Wednesday, November 2, 2011

"Unguarded": great sports doc, terrible sponsor. Shame on ESPN

Last night I caught “Unguarded” on ESPN—a documentary that I thoroughly enjoyed about Chris Herren, a Massachusetts prep basketball star who had a brief stint in the NBA while addicted to Oxycontin.  Director Jonathan Hock did a great job using Herren's own narrative as he speaks to audiences at high schools, prisons, and treatment centers about the crippling addiction that (amazingly) he hid from his teammates and family during his whole career.

But there was one major problem with the airing of the documentary: “This portion of Ungaurded brought to you by Jameson's whiskey.”

*Record scratch, falls off the needle*  WHAT, WHAT, WHAT?!?

Yes, that's right.  As viewers see a visibly emotional Herren painfully recount, for example, how he left treatment to attend the birth of his son—this, after a near death heroin-fueled automotive bender and consequent estrangement from his expectant wife, family, and community had him on the brink of suicide—we, the audience are reminded that Jameson’s Irish whiskey is the proud sponsor of ESPN films.

Now I've never been in recovery myself, I regularly watch and am a fan of ESPN films[1], and every now and then I enjoy the smooth burn of snort of Jameson’s.  But holy hell, even I can plainly see the horrendously insensitive juxtaposition of a whiskey maker advertising during a documentary about drug and alcohol addiction.

Jameson’s whiskey should be appalled.  Director Jonathan Hock and the family of Chris Herren should be outraged.  ESPN should be ashamed.  This is almost as bad as an MTV show about teenage drug addiction hosted by DJ AM[2].

In between commercial cuts, for example, we see a present day, sober, and clearly emotional Herren speaking to an invested crowd about how celebrated his new-fatherhood trip to the liquor store to relapse on vodka and then more drugs, en route to rock bottom.  Brought to you by Jameson’s!

I’m also unfamiliar with the politics of television advertising.  Sure, maybe this was an unfortunate coincidence, or maybe the higher-ups and ESPN saw the conflict and were impotent to circumvent it.  In the latter case, did those folks even see the documentary?

I watch PTI daily, which is sponsored by a booze carousel of Jeremiah Weed, Jose Cuervo, Red Stripe, or some new formulation of Guinness—all of which I occasionally enjoy[3].  Sponsorship from alcoholic beverage corporations is entrenched with sports programming and in the culture of sports in general.  So on some level, the contrast between “Unguarded” and Jameson’s could be expected.

But this doesn’t mean it should be excused.  Knowing very little about broadcast sponsorship, ESPN still could’ve picked any other sponsor to advertise during “Unguarded.”  Even if that meant showing more commercials, I’d prefer that the advertising limitations of TV broadcasts do anything to not diametrically conflict and dilute the otherwise powerful message that Hock’s documentary intended to convey.

“Unguarded” re-airs this Saturday on ESPN 2.  I will set my DVR to see if anything changes.

[1] The best in the 30 for 30 series, hands down, has to have been “The Two Escobars”.  If ever one needed proof of the interrelationship between sports and drugs, there it is.  Runner up to surprise Director Vlade Divac for “Once Brothers” (I literally cried).  And the worst one (easily) was about the Raiders directed by Ice Cube, who basically decided to make a documentary declaring how much he likes and (with NWA) takes credit for the Raiders—not a successful football franchise, they (arguably) weren’t—but as a fashion/culture fad.  Please Cube, stick to Coors Light commercials and TBS family comedies.
[2] What?  This was actually a show called “Gone Too Far”?  Talk about the wrong messenger.
[3] Except for Jeremiah Weed, which nobody enjoys, especially the meatheaded arm-wrestling contestants, gluttons, and other proudly portrayed “manly men” who the majority of cable-subscribing PTI viewers in no way aspire to become.

Friday, October 28, 2011

Tosh.0: friend or foe?

