The New World of Legal Highs

Posted on November 13, 2013 by Carl Zimmer

Uncontrolled Substances: How The Chemical Underground is Going Mainstream. By Mike Power. Matter, Kindle Single, $.99.

Reviewed by Maia Szalavitz

I've been reading and writing about drugs and addiction for over a quarter century (yikes!) so I'm somewhat curmudgeonly in this area: what's news to many isn't likely to be so to me, and even the most egregious errors can only enrage you a certain number of times before you develop, unfortunately, at least some degree of tolerance.

But Mike Power's new Matter ebook, Uncontrolled Substances, is different.

Power avoids both the clichés and the errors, delivering a compelling story about a genuinely new development in the drugs world: the advent of so-called "legal highs." These are new synthetic substances similar to illegal drugs that are sold over-the-counter at head shops and convenience stories, often winkingly labeled as apparently innocuous products like "bath salts" or "plant food."

Often never even tested first on animals, the drugs are typically manufactured in Chinese factories and distributed globally via the internet. They range from marijuana-like products to those aimed at mimicking psychedelics or stimulants.

Power takes us into the story in several ways: by describing the difficulties faced by E.R. doctors dealing with overdoses and bad reactions to the substances, by telling the stories of key chemists, and by seeking to have a Chinese company produce a sample of a stimulant once taken legally by the Beatles, John F. Kennedy, Frank Sinatra and Marilyn Monroe that was pulled from the market in 1971. Power weaves these elements together seamlessly, while describing the difficulties that the new substances present to public health and regulators.

Synthetic drugs reveal a fundamental flaw in the foundation of the current international drug control regime, which is its irrationality. It is impossible to make a scientific case for a system that makes cigarettes and alcohol legal for recreational use, some opioids legal in some places for pain relief, and marijuana completely illegal. This means there are no objective criteria in existing law for determining which of the new drugs should be legal and which should not be.

Regulators have tried to address the problem by banning "chemical analogues" of illegal drugs, but this, again, runs into science: drugs that are structurally similar can have very different effects, and drugs that are completely dissimilar structurally can be pharmacologically alike. Simply banning every new drug as it appears also runs into issues with pharma: prohibit willy-nilly and you may unwittingly be blocking cures for cancer, Alzheimer's or depression.

As Power notes, even the hardliners at the United Nations Office of Drug Control Policy admitted in their World Drug Report this year that the system is "floundering" in its attempts to deal with the problem: one in 12 adults worldwide has at least tried one of the drugs.

Uncontrolled Substances offers a fascinating introduction to the issue–but it may, like many drugs, leave you craving more. In this case, however, I highly recommend it!

[Disclosure: I am writing a forthcoming ebook for Matter, with a different editor]

Maia Szalavitz is a neuroscience journalist for TIME.com and other publications. She is author, most recently of Born for Love: Why Empathy is Essential—and Endangered , with Bruce Perry, M.D. Ph.D. Her next book, Unbroken Brain, will examine addiction as a developmental disorder.

Seduced By Character

Posted on August 26, 2013 by Virginia Hughes

Obsessed, by Steve Volk. Published by Discover In-Depth. Available at Kalmbach Bookstore, $1.99.

Reviewed by Virginia Hughes

A great long-form narrative demands at least one irresistible character. If a writer finds a protagonist who is quirky, contradictory, charming, sadistic, or interesting in any other way, the reader will follow that character through any number of complex ideas.

In OBSESSED: The Compulsions and Creations of Dr. Jeffrey Schwartz, released this past weekend, writer Steve Volk finds that special character and describes him beautifully. According to Volk's depiction, Schwartz is a socially awkward, belligerent psychiatrist whose research has been unfairly shunned by the scientific establishment. He is an unsung hero whose revolutionary behavioral therapy has rescued thousands of people from the irrational fears and repetitive behaviors of obsessive-compulsive disorder (OCD). If his success continues, Schwartz may even rescue the withering concept of free will.

Great long-form science writing is not only about the yarn, however. It's also about pulling away from the character's seductive orbit in order to put his or her ideas into a wider scientific context. And Obsessed, unfortunately, doesn't do that well. Volk tells a slanted truth about Schwartz, the man, and about how his work fits into the larger field of anxiety research. That shortcoming is particularly disappointing given that Obsessed is the debut long-form e-book of an established science magazine, Discover.

