MDMA is an illegal drug that, according to the Drug Enforcement Administration, has no medical value and a high potential for abuse.
Yet MDMA — better known as ecstasy or molly — is being welcomed into a veterans administration hospital where it will be used to help combat veterans with PTSD.
How can that be?
As a practical matter, the research at a Bronx, NY, VA hospital has been permitted by the FDA, which, to its credit, continues to approve clinical trials to assess the therapeutic benefits of psychedelic medicines. Guided by science and not by the politics of the war on drugs, FDA regulators are increasingly aware of the potential of psychedelics; when accompanied by therapy, they appear to be able to help alleviate suffering from a range of mental disorders.
Specifically, this clinical trial took root at a meeting at Burning Man and was made possible by the philanthropy of two colorful billionaires. You can read more in my latest story at Medium.
Here we are, with summer coming to a close, and I am more than a little surprised to find that I have devoted most of my working time during 2021 to a single topic–electronic cigarettes. I’ve never been a smoker or a vaper, and paid no attention to e-cigarettes until late last year, when I began reporting a story about Bloomberg Philanthropies and the Campaign for Tobacco-Free Kids for the Chronicle of Philanthropy.
The more I learned, the more I came to believe that the topic meets the three criteria that I try to apply when deciding what stories to report. (1) Is it important? (2) Is it being covered well by others, i.e., do I have something to contribute? (3) Can my coverage in some way, big or small, make a difference?
(Those of you familiar with Effective Altruism will recognize those criteria as the framework of importance, neglectedness and tractability used by EA-influenced organizations such as the Open Philanthropy Project when deciding where to allocate resources to solve a problem.)
Tobacco policy is important–a life and death matter, literally, and one involving questions of racial justice and personal freedom as well. The topic is neglected or poorly covered by the mainstream media; misinformation is rampant. My stories are getting read (although not as widely as I would like) so, for now, I’m going to keep writing them.
In the last week, I’ve written two new stories for Medium about e-cigs.
Why do opponents of vaping want to suppress or dismiss science? explores the debate over conflicts of interest in the tobacco-control community. There’s a mini-scoop in the story: I report that Joanna Cohen, a Johns Hopkins University professor who opposes the publication of science that is backed by tobacco or e-cigarette interests, turned for PR advice to the Campaign for Tobacco-Free Kids, an anti-vaping group. See the problem? She’s opposed to conflicts of interest but collaborating with an organization that has staked out a hard-line, neo-prohibitionist approach to e-cigarettes.
Yesterday, I posted a story with the headline “Vaping can benefit public health.” That’s not my opinion. It’s the conclusion of 15 former presidents of the Society for Research on Nicotine and Tobacco, who argue in a new paper that a growing body of evidence suggests that vaping, which is safer than smoking, can be an effective way of helping today’s smokers quit. “The potential lifesaving benefits of e-cigarettes for adult smokers deserve attention equal to the risks to youths,” these scientists write. “Millions of middle-aged and older smokers are at high risk of near-future disease and death.” This is rebuke to, among others, government health authorities in the US and elsewhere, Bloomberg and Tobacco-Free Kids, all of which are pushing to restrict access to vapes. The paper by these eminent scientists deserves to be read widely.
If nothing else, my reporting on vaping has reminded me of lessons that we all should have learned long ago–that we should greet pronouncements from foundations and so-called public interest groups with the same skepticism that we apply to government or corporate action.
Stanton Glantz, one of the world’s best-known tobacco researchers, had everything going for him — a first-class brain, financial support, a tenured professorship and a passion for the task at hand. No scientist, it seemed, was more committed to reducing the death and disease caused by smoking
Glantz led the creation of an invaluable archive of tobacco-industry documents at the University of California at San Francisco, where he was a professor of medicine. He famously called attention to the risks of second-hand smoke, which helped turn public opinion against smoking. He inspired many.
“He was a hero of mine,” says Michael Siegel, a physician and tobacco control expert who worked with Glantz at UCSF.
Glantz is no longer a hero, not to Siegel and not to other critics who fought alongside him in the battle against smoking. They say that Glantz’s hard-line opposition to all things tobacco has led him to exaggerate the dangers and downplay the benefits of e-cigarettes, which have helped millions of smokers quit.