Tosh.0 is a show that I won’t let my mom watch.  I just … can’t.  It’s far too raunchy, graphic, and I have to explain everything.  But I watch it myself in part so I’m aware of things that nobody should be aware of.  Like “cinnamon challenges,” “The Human Centipede,” and—in accordance with the theme of this blog—salvia.
            Tosh.0 can be funny[1] in part because it is filled with horrible ideas.  If heapings of schadenfreude are funny to you, you’d probably like Tosh.0.  What “America’s Funniest Home Videos” was 20 years ago, Tosh.0 has managed to update by mining the dredges of YouTube.  It’s basically the “Talk Soup” format only with internet videos, which is a guaranteed recipe for success[2].  It is insanely popular among the high school students who I teach.  Is this a problem that every episode makes light of pain, inebriation, fights, and people either less fortunate or less self-aware?
            The previous “Breaking Bad” entry opened up a world of discussion about the role of popular culture in the acceptability of drugs.  Does TV, music, and film give us more bad ideas about drugs than it does good ones?  I would argue that it’s ultimately not the responsibility of popular culture to hold back from anything—real or scripted—that large markets of adult viewers actually want to see.  This argument applies to adults, whereas kids and knuckleheaded man-children are different, to which I invoke the Charles Barkley postulate of individual determinism and something called “parenting.”
            However, popular culture is also, of course, popular.  It’s not necessarily a good thing to let masses of otherwise-unknowing collegiate Comedy Central viewers know that there are a range of quasi-legal substances that are: (1.) widely available; and (2.) funny.
Even though I research substance abuse issues, the first time I heard about salvia was from Tosh.0.  More specifically, from friends talking about Tosh.0.  I think my first question was, “what is Tosh.0?”  Then, “what is salvia?”  What I found was a clip from the first season where host/comedian Daniel Tosh himself simultaneously attempts several of the more dubious internet “challenges,” resulting in a surprisingly compelling segment of high comedy.
You can see the clip here.
I find it interesting that, though currently legal in most states, Comedy Central couldn’t show salvia being smoked[3].  All you need to know is that, essentially, salvia completely impairs you for about 15 minutes, producing complete loss of motor skills and mild hallucinations, depending on the dosage[4].  And attempting to swallow a tablespoon of cinnamon also, basically, fucks you up—choking, vomiting, crying—nonetheless it’s widely attempted online.  Saltine crackers are nothing new, and as for the coconut thing, I believe that was premised on a guy who actually tried to karate chop 100 coconuts and didn’t get far.
Tosh doing all of these things has a certain internet Jesus quality to it: he suffers for us so we don’t have to.  But, of course, we do.  Everything on TV has the potential to be emulated with disastrous results.  This is why shows like Tosh.0, Jackass, etc. are all bookended by disclaimers that are inevitably and routinely ignored.
What’s more, Daniel Tosh seems to have a real thing for salvia.  There was the above salvia/cinnamon/saltine/coconut challenge.  Then in an event dubbed “weed vs.salvia” he pits Tommy Chong (representing team weed) vesrsus “Salvia Eric” who is known for doing lots of salvia and documenting it online.  More recently Tosh.0 featured a breakdown of a clip of a guy climbing and eventually crashing through his apartment window after smoking salvia.  It looks like a pretty painful fall, and would have come across as a purely cautionary tale if not for Tosh’s mock-instructing viewers on how to find salvia online—he even goes so far as to spell it out and highlight its availability online:
“Remember kids, salvia is completely legal and you can buy it anywhere online.  That’s s-a-l-v-i-a, salvia, and for that, we just say no.”
I think I “get it,” but the nuance of the “joke” will surely be lost on the hundreds (or more) Tosh.0 viewers who are feeling experimental and will inevitably heed Tosh’s advice.
But in an episode that aired two weeks ago, he “redeems” a guy who had his shroom-induced freakout go web-viral by offering a smorgasbord of terrible ideas: bath salts, air dusters and (worst of all) jenkem (which I’ll get to).  This is not to be confused with Tosh’s redemption weeks earlier of the “naked wizard” who was tazed repeatedly at a music festival while on LSD.  The take away seems to be: if you manage to survive an unfortunate and traumatic experience with psychoactive substances and if you have the additional misfortune of having your embarrassing/injurious episode being documented and posted online, then there’s an off chance Tosh.0 will extend your 15 minutes of infame.
Granted, these “web redemptions” are satirical, scripted bits.  But there’s a lot of real information (or misinformation) about what these drugs are, without at all cautioning against them.  Sometimes he seems to convey the opposite of caution.  Tosh describes jenkem as “pee and poo and spit,” and then, tounge-in-cheek, “but don’t worry, it’s mine.”  And yes, that is basically the raw ingredients of jenkem, a.k.a. “butt hash,” which captures the toxic emissions from fermenting human detritus in a balloon or bag that is then (ugh) inhaled.  Here’s a not-so-recent news report from (surprise!) Florida on the troubling trend among high school kids.
            If there’s a case for the legalization of marijuana, it’s jenkem.  It’s foul, and homemade, and like what Robert Oppenheimer said about the atom bomb, it cannot be un-invented[5].
            Bath salts are different and are more in the salvia class of currently unregulated but clearly very potent and dangerous substances.  And air dusters are great for cleaning keyboards, but otherwise horrible as inhalants of choice.  Just take, for example, the “Intervention” episode with Allison.  Could there be a more persuasive argument against inhalants?
            Tosh.0 can be funny, but the show seems to be relying more on drug bits to separate it from the deluge of crotch shots and alternative sport calamities found on “Rediculousness.”  And as far as drugs go, Tosh.0’s increasing recklessness is disconcerting: why must it continue to inform its relatively large and (I’d argue) already-drug-prone audience about the latest substances of abuse?
            The answer, I presume, is because since occupying this niche of esoteric drug glamorization several seasons ago, nobody else on TV either can, or wants to claim it.  Even though Tosh.0 is arguably the leading culprit of popularly portraying an expanding drug catalog, they (he and his writers[6]) are not the only ones.
            Grantland writer and Bill Simmons entourage member Dave Jacoby (a.k.a. “The Reality TV Czar”) routinely jokes about “celebrity” bath salt use in the Grantland Reality TV Fantasy League.  “It’s Always Sunny in Philadelphia” is a dark comedy that I, and a relatively large (cable) audience enjoy, despite regular inhalant and other drug use among many of its main characters.  And ecstasy, steroids, and huffing abound on “Eastbound and Down” which features one of my favorite anti-heroes ever in Kenny Powers[7].
            But with Tosh.0, drugs are not merely a plot point.  It’s “hey, look at this … let’s laugh at this.  Come on my show and let’s trivialize drugs together!”  And even worse, as with salvia: “here’s more examples, kids … they’re everywhere, here’s how to get them.”
            Just this last week Tosh addressed the futility of his show’s legal disclaimers by mocking his own insistence that viewers don’t send in their own examples of “pie smash, nut tap, bitch slap” (which is precicely what it sounds like), only to follow with several fresh examples sent expressly from impressionable viewers eager to emulate the latest Tosh.0 trend.  Is it really that much of a stretch to assume that, as I type this, some poor Tosh.0 fans are out there stewing homemade jenkem?
            I know I’ll keep watching, if only to learn about drugs that I otherwise wouldn’t, and other terrible things that I probably shouldn’t.  And chances are I’ll laugh, even as I shake my head in disapproval.