It's obvious from the first few pages of Obsessed that Volk, a senior writer at Philadelphia Magazine, is a master of narrative. If there was ever a dull moment in the book's 13,000-plus words, I don't remember it.

I worry, though, that because of its compelling and seemingly authoritative story, readers will come away from the book with inaccurate ideas about anxiety disorders and how the mind works.

Take Schwartz's therapy, for example, which is a combination of mindfulness—a technique borrowed from Buddhist meditation in which you try to detach yourself from your emotions by focusing on breathing or some other innocuous behavior—and reappraisal, or explicitly focusing on naming and re-framing your emotions. Volk describes Schwartz's therapy as novel and even revolutionary—a thorn in the side of the psychiatric establishment and its beloved pharmaceuticals.

But Volk largely ignores the fact that Schwartz's approach is only a slight variation of other kinds of cognitive behavioral therapies (including exposure therapy, which Schwartz oddly villifies). These treatments have been around for decades and are firmly established among psychiatrists as effective for some people with anxiety disorders.

So the fact that Schwartz's therapy works for many people with OCD is not at all surprising. The brain changes with our day-to-day experiences—it's why even adults can learn new things, and yes, why some people with addiction, depression, and anxiety disorders can overcome them without drugs. There aren't many neuroscientists or psychiatrists who would disagree with that.

Where Schwartz stirs up trouble, Volk explains, is in his leap from the existence of an adaptable brain to the existence of free will:

“We’re talking about people with a biological brain disorder,” says Schwartz, “who learn through the use of neuroplasticity to change their brain function! That’s free will in action!”

It is a claim that flies in the face of most modern neuroscientific research, which suggests an ever-increasing number of our “choices” are somehow hard-wired into us—from which candidate we vote for to which flavor of ice cream tops our cone.

But there are actually lots of neuroscientists who believe in free will. (Even David Eagleman, one of the three scientists whom Volk puts in the anti-free-will camp, is on the fence about it.) It's an age-old question that people have debated forever. I suspect that Schwartz's colleagues don't like him for two of his other, crazier ideas, neither of which is adequately challenged in the book.

The first is Schwartz's theory about the physical processes underlying free will. In one head-spinning chapter, Volk explains how a combination of wave-particle duality, quantum Zeno, and Hebb's law might prove that the mind is separate from the brain. Volk tells us that "this is an idea in its infancy", yet neglects to include any outside comments from independent physicists or neuroscientists. The reader is left with no sense of how plausible—or crackpot—this theory is.

The second overlooked part of Schwartz's biography is his recent conversion to Christianity. Here's how Volk describes it:

The most important new development in Schwartz’s life underscores the schism between the champion of free will and the academics who oppose him: Schwartz has become a devoted Christian, his faith formed in great part by reading the essays of Deitrich Bonhoeffer, the German Lutheran pastor executed by the Nazis for insurrection. His faith seems odd at first—the young Jew, turned Buddhist, scientist and then Christian. But in the life-story of Deitrich Bonhoeffer, Schwartz’s guidepost for Christianity, there is a finer and firmer example of Schwartz’s own tough-mindedness. Bonhoeffer believed so strongly he died for it, openly opposing the Hitler regime that ultimately assassinated him.

What's never mentioned, however, is that in accepting Christ, Schwartz also seems to have rejected evolution. He is one of several hundred scientists to sign A Scientific Dissent from Darwinism, a document put together by the Discovery Institute, a conservative Christian think tank that lobbies for creationism. The signatories of that document, including Schwartz, endorsed the statement: "We are skeptical of claims for the ability of random mutation and natural selection to account for the complexity of life."

With that kind of public rejection of a fundamental law of biology, is it any wonder that some scientists are skeptical of Schwartz's other ideas?* And doesn't his alignment with creationists deserve at least a mention in a story of his scientific career?

Jeffrey Schwartz is a character, and one that I thoroughly enjoyed getting to know. But ultimately, the man's obsessions corrupted his work—and Volk's work, too.

*Update, 9/8/13: Schwartz signed the Discovery Institute document in 2004, years after being condemned by his peers. So that couldn't be part of his critics' motivations, as I speculated in the review, and I regret that error. Since my review appeared, Volk and Discover In-Depth have issued an updated version of the book that includes a paragraph about Schwartz's ties with the Discovery Institute. You can download the book here.

