Not to blow up my own spot but the bit about GHB being a powerful CNS depressant is just as true about alcohol and it strikes me as a bit dramatic.
There are reasons why researchers are interested in pursuing it as a potentially helpful tool for opium addicts, and focusing on the prurient aspects of a substance is exactly what makes research into _controlled_ therapeutic use of GHB or Cannabis or psilocybin so hard to do in this country.
I also found that part very dramatic as someone who has a GHB prescription for cataplexy. Does the drug have a checkered past? Yes, but a lot of the public sentiment towards it is the result of journalistic histrionics.
For years it was sold over the counter at GNC to body builders because of its impact on prolactin levels in the body, and AFAIK it is the only known substance that mimics natural sleep. It improves REM sleep and stages 3 & 4 of slow-wave sleep.
I myself have one of the few known cases of very very mild cataplexy, so I don't absolutely have to have GHB to function, but for most people who also test positive for the HLA marker DQB1*0602 and have severe cataplexy, GHB is an absolute life saver. These people don't really experience and long term psychological effects as would be implied by the scare words used in the paragraph describing GHB. Yes, it has powerful CNS depressive effects and can be lethal in high doses, but those effects are pretty much only applicable while under the influence of the drug and not after your body has metabolized it and flushed it from the body.
Reading the backs and forths of various drugs and medical treatments over the years has left me with two overall lessons:
* A drug with horrific potential side effects can be worth it, if the condition it is treating is worse. For instance, a drug which can cause strokes might be worth it to prevent horrible seizures, but not to prevent mild hay fever.
* Even if a drug can be abused, it doesn't change the fact that some people legitimately need it. You see this most in pain management, where people who need powerful pain killers just to function face criminal charges and roadblocks to getting the medicine they need.
> the bit about GHB being a powerful CNS depressant is just as true about alcohol
In the US, a "standard drink" is 14 grams of pure alcohol. It's the equivalent of a typical can of beer.
3.5 grams of GHB can trigger unconsciousness, and 7 grams is potentially lethal.
If this is "just as true", I think our definitions of truth are wildly different.
EDIT: If you feel the need to reply to this comment, please read the entire thread first and realize there's nothing "between the lines" of the comment. I have no agenda here. I'm not making a policy argument. I'm not advocating for or against GHB or any other substance. You don't need to tell me what the LD50 is for any particular substance (chances are I already know).
Potency is a pretty misleading comparison. There are drugs that are prescribed in μg (mcg) doses, and drugs that are prescribed in mg - mistaking μg for mg has caused deaths.
The LD50 of caffeine for an average male is about 14 g. That's the same (in terms of mass) as the alcohol in a beer. Does that make caffeine more or less "powerful"? It takes something like a hundred cups of coffee to reach caffeine's LD50; for alcohol, it's slightly over one bottle of strong spirits. Despite caffeine's higher potency, it's a lot easier to kill yourself by drinking too much whisky than too much coffee.
I cannot begin to understand what point you're trying to make. The person I was replying to was explicitly comparing the potency of GHB to alcohol, both depressants commonly encountered in a highly concentrated form.
Making this about caffeine or any other substance that can be lethal in small amounts seems a non-sequitur.
There seem to be 2 confused issues in this (sub)thread.
Firstly, the Therapeutic Index argument (ratio of effective dose to dangerous/fatal dose), for which the 2 drugs are (very) roughly equivalent, based on some back-of-envelope estimates (~10:1 for EtOH, 14:1 - 3:1 for GHB).
The second is the 'commonly encountered form' argument, which I think was your main point, and appears to be misunderstood. Alcohol, with the benefits of being legal and easily available, is available in known purity solutions anywhere from 1~90%.