[1] Though I’d argue it peaked during the first two seasons.
[2] It has since been emulated by the more sports oriented “Rediculousness,” which has even recycled a lot of the same painful internet footage seen in Tosh.0 episodes.  But “Rediculousness” doesn’t do drug stuff, which is thus why I’m solely interested in Tosh.0.
[3] This, from the network that allowed “shit” to be said hundreds of times in a single episode “South Park,” and allowed Anthony Jeselnik (who I love) to tell Steve-O “don’t give up on your suicide.”
[4] For more about this, there is a pretty good peer-reviewed journal entry from colleague and friend Jim Lange and SDSU, who actually used YouTube footage as original qualitative data.  I think the more valuable scholarly contribution there might be the methodological viability of YouTube as qualitative data, but since there is virtually nothing published on salvia, it’s an invaluable article in multiple ways.
[5] I have no idea if I’m attributing this properly, but I know that somebody’s said it about the a-bomb, and the analogy has also been applied to meth.
[6] Including Todd Glass, who I like a lot.
[7] Like Tosh.0, the last season of EB&D was a relative letdown.  However, I’m encouraged with the recruitment of Jason Sudekis to play Kenny’s new catcher, wingman, and (supposedly) equally John Rockerish dipshit in the upcoming third (and hopefully last) season.