Virginia Hughes is a science writer based in Brooklyn. Her work has appeared in Nature, Popular Science, and Slate, and her blog Only Human is part of National Geographic magazine’s Phenomena. Follow her on Twitter.

DTU Editor Maia Szalavitz contributed much to the reporting and thinking behind this review

The Wrong Way to Write about Epigenetics and Violence

Posted on April 9, 2013 by admin

"The Ghost in the Cell," by Scott C. Johnson. Published by Matter. Available via Web, ePub, Kindle. $.99.

Reviewed by Annalee Newitz

It's a prize that scientists have sought since the early nineteenth century: a biological marker that predicts violent behavior in humans. In the 1830s, phrenologists believed head bumps could reveal a criminal personality — often, prostitutes and the poor were said to have bumps that marked them as deviants from birth. But today, it seems this pursuit may have moved beyond the realm of pseudoscience.

Thanks to recent discoveries, we have evidence that the genes of abused children are marked by the experience. Over time, these effects leave them prone to depression and make it harder for them to control their violent impulses. Could we be on the cusp of discovering a scientific approach to a social problem? In an essay for Matter magazine, former war correspondent Scott C. Johnson suggests that we are. Unfortunately, Johnson fails spectacularly to explain the complexity of this problem, and winds up telling a story that distorts both the science and the reality of abuse in many people's lives.

Continue reading “The Wrong Way to Write about Epigenetics and Violence” →

Autism, Inside and Out

Posted on April 2, 2013 by admin

Asperger
Love: Searching for Romance When You're Not Wired to Connect by Amy Harmon. A New York Times/Byliner Original. Available for Kindle, iPad, Kobo, and Nook, $2.99.

And Straight On Till Morning: Essays on Autism Acceptance, edited by Julia Bascom. Published by the Autistic Self-Advocacy Network. Available for Kindle, $2.99.

Reviewed by Steve Silberman

In the early 1990s, a mother told a conference of autism
professionals that the upside of having a teenager on the spectrum at home is that
they will never want to do the things that often get kids in trouble. There will
be no need for awkward conversations about sex, because people with autism are
either uninterested in or incapable of intimacy. Parents won't have to worry
about a late-night knock on the door from the local sheriff, because autistic teens
have no desire to party. If these generalizations now seem naïve, offensive, or
some combination of the two, this mother had a lot of company in her assumptions.
The notion that people on the spectrum are disinclined to seek connection with
others is embedded in the very word autism,
which is derived from the Greek word for self, autos.

One of the world's leading
authorities on the subject, psychologist Tony Attwood, devotes only a handful
of pages in his Complete Guide to
Asperger's Syndrome to sexuality and relationships. Specifically, there are
two references to "lack of desire," four to pornography, two to
exploitation by predators, and two to celibacy. Casting a further chilling
effect on the notion of romance, Atwood cautions potential suitors that people on
the spectrum may find a friendly touch on the arm "unpleasant and even
difficult to tolerate, let alone enjoy" because of sensory sensitivity,
and compares embracing an autistic partner to "hugging a piece of
wood." This is the historical backdrop that looms — albeit invisibly to
most readers — behind the publication of a new ebook by Pulitzer prize-winning
New York Times reporter Amy Harmon, Asperger Love: Searching for Romance When
You're Not Wired to Connect.

Continue reading “Autism, Inside and Out” →

The Elusive Psychology of Mass Murder

Posted on February 20, 2013 by Carl Zimmer

The Mind of a Madman: Norway's Struggle to Understand Anders Breivik. By Richard Orange. Kindle Single, $1.99.

Review by Maia Szalavitz

Following Aurora and Sandy Hook— and the concerns that have not surprisingly arisen over the questions of violence, guns and mental illness— I was eager to
read journalist Richard Orange’s

Mind of a Madman: Norway’s Struggle to Understand Anders Breivik
.

The book ably and lucidly details the story of the trial of the man who carried out the world’s deadliest mass shooting by a single individual. It’s full
of twists and turns, with Orange expertly doling out the suspense as to whether the killer will ultimately be declared sane or not. But it lacks the
context and analysis I’d hoped to find in an account of an event in which psychiatry faces off against what can only be called evil.

