Category: News

Swansea Love Story is a gritty, tragic and surprisingly funny documentary about heroin users in a struggling South Wales town.

It follows a number of addicts as they score, skip meetings with drugs counsellors, philosophise about their predicament and go about their chaotic daily lives.

The piece is, in parts, desolate, particularly as we hear about the lives of those now relying on heroin, but there are also some outrageously funny moments as the protagonists relate their intense experiences with a combination of unintentional irony and casual exaggeration.

The film is produced and directed by Andy Capper and Leo Leigh, the latter apparently being the son of famous British director Mike Leigh and although it has only recently been released, the video is available in full on archive.org.

It makes an interesting comparison to the 1999 documentary Black Tar Heroin, that follows several users in Southern California, although is no less downbeat in its conclusions.

Link to documentary on archive.org (via Addiction Inbox).

France has become the first country in the world to remove gender identity disorder, also known as transexualism, from its list of officially recognised mental illnesses. This is huge news but seems yet to have been picked up by English language news sources.

The news was reported yesterday in the French national daily Le Figaro and by the AFP newswire in French and English, so my details are from the Spanish language report (e.g. this report in Colombian national El Tiempo).

My translation of an excerpt from the Spanish-language AFP newswire report:

The Minister of Health, Roselyne Bachelot, had announced on 16th May 2009, before the International Day Against Homophobia and Transphobia, that transexualism would not be not considered a psychiatric disorder in France.

On that occasion, numerous personalities from the world of politics and science had signed an article that appeared in the press to petition the World Health Organisation to stop “considering transexuals as affected by mental illness”.

“France is the first country in the world that does not consider transexualism as a mental illness” said Jo√´l Bedos, French representative of IDAHO (International Day Against Homophobia and Transphobia), to AFP on Friday. “It’s historic”, added Philippe Caste, spokesperson for the ‘Interasociativa lesbiana, gay, bi y trans’. “It was something very important and was greatly anticipated since the promise was made” added Roselyne Bachelot.

This move will likely be widely supported by the transgender community. However, the prospect of the diagnoses being removed in all countries might be a double-edge sword for some. Although the fact that being diagnosed as mentally ill is a requirement to obtain sex-reassignment in some places has been resented, the removal of the diagnosis could raise fears that the procedure may become less accessible.

Simply being transgendered or having trangender desires itself does not currently qualify for the diagnoses, as it requires significant psychological distress to also be present. However, campaigners argue that this distress is largely caused by discrimination and stigma, to which the diagnosis contributes.

The move by France, however, does not de-list the diagnoses from the World Health Organisation’s ICD-10 classification or the American Psychiatric Association’s DSM and, in fact, the draft DSM-V only slightly modifies the criteria for the diagnoses in children and adults although does rename it ‘gender incongruence’.

Nevertheless, this will put pressure on both the World Health Organisation and the American Psychiatric Association to remove the diagnoses which have a long-standing target of criticism from the LGBT community.

Link to French-language report in Le Figaro.
Link to Spanish-language AFP newswire report.

The draft version of the American Psychiatric Association’s DSM 5, the psychiatric ‘bible’ that defines the revised criteria for diagnosing mental illness, has finally been published.

It’s a masterpiece of compromise – intended to be largely backwardly compatible, so most psychiatrists could just get on diagnosing the few major mental illnesses that all clinicians recognise in the same way they always did, with some extra features if you’re an advanced user.

One of the most striking extra features is the addition of dimensions. These are essentially mini questionnaire-like ratings that allow the extent of a condition to be numerically rated, rather than just relying on a ‘you have it or you do not’ categorical diagnosis.

For example, the proposed dimension of emotional distress in depression is available online as a pdf and you will recognise the format if you’ve ever filled out a mood questionnaire. Take this item for example: “I felt worthless…” Never / Rarely / Sometimes / Often / Always.

One of the most striking changes is to the diagnosis of schizophrenia, which, although the core features remain the same, has changed radically in some ways. This is interesting because many people thought it would be largely untouched with just the addition of dimensions, but actually it’s been fundamentally restructured.

For many years, schizophrenia has been divided into various subtypes: paranoid schizophrenia, disorganised schizophrenia, catatonic schizophrenia, and the like, that reflect different symptom profiles.

The subtypes are currently a mess. It’s possible for two people to be diagnosed with schizophrenia with not a single psychological symptom in common and the groupings were made on a rather ad-hoc basis.