Sunday, October 9, 2011

Breaking Bad is getting good

AMC’s Breaking Bad is the one show that everybody tells me I “have to watch.”  Much of this comes from friends who are both BB fans and know about my interests and blog (of which there are literally couples), who swear that it’s the best show on AMC and that Bryan Cranston is the best actor on TV.  As an ardent fan of Mad Men (and The Walking Dead) I presumed that that was crazy talk.  But after binging on the first three seasons of BB, comparisons aren’t entirely sacrilegious, and every bit of praise aimed at Cranston I will buy wholesale.

The most trafficked post to date was my review of Limitless and clearly there is a huge online thirst for editorials about popular culture[1].  My past few entries—and well, this whole blog really—articulate the tension between the neo-prohibitionist movement of drug temperance and the “new school” of substance abuse awareness where there is such thing as “responsible use” even if said use isn’t always in accordance with the law.

For the record, I like to hedge by falling vaguely in between these two camps.  The law is surely flawed, but true drug abuse is a terrible human condition.  Defining what’s what is where things get tricky.

From this blog’s ongoing perspective of weighing if popular culture seems to glamorize drug issues responsibly or irresponsibly, Breaking Bad begs to be scrutinized.  When Netflix expanded its instant streaming catalog to include BB, I couldn’t resist[2].

For those not familiar, Breaking Bad is a serial drama about a very good high school chemistry teacher named Walter White who resorts to learns that he has terminal cancer and resorts to cooking meth in order to provide for his family’s future.  (For those not familiar who also may want to discover BB for themselves in the future, this entry contains spoilers.  You’ve been warned).

The series’ protagonist Walter “Walt” White is exceptionally played by Bryan Cranston, who is otherwise arguably known as the dad from Malcolm in the Middle.  I was never a big fan of Malcolm, but from what little I did watch, Cranston always had a daft comedic touch.  In BB, he sheds any glimmer of lightness in the first few episodes and becomes something completely different and darker.  When Walt’s cancer (or market-research savvy showrunners, I suspect) progress to take his hair in the first season and add a badass ginger-beard, the transformation is complete.  There is absolutely no sign of Malcolm’s dad[3].

Cranston is simply awesome.  This is no secret, as he’s won 3 Emmy’s for his manically complex portrayal of Walt[4].  Everybody else keeps up admirably.  The only other guy in Cranston’s league is Bob Odenkirk as sleazy lawyer Saul Goodman, the best TV lawyer since Lionel Hutz, and this is Odenkirk’s best work ever (yes, that includes Mr. Show).

There’s a lot of secrets going on between Walt and his family.  It would be like if Tony Soprano never told his family about being a mafia kingpin: BB is rich with opportunities for suspense.  We care a lot about Walt, his wife (preggers!) and son (cerebral palsy!), who are both sympathetic characters.  We also care about Walt’s Michael Chiklisish brother-in-law—who just so happens to be a DEA agent—and less so about his bitch-narcissist sister-in-law, who is basically a total twat.

I’m more on-the-fence about Walt’s partner-in-crime Jessie Pinkman, who was a burnout former student in Walt’s high school chemistry class, and who constantly seems to be high-strung and stammering his lines like Jonah Hill[5].  Their worlds collide in the pilot episode when a fresh-from-the-doctor’s-office Walt volunteers to go on a meth-lab raid with his garish brother-in-law as a way to contemplate entering the meth business.  As the DEA busts into a New Mexico suburban home, only Walt notices him escape, and viola, the chemist has found his distributor.