The biggest problem (AFAIK) with things like GHB in a bar/club environment is the fact it must be concentrated enough to be small enough to easily smuggle in/out. It has specific other unfortunate properties as well, like being very destructive to many types of plastic. Dosing with an eye-dropper into an existing drink is apparently quite common, and I can easily imagine this leading to accidental overdosing in a crowded/loud/intoxicated environment. You must also account for the fact that there's not nearly the same quality control in terms of purity from batch to batch, which combines badly with the low Therapeutic/Effective Index.
The other difference is, even if your bartender is serving you 180 proof rum, he's probably not going to let you chug the whole bottle of it, regardless of demand.
The point is that what we generally consider as "power" or "potency" is more than just effect per unit mass. We don't generally consider capsaicin to be more powerful than alcohol even though, purely on the basis of how much you have to ingest, it's far easier to kill yourself with it.
To be slightly pedantic, I used the term "potency" specifically because that does have a pharmacological meaning: it's a measure of drug activity in terms of concentration. "Power", on the other hand, is a rather ill-defined concept.
> what we generally consider as "power" or "potency" is more than just effect per unit mass
Um, OK, that may be true for you, and maybe even for society at large, but I've personally never heard such a thing before right now. It's certainly not how I would define the words.
To address the point I think you're trying to make (which still doesn't make much sense to me), in the forms they are commonly encountered in, GHB is unquestionably much more dangerous/"powerful" than alcohol. So I still don't see why my comment attracted this sort of argument.
Your head is liable to E-X-P-L-O-D-E when you hear that there's a drug for sale - nationwide - that's a CNS depressant, where 1 gram of is FATAL. Can you believe that? And yet they sell this thing called "nicotine" to people as young as 16!
Ugh. I was going to just step out, but I can't let this pass, because it's incredibly insulting.
I'm not arguing for the banning of a substance. I'm not arguing one substance is subjectively better than another. I don't care that GHB or any other drug is being used in studies.
You're reading something into my comments that simply is not there. Please stop it.
My comment was about what was, in my view, an objectively inaccurate characterization of alcohol being "just as powerful" a CNS depressant as GHB. That is all it was. If you want to argue about something else, I'm not the opponent you're looking for.
Just comparing quantities isn't all that useful. Availability needs to be compared, and how much one would "usually" take.
With 7 grams being potentially lethal, it's roughly similar to Tylenol (not recommended to exceed 4 grams), caffeine (foolishly extrapolating the LD50 in rats to a human puts the lethal dose at around 10 grams), aspirin (similar to caffeine), and a lot better than capsaicin (foolishly extrapolated lethal dose around 2 grams).
Since you and threedaymonk both seem to be making a similar argument that makes absolutely no sense to me in context, I'll just point you at my reply to him.
Some background, which may have even appeared on HN before. Markington, the suicide victim, was coerced to join the study through a dubious sounding scheme.
"Dan was acutely psychotic, plagued by delusions about demons, and he had repeatedly been judged incapable of making his own medical decisions. Even worse, he had been placed under an involuntary commitment order that legally compelled him to obey the recommendations of the psychiatrist who recruited him into the study."
I can't claim to be well-versed on this story, but I would like to point out that a couple weeks ago the author of this piece was accused of misrepresenting the issue in the local paper, The Star Tribune. In particular he was called out for glossing over the fact that there have already been several investigations of the matter, which I see he has again failed to mention in the piece linked here.
>>University officials have repeatedly claimed to have been investigated and exonerated by various legal and regulatory bodies, but those claims have fallen apart.
When institutions behave like this they're not just tarnishing their own image. They're destroying civilization.
Got into a debate around here a while back trying to explain why otherwise-rational people are afraid of GMO foods. This is an example of my point. Things like this erode trust not just in the particular institution in question but of all institutions in our society. At some point many people actually start to assume the worst and flip over into seeing official pronouncements as contrarian indicators: "oh, the paid shills say it's safe and it's produced by a big agribusiness corporation so it must be bad for you..."
I've seen a rash of these articles lately, deconstructing in elaborate detail why people distrust science and officialdom and believe in increasingly outlandish "conspiracy theories." They're all elaborate dances to avoid the obvious issue: trust.