In the draft version the subtypes have been completely eliminated and instead, the replaced by dimensions, reflecting the fact most of the symptoms occur in different patients at different severities and that symptom profiles can change over time.

There is also a long overdue fix. Catatonic schizophrenia is a subtype that describes a pattern where patients have movement problems: catatonia – like being ‘frozen’ in one place or having an unusual symptom called waxy flexibility where no movement is initiated but if a limb is moved, it just stays there – a bit like a bendy doll.

It’s an unusual condition that was first described by the psychiatrist Karl Kahlbaum in 1874, but which isn’t actually specific to schizophrenia. In fact, it is more likely to turn up alongside severe depression and bipolar disorder, or in some types of brain damage, and is treated in a completely different way to schizophrenia, responding best to anti-anxiety drugs and ECT.

For reasons of misguided convenience, and against the best knowledge that was around for a century, it got classified as a subtype of schizophrenia. In a move that will have older psychiatrists rolling their eyes in a ‘I told you so’ sort of way, it is now a specifier that can just be plonked onto pretty much any other diagnosis if it occurs.

One of the changes likely to have the widest and most controversial effects is the creation of the ‘Psychosis Risk Syndrome‘ – a sort of something’s-a-bit-strange-but-you’re-not-completely-mad state, where people might have hallucinations, delusion-like ideas and disorganised thoughts, but not to the extent that they are completely disabled by them.

This is drawn from research on what has been called the ‘prodromal’ or ‘at risk’ mental state with the hope that it could identify and treat patients before they become properly psychotic.

One difficulty is that only about a third of people identified as being ‘at risk’ actually become psychotic at a later date. This wouldn’t be particularly worrying were it not for the fact that people in this ‘at risk’ state (perhaps better called 1-in-3 chance state) are often prescribed antipsychotic drugs.

As the first effective treatment for madness, antipsychotics are some of the most important drugs in medical history, but they are also some of the most toxic with long-lasting effects on the body and brain. The thought of giving them out to large numbers of people who might never become psychotic frightens many.

There is also the issue that this diagnosis might pathologise lots of eccentric but perfectly functional people. Research has shown that about %10 of Joe Public have higher levels of hallucinations and delusion-like ideas than the average psychotic inpatient but are rarely bothered by their experiences.

In other words, lots, and I mean lots, of people have unusual experiences – hearing voices, magical ideas, expansive moments – that never cause them any problems, but these people could now be diagnosed with a form of not-quite-mental-illness.

The other diagnoses that have received a radical rethink are the personality disorders which have been completely reconceptualised. Interestingly, the idea has been brought more in line with psychological definitions of personality and the consequent disorders are described as being disruptions to the self (identity integration, integrity of self-concept, and self-directedness) and interpersonal relations (empathy, intimacy and cooperativeness, and complexity and integration of representations of others).

A new child diagnosis of Temper Dysregulation Disorder with Dysphoria has been added. If this seems unremarkable it’s actually big slap in the face for a small but vocal group of US psychiatrists who have been pushing the idea of ‘child bipolar disorder’ – arguing that sad children who have tantrums are showing a juvenile form of ‘manic depression’.

This has become popular, almost entirely in the US, and has led to the alarming rise in children taking antipsychotics. The LA Times reports that this new diagnosis has been created in large part to stop kids being diagnosed with child bipolar. That’s the slap.

Many of the other changes are largely bug fixes. The much discussed change where Asperger’s syndrome and autism have been combined into autism spectrum disorder fixes the anomaly that the only difference between Asperger’s and high functioning autism was a technical point about what age the child started talking.

Post-traumatic stress disorder has been tightened up so it doesn’t rely solely on someone’s self-definition of trauma, preventing PTSD being diagnosed after seeing disasters on TV or after being troubled by upsetting but everyday events, such as insults at work.

The sexual disorders see quite a few additions including hypersexual disorder, that attempts to define being too interested in sex as a mental illness, and paraphilic coercive disorder, that is likely to cause legal controversy as it defines being turned on by forcing people into sex as a psychiatric problem, rather than a moral failing.

Binge-eating disorder has been added, addiction diagnoses for specific drugs have been created (included cannabis withdrawal), gambling addiction has been added, and the manual mentions ‘internet addiction’ in the non-committal, we need more information category.