The meth/cancer subplot is really not a subplot but the central plot of the series around which everything else seems to orbit[6].  Early episodes are viscerally discomforting purely because of how Cranston portrays the suffering he incurs from cancer.  I began rooting for Walt’s recovery not for plot-resolution reasons of extending the series, but because it can be really difficult to watch this guy cough to the point of nearly (or actually) passing out in nearly every episode.

But this isn’t a cancer blog, this is a drug blog.  In terms of portraying bad things with a responsible degree of realism, cancer clearly sucks, but the meth business seems comparatively awesome, even though the protagonists endure innumerable risks and hardships related to the violence and sketchiness of their illicit trade.

This is a pretty bold claim for me to be making.  After all, Walt and Jesse almost die in the first episode and rolling-in-money success montages a la Scarface are few and far between.  The meth business is hardly portrayed as glamorous, but the harms of drugs don’t acquire the kind of weight and realism that make me comfortable as a substance abuse researcher.  For example, Jesse and his friends seem to functionally use meth sporadically without slipping into full-blown addiction.  In addition to flagrantly violating the Notorious B.I.G’s “10 crack commandments,” this is an egregiously casual portrayal of a hard-core drug.

This criticism disappears almost completely in season 2, where after a season and a half of transient mayhem for Walt and Jesse, their enterprise becomes stable enough for Jesse to rent a place and meet a lovely neighbor, Jane, who is a recovering addict[7].

(Spoiler alert).  While I think BB dangerously under-exaggerates the harms of methamphetamine, it makes up for this with the introduction of heroin.  Jane’s heroin overdose is the most salient resemblance of a cautionary drug tale in BB—or at least in its first 3 seasons.  Not that the characters aren’t individually tortured in different ways by their different choices, but after all, team Walt/Jesse manage to stay lucrative and alive.

On top of this, Walt is portrayed as a brilliant man and talented chemist who takes pride in the “artistry” of his meth manufacturing.  Another major plot pivot isn’t just about how the protagonist tandem stay alive making meth, but how they make the best meth in the universe.  Like Jamaican Blue Mountain coffee or Kobe beef, Walt’s meth is glamorized to a point where the quest to procure it sounds challenging and intriguing.  As in, like, in real life.  I don’t know if any impressionable scofflaws were inspired to enter the meth biz after watching BB, but I’ll bet it’s happened.

I’m both pro-responsible drug realism in TV, but I’m also pro-TV.  I understand that we can’t have edgy, innovative shows that centralize around things like meth, while: A. keeping the show watchable; and B. keeping its characters likable.  Meth has earned the recent title as the world’s “most dangerous drug.”  But heroin has historically been the world’s scariest drug, and gives meth a run for its money in the danger department too.  The key difference in 2011 is that young adult heroin use has hovered between 1-2% for decades, while meth use is entrenched at around 15%.

The show itself seems to be aware that it underexaggerates the dangers of meth, and chooses to compensate by scapegoating heroin, as if its overall portrayal of drugs, on balance, is reasonably stark.
From a responsibility standpoint I don’t think this kind of hedging quite works.  But Breaking Bad isn’t meant to be an anti-drug PSA.  It’s meant to be good fucking TV.  And it is.

With the exception of a recurring meth addicted prostitute and minor junkie characters[8], Jesse’s casual meth use never seems to visibly affect him as it arguably would in reality: his teeth remain gleaming and he never breaks out in scabs and sores like the “faces of meth.”  He looks like, well, an actor.  But this is the rule of good TV about bad subjects: you can’t have it both ways if you want it to be both stringently realistic and watchable.

Breaking Bad may downplay or even glorify some aspects of meth manufacturing, but arguably no other show on television treats death with such reference and gravity.  Walt and Jesse are not killers, so when it happens, consequences and grief carry real weight that often arc across multiple episodes.  For me, BB transitioned from simply good entertainment into something much more “real” when Walt’s DEA brother-in-law Hank goes through PTSD after a particularly gruesome series of narco-terrorism related events.

Whatever BB lacks in reverence for the risks of meth cooking, it makes up for by reminding us that there is a real drug war occurring on the border.

I’m excited to see where this goes in season 4.  I just hope there’s a lot more Saul Goodman.