His bad science has enabled bad policy, which makes it harder for people to switch from deadly combustible cigarettes to vapes, which are safer although by no means entirely safe. (Young people, whose brains are still developing, should not smoke or vape.) Misinformation about vaping promulgated by Glantz and his allies has sure kept many people smoking. That’s tragic.
Undark, a web magazine about science, has just published my 5,000-word story about Glantz. (It was republished today by Mother Jones.) Please read the story, which goes into great detail about Glantz’s work. Undark editors carefully vetted the story and made it better, but their approach to journalism (“just-the-facts”) is more conservative than my own. So I want to offer a few additional thoughts here, in the form of a q-and-a.
Why write about Stanton Glantz?
Glantz, who is 75, remains the go-to scientist for the anti-vaping movement, even though he retired last year from UCSF.
Even so, Glantz’s claims about the dangers of vaping continue to be cited in scientific journals and by the anti-vaping forces.
That said, the problem of misinformation goes way beyond Glantz. The outbreak of a lung disease called EVALI had nothing to do with vaping nicotine, it turns out. Nor did vaping increase Covid-19 risks. But Glantz is among the worst offenders.
His two heart attack studies were the most egregious. The Journal of the American Heart Association retracted a 2019 study after other scholars discovered that some heart attacks in the analysis took place before the victims began vaping. Glantz knew that, according to the journal, but claimed that the study offered “more evidence that e-cigs cause heart attacks.”
“There’s no way these are innocent mistakes,” says Brad Rodu, a professor of medicine at the University of Louisville whose work has been supported by the tobacco industry. “This is falsification.”
Increasingly, former allies are going public with complaints about Glantz. During a webinar last month about conflicts of interest in tobacco research, Mike Cummings, a professor at the Medical University of South Carolina and longtime critic of the cigarette makers, said that academics as well as industry-backed researchers need to be held accountable for their work.
“We’re not calling out our colleagues who are polluting the science,” Cummings said. “I’ll call out Stan Glantz.”
How so? The evidence is growing that banning e-cigarettes or raising taxes on them — the policies favored by Glantz and his allies — lead more people to keep smoking. So does misinformation about the dangers of vaping.
“The inevitable result,” Sweanor has said, “is that it is more likely that smokers will stick with deadly combustibles, more vapers will revert to smoking, smoking will decline more slowly than it otherwise would, and the lucrative cigarette trade will have again been protected from a disruptive threat.”
It’s a terrible irony that a scientist who made no secret of his contempt for cigarette companies has in the twilight of his career become their unwitting ally.
My latest story for Medium looks a new research that points to a path forward for e-cigarettes that, at least in theory, could satisfy all but the most uncompromising voices on both sides of the great vape debate. Increasingly, evidence shows that it’s possible to make it harder for young people to vape, while preserving access to e-cigarettes for smokers who use them to quit.
Last month, a scientific journal published a peer-reviewed study with encouraging news for anyone concerned by the impact of smoking on health.
The study in the American Journal of Health Behavior identified more than 17,000 cigarette smokers who purchased a Juul starter kit, which includes a rechargeable e-cigarette and four flavored pods. A year later, more than half said they had stopped smoking and switched to e-cigarettes, which, by nearly all accounts, cause much less harm than combustible tobacco.
“It is a startling result,” says Cheryl Healton, the dean of New York University’s School of Public Health and former president of the Truth Initiative, an anti-tobacco nonprofit. The study has limitations, she says, but its findings align with experience in the UK, where smoking has declined sharply as public health authorities encourage smokers to switch to e-cigarettes.
There’s just one problem: The study was conducted by Juul Labs.
The research, as a consequence, has been summarily dismissed by tobacco control activists.
In 1976, Alexander “Sasha” Shulgin, a brilliant and eccentric chemist who concocted hundreds of psychoactive drugs in a home-based laboratory in the hills of Berkeley, California, cooked up a batch of MDMA, the drug that later became known as Ecstasy or Molly. He then tried some, as was his habit.