Another interesting change is to conversion disorder, traditionally known as ‘hysteria’, where medical symptoms appear – such as paralysis – without the usual tissue or nerve damage. The Freudian theory is that the mind is ‘converting’ trauma into physical symptoms to protect consciousness from the mental pain, but the last remnants of Freud have been removed.

Previously, the clinician had to attribute motivations, unconscious or otherwise to the symptoms, but now they just have to appear without being explained by “a general medical condition, the direct effects of a substance, or a culturally sanctioned behavior or experience”.

The related cluster of dissociative and somatoform disorder have also been subtly de-Freuded, as American psychiatry presumably wishes to finally put the old Viennese ghost to rest.

As for the scientific basis of the disorders as distinct separate entities rather than somewhat cobbled together pragmatic descriptions, a quote in The New York Times article hits the nail on the head:

The good news, said Edward Shorter, a historian of psychiatry who has been critical of the manual, is that most patients will be spared the confusion of a changed diagnosis. But “the bad news,” he added, “is that the scientific status of the main diseases in previous editions of the D.S.M. — the keystones of the vault of psychiatry — is fragile.”

Link to draft version of the DSM-V.
Link to Washington Post coverage.
Link to New York Times coverage.
Link to LA Times coverage.
Link to Wall Street Journal blog coverage.
Link to NPR coverage via Integral Options Cafe.

On Thursday, I shall be taking part in a live debate hosted by The Times Online entitled ‘Is screen culture damaging our children’s brains?’ where I will be debating psychologist Tracey Alloway who recently made headlines by suggesting Facebook ‘enhances intelligence’ but Twitter ‘diminishes it’.

It one of those online chat things but you are welcome to sign up and take part. It happens at 1pm UK time which turns out to be far-too-early-o’clock Colombian time so I may be in my dressing gown. Don’t let that put you off.

An article on the same topic will also be coming out on Thursday which should help set the scene and which I’ll link to when it appears.

Link to ‘Is screen culture damaging our children’s brains?’ debate.

This chapter was due for inclusion in The Rough Guide Book of Brain Training, but was cut – probably because the advice it gives is so unsexy!

The idea of cognitive enhancers is an appealing one, and its attraction is obvious. Who wouldn’t want to take a pill to make them smarter? It’s the sort of vision of the future we were promised on kids TV, alongside jetpacks and talking computers.

Sadly, this glorious future isn’t here yet. The original and best cognitive enhancer is caffeine (“creative lighter fluid” as one author called it), and experts agree that there isn’t anything else available to beat it. Lately, sleep researchers have been staying up and getting exciting about a stimulant called modafinil, which seems to temporarily eliminate the need for sleep without the jitters or comedown of caffeine. Modafinil isn’t a cognitive enhancer so much as something that might help with jetlag, or let you stay awake when you really should be getting some kip.

Creative types have had a long romance with alcohol and other more illicit narcotics. The big problem with this sort of drug (aside from the oft-documented propensity for turning people into terrible bores), is that your brain adapts to, and tries to counteract, the effects of foreign substances that affect its function. This produces the tolerance that is a feature of most prolonged drug use – whereby the user needs more and more to get the same effect – and also the withdrawal that characterises drug addiction. You might think this is a problem only for junkies but, if you are a coffee or tea drinker just pause for moment and reflect on any morning when you’ve felt stupid and unable to function until your morning cuppa. It might be for this reason that the pharmaceutical industry is not currently focusing on developing drugs for creativity. Plans for future cognitive enhancers focus on more mundane, workplace-useful skills such as memory and concentration. Memory-boosters would likely be most useful to older adults, especially those with worries about failing memories, rather than younger adults.

Although there is no reason in principle why cognitive enhancers couldn’t be found which fine-tune our concentration or hone our memories, the likelihood is that, as with recreational drugs, tolerance and addiction would develop. These enhancing drugs would need to be taken in moderate doses and have mild effects – just as many people successfully use caffeine and nicotine for their cognitive effects on concentration today. Even if this allowed us to manage the consequences of the brain trying to achieve its natural level, there’s still the very real possibility that use of the enhancing drugs would need to be fairly continuous – just as it is with smokers and drinkers of tea and coffee. And even then our brains would learn to associate the drug with the purpose for which they are taken, which means it would get harder and harder to perform that purpose without the drugs, as with the coffee drinker who can’t start work until he’s had his coffee. Furthermore, some reports suggest that those with high IQ who take cognitive enhancers are mostly likely to mistake the pleasurable effect of the substance in question for a performance benefit, while actually getting worse at the thing they’re taking the drug for.