Orange, a foreign correspondent for the UK’s Daily Telegraph, covered Breivik’s trial after the Norwegian right wing ideologue killed 8 people in bomb
attacks on government buildings in Oslo, then gunned down 69 people, mostly teens, who were attending a political youth camp in July 2011.

Breivik claimed he committed the attacks to “save” Norway from Islam, multiculturalism, “cultural Marxism” and feminism. Initially, a psychiatric report by
two of the country’s leading experts claimed that he had paranoid schizophrenia.

Their evidence for this diagnosis was his apparently false claims about being connected to a larger terrorist network, his self-bestowed medals and
handmade military “uniform” and his belief that he had the right to kill for his ideas. These were seen as “delusions,” which occurred after a period of
social withdrawal before the attacks and his rants were said to contain “neologisms” or made-up words, additional evidence of disordered thinking.

According to the initial report, these factors were apparently enough to qualify Breivik for a diagnosis of schizophrenia under the ICD 10, which is the
international medical diagnostic manual and is similar in its psychiatric classifications to the DSM.

“His political world exists just to have a world to be psychotic in,” one of authors of the report testified.

But after the report was leaked, experts on the far right argued that Breivik’s “neologisms” were actually common terms used by others with similar views,
making the diagnosis controversial. The ICD criteria apparently require that schizophrenic beliefs be “culturally inappropriate,” and the fact that the
other far right groups he saw as his peers had similar views called that into question.

Breivik was surprisingly insightful about this paradox: “What I think is that [they] could not believe that a normal person could do such a thing. A
person who does something so terrible cannot be normal. He must be sick.”

After widespread outrage, a second report was ordered. This time, a new group of professionals determined that Breivik had not been psychotic
while carrying out the attacks. The second report accepted that his ideology and resulting actions, while clearly despicable, were not in and of themselves
evidence of psychosis.

But there was still disagreement among the experts who testified as to what Breivik’s diagnosis— and everyone agreed that there should be one— actually
was. Breivik had been diagnosed with an autism spectrum disorder as a child because of his “pedantic” ways and obsessive compulsive behavior, so one
psychiatrist suggested that this led to his “lack of empathy.”

However, a psychologist disagreed with the accuracy of that diagnosis, testifying that during an evaluation, Breivik was “polite and friendly and seemed
empathetic.” One of Brievik’s childhood friends had called him “one of the most sociable people” that he knew.

Other psychiatrists argued that Brievik’s real problem was a personality disorder— either narcissistic personality disorder or antisocial personality
disorder, probably well into psychopathy— or some toxic combination of the two, along with his racist ideology.

Mind of a Madman,
however, does not provide readers enough context to draw conclusions about Breivik's true state of mind. It does not include the ICD diagnostic criteria or give any background information
about conditions like personality disorders, schizophrenia and Asperger’s. As a result, it’s very difficult to weigh the battling
reports and conflicting testimony. The book doesn’t mention that autism
spectrum disorders are not linked with violence, nor does it explore the
controversy over the link between schizophrenia and violence. It also fails to examine the question of empathy itself. This quality is critical to several of the diagnoses and seems to have been misunderstood by some of those who testified, incorrectly claiming that autistic people always lack empathy.

While this probably reflects a newspaper journalist’s attempt to be “objective” and simply detail the (most certainly compelling) story of the trial, it
left me frustrated. Underneath this story is a tale of the ongoing problems with our current system of psychiatric diagnosis and the lack of objective
measures available to characterize mental illness. There’s also a story about why some diagnoses— like schizophrenia— are seen as mitigating, while others—
like personality disorders— are seen as aggravating. And of what brain science suggests about moral responsibility.

Moreover, there’s also an untold story of a country which is not bent on vengeance even after such an unimaginable crime, a country that would have
accepted either an insanity verdict or the one that came down, which found Breivik morally responsible and sentenced him to 21 years, a sentence that can
and likely will be extended if he is still found dangerous at that time.

Of course, a short ebook may not be the place for such depth, but some basic facts about diagnosis and the controversies it evokes would have been
extremely useful. There’s certainly room for greater exploration of the Breivik case in light of these distressingly frequent events— and especially for an
examination of the role of culture, psychiatric ideas and varying legal systems so that we can become better at preventing or dealing with them.

Maia Szalavitz is a neuroscience journalist for TIME.com and the author of five books, most recently Born for Love: Why Empathy is Essential—and Endangered, with Bruce Perry, M.D. Ph.D.