He loved it. “I feel absolutely clean inside, and there is nothing but pure euphoria,” he wrote in his lab notes afterwards. “I have never felt so great, or believed this to be possible. The cleanliness, clarity, and marvelous feeling of solid inner strength continued throughout the rest of the day and evening. I am overcome by the profundity of the experience.”
This is quite the endorsement, if only because Shulgin took a lot of drugs during his long life.
Thirty five years later, MDMA is having a moment. A clinical trial of MDMA-assisted psychotherapy for PTSD, run by the Multidisciplinary Association for Psychedelic Studies, or MAPs, produced impressive results, moving the combination of MDMA and therapy closer to FDA approval. The first study of MDMA-assisted therapy for alcohol-use disorder, conducted by researchers at Imperial College in London and the University of Bristol, delivered encouraging, albeit very preliminary, findings. Researchers studying MDMA, as well as experienced users, say that the drug could be an effective way to treat other psychological ailments, while improving the health and happiness of so-called “healthy normals.”
Atlantic Sapphire, a Norwegian company, calls itself the largest land-based aquaculture company in the world. It is building a giant salmon farm, known as the Bluehouse, on what used to be a tomato field in Homestead, FL, about 40 miles southwest of Miami.
Lately, things have not been going well.
In March, Atlantic Sapphire destroyed five hundred tons of fish, the equivalent of about 600,000 salmon (1), after a filtration system failed to keep water tanks clean. “Fish gathered at the bottom of the tanks, disrupting the flow of new water, causing increasing mortality,” the company said.
The previous July, Atlantic Salmon conducted an emergency harvest of about 200,000 fish after “disruptive construction work… including loud sounds and severe vibrations stressed the fish,” the company said. The fish were then “vacuum pumped . . . through an electrical stunner,” given an electric shock and bled to death, according to documents obtained by Animal Outlook, a nonprofit group based in Washington DC. that has filed a complaint against the company.
It hasn’t been smooth sailing for people either. Three workers were hospitalized in April after being overcome by fumes from an unknown gas, according to Seafood Source.
Take a look, please, at this poster from the Partnership for a Drug Free New Jersey, a nonprofit supported by tax dollars. Setting aside the absurd notion of a drug-free New Jersey — presumably, there are no plans to ban alcohol, caffeine and aspirin from the Garden State — the clear implication is that e-cigarettes will kill everyone who tries them. This is so patently false that it is unlikely to deter anyone from vaping. It is, however, an extreme example of how unscientific, distorted and one-sided the debate about vaping has become in the US.
It is not often that well-respected nonprofit organizations take the side of the powerful against the weak. Yet that, in my view, is where the Campaign for Tobacco-Free Kids and the Truth Campaign find themselves these days in the debate over e-cigarettes.
That’s why I’ve been spending time lately reporting and writing about e-cigarettes, and why I hope to continue to do so. The topic has been neglected, and it’s important because the lives of tens of millions of smokers are at stake.
Yesterday in Medium, I wrote a story about bans on flavored e-cigarettes that have been enacted by three states — New York, New Jersey, Rhode Island — and a number of cities, including San Francisco and Chicago. Similar bans are being debated around the country.
Public health experts, some of whom have worked on tobacco issues for decades, tell me that these bans are misguided. E-cigarettes are far less harmful than smoking. Their use by teens is declining. They are also a tool that can help smokers quit.
So why the bans? Because parents, most of them white and middle-class, have been whipped into a frenzy about vaping by groups like Tobacco-Free Kids and the Truth Initiative, as well as by the U.S. Surgeon General and the CDC. My reporting has led me to believe that they have exaggerated the dangers of vaping and downplayed the benefits. This isn’t to suggest that anyone who is not a smoker should vape. They most definitely should not. The nicotine in e-cigs is addictive and it may have negative affects on developing brains.
But fears of a so-called epidemic of vaping among teenagers have led to these bans, which keep flavored vapes out of the hands of smokers for whom they could be life-saving. (In England, the government recommends vapes as an aid to quitting.) The 34 million smokers in the US tend to be less-educated, poor, more likely to suffer from mental illness, LGBTQ or Native American, when compared to the total population. They don’t have political clout. They’re mostly unheard in this debate.