The best cognitive enhancer may well be simply making best use of the brain’s natural ability to adapt. Over time we improve anything we practice, and we can practice almost anything. There’s a hundred better ways to think and learn – some of them are in this book. By practicing different mental activities we can enhance our cognitive skills without drugs. The effects can be long lasting, the side effects are positive, and we won’t have to put money in the pockets of a pharmaceutical company.

Link to more about The Rough Guide book of Brain Training
Three excellent magazine articles on cognitive enhancers, from: The New Yorker, Wired and Discover

Cognitive Daily, one of the most established and respected psychology blogs on the internet, has just announced it has come to an end on the five year anniversary of its first post.

We’ve been fans of CD since, well, since they started as they kicked off only a few months after we did.

However, all is not lost, as both Dave and Greta will continue with their many online projects and there is a mysterious ‘new project’ soon to be announced (greatest hits? musical? concept album?)

What will we do with all that time we’ve freed up? Greta plans to continue her work as Professor of Psychology at Davidson College, teaching and mentoring students, conducting research, and sharing her love of music, literature, and art. Dave will continue as editor of ResearchBlogging.org and weekly columnist for SEEDMAGAZINE.COM, and he’ll maintain his personal blog, Word Munger and his obsessively-updated Twitter account. In addition, Dave’s planning a new project, to be unveiled within the next few weeks. Look for more information about it on Twitter and Word Munger.

Many thanks to you both for five years of fantastic psychology coverage on Cognitive Daily and we wish you all the best for future projects.

Link to Cognitive Daily announcement.

Wired has an excellent report on abuses in China’s ‘internet addiction’ boot camps in the wake of the death of a young man from a beating only hours after he was admitted to one of the facilities.

As we reported last August, after years of promoting the ‘psychiatric dangers’ of the internet, the Chinese government has started to rein in its own clinics after criticisms of its treatments (that included electroshock) and has begun to crack down on the numerous private clinics after reports of widespread abuses.

The Wired piece follows the story of Deng Senshan, the young man who was beaten to death in one of the camps, and explores how the rise of the treatment clinics have followed the increase in anxiety about young people using the internet.

The article also pulls out some of the cultural factors that drive the concept of internet addiction in China, which are quite different from those that are common in the United States.

In fact, this was discussed in a study by anthropologists Alex Golub and Kate Lingley, who noted that in America, parents typically take their children to internet addiction clinics because they don’t spend any time outside or don’t socialise, whereas in China, people take their children to Internet addiction clinics because their children are playing basketball, dating, and playing video games instead of studying.

Link to Wired article ‘Obsessed With the Internet: A Tale From China’.
Link to our previous report on China’s ‘net addiction’ clinics.
Link to study on cultural factors behind Chinese ‘net addiction’.

The Rough Guide to Brain Training is a puzzle book which incluces essays and vignettes by myself. The book has 100 days of puzzles which will challenge your mental imagery, verbal fluency, numeracy, working memory and reasoning skills. There are puzzles that will look familiar like suduko, and some new ones I’ve never seen before. Fortunately the answers are included at the back. Gareth made these puzzles. I find them really hard.

I have 10 short essays in the book, covering topics such as evidence-based brain training, how music affects the developing brain, optimal brain nutrition and what the brains of the future will look like. As well as the essays, I wrote numerous short vignettes, helpful hints and suprising facts from the world of psychology and neuroscience (did you know that squids have dounut shaped brains? That you share 50% of your genes with a banana? That signals travel between brain cells at up to 200mph, which is fast compared to a cycle courier, but slow compared to a fibre optic cable). Throughout the book I try to tell it straight about what is, isn’t and might be true about brain training. I read the latest research and I hope I tell a sober, but optimistic, message about the potential for us to change how we think over our lifetimes (and the potential to protect our minds against cognitive decline in older age). I also used my research to provide a sprinkling of evidence-based advice for those who are trying to improve a skill, study for an exam or simply remember things better.

