not make the data, materials and analysis code publicly available. You can read the exact details of the initiative here and you can sign it here.

The good of society, and for the good of science, everybody should be able to benefit from, and criticise, in all details, scientific work. Good science is open science.

Link: The Peer Reviewers’ Openness Initiative

Drug control through fantasy neuroscience

I’ve got an article in today’s Observer about the disastrous Psychoactive Substances Bill, a proposed law designed to outlaw all psychoactive substances based on a fantasy land version of neuroscience.

“The bottom line is, the only way of knowing whether a mystery substance alters the mind is to take it. You simply can’t tell by chemical tests, because there is no direct mapping between molecular structure and mental experience. If you could solve the problem of working out whether a substance would affect the conscious mind purely from its chemistry, you would have done Nobel prize winning work on the the problem of consciousness. A second-rank approach is just to see whether a new substance is similar to a known family of mind-altering drugs, but even here there are no guarantees. A slight tweak can make a similar drug completely inactive and about as much fun as Theresa May at a techno night.”

Although I talk about the scientific problems of the Psychoactive Substances Bill, the whole process has been a farce.

From the minister in charge clearly not understanding his own legislation to the Government having to reassure churches that incense won’t be banned.

It’s been criticised from everyone from the Royal Society of Chemistry to traditional Tory supporters stalwarts like The Spectator.

The Medical Research Council have expressed concerns that it could “inhibit worthwhile research and/or potential new therapeutics”.

Just as the rest of the world is turning away from the failed ‘war on drugs’ approach to drug legislation, the UK has decided to make up its own scientific impossibilities to support it.

Normally, scientific impossibilities would be the death knell for proposed regulation but for drugs laws I have long since stopped believing that scientific incompetence was any barrier to enacting legislation.
 

Link to article ‘Theresa May’s futile war on psychoactive drugs’