It's almost a kind of blame-the-victim mentality: yes you have been lied to, but you should ignore that. If the fact that you've been treated contemptuously causes you to begin harboring suspicions, it's because you are irrational and stupid. Now shut up and believe what you're told.
No, it's not the victim's fault. It is the authorities' fault. Trust is earned through consistent transparency and honorable behavior. When the institutions of society behave dishonorably and unethically, trust is systematically weakened across the entire society.
Once a person learns that their authorities may well be shills, liars, quacks, fools, or worse, then it becomes increasingly easy to harbor increasingly-damning suspicions about what else "they" might be lying about. Hence 9/11 was an inside job, moon hoax, and other conspiracy theories.
Keep in mind that sometimes such suspicions are correct. The executive branch lied the US into war in Iraq, to give one example. With examples of that magnitude, I personally question whether belief in outlandish conspiracy theories is even particularly irrational.
And it's very, very dangerous. Trust is one of the key differences between the first world and the third world. Part of why places like sub-Saharan Africa can never develop is that nobody trusts anyone and nobody dares do anything. They "know" (and sometimes with good reason) that anything they do will simply be stolen by their kleptocracies, and that anything their authorities say is probably a lie. (Hence the prevalence of things like HIV/AIDS denialism in those cultures... another symptom of decayed trust.)
If our leaders, authorities, and institutions continue to treat the public with dismissive contempt, the third world is where we are headed. The prevalence of conspiracy theories and alt-health fearmongering is a leading indicator of an overall breakdown in the implicit trust relationships and social contract that underlies advanced Western societies.
Looking over things like MKULTRA and the list of problematic experiments that have been committed in the name of science, it is easy to grasp why conspiracy theories form.
Yeah, at least we have IRBs today. The mid-20th century was an ugly time for that kind of thing: MKUltra, syphillis experiments, "here guys, look at the atomic blast, it's pretty!", and so on...
I don't care how little trust you have, it's stubborn and wrongheaded to believe in hideously impractical conspiracies. Just because 'they' don't tell you the truth doesn't give them magical powers.
The reason I don't think 9/11 was an inside job isn't that I don't think there are people in Washington or in -- say -- the defense industry who would do such a thing. There surely are. I don't think it was an inside job because I doubt there are enough of such people or that they are cooperative or competent enough to pull of something of that magnitude and audacity.
But yeah, I think there are people who'd do it. Consider how ugly a statement that is about our leaders.
There obviously were enough people who could pull off such an atrocity. (Unless you think it was all done with mirrors and holograms).
And, looking at other attacks which have come out as state sponsored (Glenanne gang), or other conspiracies (Iran–Contra) - there are obviously enough people within "the system" who demonstrably have pulled off such plots.
The only questions left are...
Was X an "inside job"?
If so, how high up did it go?
(For the record, I don't have an opinion on 9/11 or any other attacks).
It's not the number of people needed to fly a plane; that's a couple people per plane. It's the enormous number of people that would have to be involved in the conspiracy timeline all maintaining perfect secrecy.
If you're interested, Machiavelli's "Discourses on Livy" is a good place to start.
He explores the institutions within different societies that allowed them to grow and develop trust. It's one the first book in history that I'm aware of that explored the idea of societal checks and balances, and how the non-enlightened self interest of a group of people can be healthy when its functions are tempered by the self interest of different groups with different agendas.
I think that idea is still fresh, and people don't play around with it enough.
Nobody is saying this. What they're saying is "apply the same level of skepticism to your pet theories as you do to consensus reality", which is something conspiracy theorists seem incapable of doing.
Which often gets translated as "now shut up and believe what you're told" as soon as it gets past your target's ears.
Also, conspiracy theories do not just get counter points. They face sneers and coarse laugh, which are very effective at quickly convincing people who haven't make up their minds yet, though it does alienate conspiracy theorists themselves.