Writing the book was a great opportunity for me to dig into the research on brain training. It is a topic I’d always meant to investigate properly, but hadn’t gotten around to. The claims of those pushing commercial brain training products always seemed suspicious, but the general idea – that our brains change based on practice and experience – seemed plausible. In fact, this idea has been one of the major trends of the last fifty years of neuroscience research. It has been a big surprise to neuroscientists as experiment after experiment has shown exactly how malleable (aka ‘plastic’) the structure and function of the brain is. The resolution of this paradox of the general plausibility of brain training with my suspicion of specific products is in the vital issue of control groups. Although experience changes our brains, and although it is now beyond doubt that a physically and mentally active life can prevent cognitive decline across the lifespan, it isn’t at all clear what kinds of activities are necessary or essential for general mental sharpness. Sure, after practicing something you’ll get better at it. And doing something is better than doing nothing, but the crucial question is doing something you pay for better than doing something else that is free? The holy grail of brain training would be a simple task which you could practice (and copyright! and sell!!) and which would have benefits for all mental skills. Nobody has shown that such a task or set of tasks exists, so while you could buy a puzzle book, you could also go for a jog or go to the theatre with friends. Science wouldn’t be able to say for certain which activity would have the most benefits for your mental sharpness as an individual – although the smart money is probably on going jogging. It is to the credit of the editors at the Rough Guides that they let me say this in the introduction to the Rough Guide to Brain Training!

There wasn’t room in the book for all the references I used while writing it. This was a great sadness to me, since I believe that unless you include the references for a claim, you’re just spouting off, relying on a dubious authority, rather than really talking about science. So, to make up for this, and by way of an apology, I’ve put the references here. It will be harder to track specific claims from this general list that it would be with in-text citations, so if you do have a query, please get in touch and I promise will point you to the evidence for any claims I make in the book.

Additionally, I’ll be posting here a few things from the cutting room floor – text that I wrote for the book which didn’t make it into the final draft. Watch out, and if you do get your hands on a copy of this Rough Guide to Brain Training, get in touch and let me know what you think.

Amazon link (only £5.24!)

Scientific references and links used in researching the book

Award winning journalist Anas Aremeyaw Anas went undercover in Ghana’s Accra Psychiatric Hospital and has published a hard hitting report on the appalling conditions in one of the country’s main institutions for treating mental illness.

In a spectacular piece of investigative reporting Anas posed as a patient, a trader, a baker and a taxi driver and has reported on institution-wide problems that include drug dealing, abuse, maltreatment, thieving, and medical negligence leading to the deaths of patients.

One of the most striking parts of the report is where he notes a few of the staff members who carry out their roles with due diligence and genuine compassion for the patients in the midst of the systemic failure of the institution.

The neglect, abuse and maltreatment of patients by nurses in the hospital remain one of the most disturbing aspects of life within the hospital. On many occasions, this reporter filmed instances where patients suffering severe fits were left to lie at the mercy of the weather, with nurses totally apathetic. Some nurses were captured beating patients who lay on the ground helpless and writhing in pain. On one occasion, a male patient is seen helping a female patient suffering from epilepsy to get on her feet. After many futile attempts to help the ailing girl, the male patient leaves her on the ground close to a nurse’s office and moves on. Minutes later, a nurse passes by without offering any assistance to the patient. Not far from the patient, three nurses could be seen chatting idly as the epileptic patient lies in pain. When help finally arrives, the patient is beaten mercilessly by the nurses amidst shouts of “get up”, “foolish girl”, “if we beat her she would get up”.

The attitude of nurses is generally so outrageous that the hard work and conscientious disposition of Ken Wholley Brantuo, Alex Baah and a few others shone forth like torch in pitch- darkness.

Francisca Ntow, a young nurse at the hospital epitomised the spirit of care and love that accompanies nursing. With beaming smiles each day, she tries her best to give attention to patients and to find out their state of being. Her shining example gives hope to the future of psychiatric nursing in the country.

If you check out nothing else I recommend listening to a gripping interview with Anas where he discusses his undercover investigation on Ghana’s Super Morning Show

His follow-up piece on abuse of people with mental illness by traditional healers and prayer camps is also a powerful piece of reporting.

Probably one of the most remarkable pieces of mental health reporting you are likely to encounter for a very long time. Truly excellent work.

Link to Exposed: Inside Ghana’s “Mad House” (via TWS).
Link to interview with Anas Aremeyaw Anas on his investigation.
Link to ‘Investigative report: Lies of prayer camps and traditional healers’.

Dr Petra has two great posts, one looking at the best and worst of sex and science stories from 2009, and another revisiting her annual predictions for the year in sexuality and sexual health.

The best and worst include everything from clitorocentric conspiracies, informed sex education, the Ugandan government, female sex drugs and Shakira (who is clearly still too shy to call).

Additionally, Petra will shortly post her predictions for the coming year online, so you can see how 2010 might shape up.

Link to ‘The best and worst sex (and science) stories of 2009’.
Link to ‘Revisiting my sex predictions for 2009’.

The Brainspin blog has a list of ‘Ten Psychology Studies from 2009 Worth Knowing About’ that covers a mix of well-known studies and hidden gems from the last year.

The descriptions, as you might expect, are a little brief and give just the punchline without some of the possible drawbacks but all are linked to the original study so you can them in full (well, at least as far as your access allows).

One of my favourites was number 7, which provides evidence against the common idea that people who connect better with others might be better at detecting lies:

A study in the journal Psychological Science tested the hypothesis that emotional mimicry—the tendency to mirror the emotions of someone we’re interacting with—makes it difficult to identify liars. Nonmimickers were significantly better at identifying liars than mimickers, and thus were harder to fool with the old flim flam sales routine. The reason is that mimicry reduces psychological distance and lowers defenses. Even if someone probably isn’t lying to you, it’s best to keep the cushion in place just in case.

Link to ‘Ten Psychology Studies from 2009 Worth Knowing About’.

A new issue of the sleek internet magazine Contemporary Psychotherapy has just appeared online and is well worth checking out if you’re interested in the art of psychological treatment.

The magazine is aimed at psychotherapists and deals with everything from the bricks-and-mortar issues of running a practice to relationship dynamics in couples and families.

However, it doesn’t wander off into the thickets of theoretical jargon and makes a good read if you’re just interested in the world of therapy.

Link to Contemporary Psychotherapy.

New Scientist has a good piece which outlines the current state of play in the contentious and recently delayed revision of the forthcoming psychiatric diagnostic manual, the DSM 5.

If you’ve been following the bad-tempered tussling among the psychiatric community over the re-writing of the manual, you probably won’t find much new in the main piece but it is a great summary and is accompanied by some examples of contentious disorders that are being considered for the new version.

These include complicated grief, a form of extended and unresolved grieving; changes to ‘gender identity disorder’, which currently describes the state of feeling like you’re a different gender; and hebephilia, a sexual interest in pubescent children.

The NewSci article is also accompanied by an interesting editorial that argues that the American Psychiatric Association should ditch the book and move to a database format where individual diagnoses could be updated when necessary as new evidence requires.

Link to NewSci article ‘Psychiatry’s civil war’.
Link to editorial ‘Psychiatry’s bible: Its time has passed’.

I really recommend the 2009 Year in Ideas review from The New York Times as it is packed full of developments in the world of psychology and social science.

If you’re a regular Mind Hacks reader you’ll recognise some of the ideas from experiments and studies we’ve covered during 2009, but there are many more curiosities that make for compulsive reading.

Probably the majority of the articles will be of interest to mind and brain enthusiasts but I particularly enjoyed Literary Alzheimer’s, Lithium in the Water Supply, Treating P.T.S.D. With Tetris, Cognitive Illiberalism, The Counterfeit Self, Drunken Ultimatums and to be fair, pretty much all the others too.

My only complaint is the short pieces don’t link to the original sources (suggestion for Year in Ideas 2010: inline links!) but otherwise if you like the sort of stuff we post on Mind Hacks there’s plenty to keep you occupied here as well.

Link to NYT Year In Ideas 2009.

The American Psychiatric Association has announced that it has put back the publication of the forthcoming ‘DSM 5’ revision of the influential diagnostic manual of mental disorders back one year to May 2013.

The press release, available online as a pdf, notes:

“Extending the timeline will allow more time for public review, field trials and revisions,” said APA President Alan Schatzberg, M.D. “The APA is committed to developing a manual that is based on the best science available and useful to clinicians and researchers.”

Which could equally well be code for ‘owing to the recent shitstorm over our behind-closed-doors policy and strident criticism from past committee members about the scientific quality of our review process, we’ve decided we need a bit of breathing space’.