I recall having receiving coarse laughs when talking about cryonics. Many people first believe it's an obvious con job. Which is a rational reaction, by the way (it's expensive, unproven, and appeals to our not wanting to die). I just happen to know a bit more than they do (the nature of identity, the possible progress of science, the possibility for intelligence explosion, and possibly a few more wacky sounding beliefs).
Oh, but that's exactly what your regular "truther" thinks: you don't believe him because you lack the background, you poor ignorant fool! But then, how can we make the difference between the conspiracy theorist and the cryonics advocate?
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By the way, I do think a relatively limited number of powerful people do influence the world in a way that is significant, against the will of most people, and not widely known. Take the monetary system for instance. Put it bluntly, private banks effectively print more money than the public states through tricks that allow them to lend more money than they have (at an interest, of course). Not exactly a conspiracy theory (it's hiding in plain sight, just look up Fractional Reserve Banking), but very close in my opinion.
What really gets me about this, beyond the tragedy itself, is the amount of bullshit I have had to go through to get IRB approval for completely insignificant projects (monitoring decibel levels in public spaces, for example, which is NOT even subject to IRB exemption but I still was forced by the funding source to pursue). Ugh.
Recently one of the pediatric residents at my hospital was found watching child pornography in the call room. After being reported, the institution did nothing about it, and tried to sweep it under the rug. It bothers me that a prestigious academic institution would rather save face than to deal with a serious issue at hand.
Depending on the country many of the workers there will have a legal duty to report that incident. They'll also have requirements from their professional registrations.
Assuming we're talking about the "other" UofM, I would hardly call what happened "doing nothing about it." It was almost certainly an egregious failure on the part of a couple individuals, but it was more about a lapse in protocol then a university cover up. Not to mention that UofM has completed two separate independent reviews of what happened and made a pretty big (and public) effort to fix it.
Jurisdiction is funny on universities. UCSB (one I have personal experience with) has a special campus police branch that overlaps somewhat with the Isla Vista branch but are nominally distinct; I don't think the county's sheriff's department has any jurisdiction there.
The University of Minnesota, if it's like the other "public" universities in the U.S. that I'm familiar with, is officially, more-or-less, when-it-wants-to-be-ish, a branch of the government of the state of Minnesota. "Sovereign immunity" extends to the university.
This ethical question is particularly interesting. Just to play Devil's Advocate, let's assume that Big Pharma is not involved. Rather, the people who are doing the research are honest researchers who gain utility through the act of research and finding breakthroughs.
If phrased this way, the incidents may suddenly now be sympathized as being yet another statistic - after all, sacrifices must be made in the name of scientific progress. The matter of coercion becomes trivial in the sense of The Greater Good (of course, not all research will yield positive results, and that's the whole point of research).
Now, if one were to have this sort of view going into doing medical trials, who's to say that one's wrong? Why is it still evil, if the net result are better drugs to control one's moods?
I think the article called to mind some other issues that were more important than the debate about how ethical studies like this are or are not.
This guy's mother was giving the researchers feedback that the participant could not. Namely, that he was getting WORSE. She tried to have him removed from the program, and apparently couldn't. That goes well beyond "yet another statistic", especially as he was deemed incapable of making his own medical decisions.
Having only read the linked article, I have no opinion on how valid the research was. The primary concern is that people have died in a way that points to the research program in question having been a contributing factor, and the fact that there wasn't even a cursory investigation to make sure things are on the up and up.
"The matter of coercion becomes trivial in the sense of The Greater Good (of course, not all research will yield positive results, and that's the whole point of research)."
Not really. There are historical reasons why informed consent is a requirement.
Put another way, would you feel the same if you were the one being coerced? How would you feel about an untreated syphilis infection?
There are reasons why researchers are interested in pursuing it as a potentially helpful tool for opium addicts, and focusing on the prurient aspects of a substance is exactly what makes research into _controlled_ therapeutic use of GHB or Cannabis or psilocybin so hard to do in this country.