As long as the time is genuinely used to get a better scientific footing for the project it could be genuinely beneficial, although to be fair, it’s hardly likely that any new revision of the controversial manual will be greeted with universal approval.

pdf of APA press release on DSM 5 delay (via @DrDavidBallard).

Forensic Science International recently published an eye-opening study on a new generation of synthetic cannabinoids that have become popular as ‘legal highs’, provided by a highly organised neuroscience-savvy industry that is ready and waiting with new compounds before the law changes.

The study concerns several legal smoking mixtures, ‘Spice‘ being the most well-known (pictured), which were recently found to contain synthetic cannabinoids.

Cannabinoids are named for their abundance in the cannabis plant, but this class of substance also naturally occurs in the nervous system as part of the normal biological signalling system. In fact, the street drug cannabis has its effect because its various cannabinoids, the most famous being THC, target one or more of the brain’s cannabinoid receptors.

Marijuana and its derivatives are illegal in most countries but the brain’s cannabinoid system is complex and so it is possible to synthesise other types of drugs in the same class as the plant’s active ingredients, which target the same receptor sites, that have similar effects, but which are completely legal.

Although officially labelled as incense and not for human consumption, Spice was typically marketed as one of the many ‘herbal smoking mixtures’ which traditionally have been sold in head shops on the basis of their druggy associations despite having no psychoactive effects to speak of.

However, this brand became wildly popular and in 2008 scientific analysis found that it also contained the synthetic cannabinoids CP 47,497-C8 and JWH-018 which are structurally similar to THC.

I can’t imagine what it was like when this was first discovered. It reminds me of the hair bristling moment in movies when the scientists discover that some form of ultra-advanced technology is behind a spate of odd occurrences.

You see, drugs like speed, heroine, cocaine and ecstasy require legally controlled raw materials but the processing stage is low-tech. That’s why some types of speed are called ‘bathtub crank’, because some of it is literally synthesised in a bathtub, as images of meth lab busts illustrate.

But this is not the case with cannabinoids which require a complex and careful lab process with many stages and sometimes the separation of mirror image molecules (enantiomers) from each other as only one of the ‘reflections’ is desirable.

These are not trivial process. They can’t be done in back rooms and they can’t be done by amateurs.

What’s more, these aren’t just copy-cat syntheses done by your average underground lab who know the illicit process and just want to recreate it. These are new compounds, perhaps reported only a handful of times in the scientific literature and selected for their specific effect on the brain.

The authors of the Forensic Science International paper note “It is evident that the producers of these products have gone about in a very methodical manner to mine the scientific literature for promising psychoactive compounds. Most likely the published CB1 binding affinities were exploited as primary criterion.”

CB1 is a specific type of cannabinoid receptor and is the one most activated by THC, the principal active ingredient in marijuana, and it seems the producers were making their selections based on their knowledge of neuroscience and psychopharmacology.

Several countries have now banned, or are in the process of banning, the synthetic cannabinoids found in Spice and related products. In fact, Germany was particularly quick off the mark and outlawed the products in January 2009.

Now this is where it gets interesting because the researchers note that a new product appeared on the market, containing JWH-073 – another synthetic cannabinoid, within four weeks of the ban. JWH-073 has similar similar effects, but isn’t covered by the law and so remains legal.

The speed at which it appeared suggests that it had been selected and synthesised in advance, in anticipation of the ban:

Our analysis demonstrated that just 4 weeks after the prohibition took effect a multitude of second generation products were flooding the market. The speed of introduction of new products and the use of JWH-073 as a substitute for JWH-018 not only showed that the producers are well aware of the legal frameworks, but that they likely anticipated the prohibition and already had an array of replacement products on hand (JWH-073-positive products are still available on the German market; last checked: June 5th, 2009).

In other words, the legal high industry is packing neuroscientists and heavyweight lab pharmacologists. It is no longer just head-shop hippies repackaging obscure psychoactive and barely recreational plants as a poor substitute for street drugs. The legal high industry has become professionalised.

Seemingly based on the model of the pharmaceutical industry, it is becoming science-led, regulation savvy and is out-manoeuvring the authorities well before they catch up.

To use drug war terminology, it’s an interesting new front because the producers are not trying to evade capture, they’re using the agility of science of evade regulation.

Link to PubMed entry for Forensic Science International paper.
Link to .rar archive with pdf of full text inside (weird huh? via Google)
Link to good EMCDDA page on synthetic cannabinoids.