[1] Pop culture is big on the internet? … No shit!
[2] Netflix also has back episodes of Mad Men, which I highly recommend for those who are nostalgic about workplace alcohol and tobacco use and retro-sexism.  As an aside, I don’t understand the Netflix backlash.  I can still “rent” three whole seasons of BB and whip through them in a week for a fraction of my monthly $10 fee, which is a huge improvement on content viewing compared to any previous legal model.  I don’t know how many discs constitute a single season, but my guess is that it would’ve cost close to $30 to rent these respective seasons at Blockbuster, even if all the discs were available.  Not to mention the hassle of having to go to an actual store and the inability to watch your goods on any TV or device, including iPads and smartphones.  What is everybody complaining about?  Plus you can activate Netflix streaming on up to 5 devices, which in my family includes my computer, iPad, my brother’s devices, all leaching from my mom’s single account.  Apparently Reed Hastings hasn’t wised up to the fact that his “egregious” new fee structure still allows anybody to basically share their account with 4 friends, which makes a tremendous value even better.  Put that in your self-loathing e-mails next time, Reed.
[3] I can’t underestimate the importance of being dexterous enough to elude being typecast.  For example, can you imagine Omar from “The Wire” in any other role? (Good luck “Boardwalk Empire”!)  This is the type of disbelief that prevented me from accepting Michael from “The Wire” as the token black kid on the new 90210.  It’s not just The Wire, Larry David and Jason Alexander famously addressed this dilemma on an episode of Curb.
[4] And he’s been nominated countless more times for Emmy’s, Golden Globes, etc.  Interestingly, he was even nominated for his supporting role in Malcolm.  However, I always like to ultimately judge the mettle of acclaimed actors by how they do hosting SNL.  In this respect, Cranston faltered, though the writers can be blamed in part for that.  By comparison, Jon Hamm was an amazing host SNL—arguably the best and most surprisingly versatile host in the past 5 years—he’s the new Tom Hanks.
[5] This might be par for the course for an on and off meth user, but I often find myself talking to my iPad or computer “chill the fuck out Jesse!”  Walt’s coughing is annoying in a purposeful, tense way.  Jesse’s constant shouting is simply annoying.
[6] Take note J.J. Abrams and creators of Lost: this is also a brilliant device for showrunners who are ambivalent about the prospects of a risqué, unorthodox serial drama.  If it doesn’t do well, then the series arc could conclude neatly when Walt succumbs to cancer.  It’s no surprise that his prognosis improves in seasons 2 and 3.
[7] And who is totally hot.  Turn the emo up on Anne Hathaway and you’ve got Krysten Ritter.
[8] One of whom, is played by Dale Dickey, who apparently has a known talent in Hollywood for playing junkies.  Not to say she’s unattractive, but with makeup, she looks strikingly like a woman from “faces of meth.”  She was also really good as a redneck rube in a bigger role in the Oscar nominated meth flick “Winter’s Bone.”

Saturday, September 17, 2011

Tuesday, September 13, 2011

The prevention problem with so-called "enhancement" drugs

I wrote this about a week ago for the White House (as in yes, that White House).  They requested blog-like information about NMPDU which is the acronym for non-medical prescription drug use.  I'm like "I have a blog on NMPDU! This should be easy."

The catch: only 200 words, which is totally hard.  But I got close (below):

Last week CNN featured an article on college students who take ADHD drugs to improve their grades.  The article featured a college student, Jared, who enthusiastically used Adderall without a prescription to successfully raise his GPA.  Though this was a self-reported sample of one, let’s assume this was empirically true.

The article was counterbalanced by an unsurprising litany of researchers and experts, who were more cautionary about the alarming trends occurring on campuses nationwide, which include real psychological and physiological risks associated with prescription stimulant misuse and abuse.

I first became aware of this piece after several esteemed drug prevention colleagues in college student health responded with collective outrage, ostensibly to the resultant tone of the article: a mélange of prevention speak obfuscated by the testimonial of a single student who essentially said that Adderall is awesome.

From a prevention standpoint, articles like this may be irresponsible.  On the other hand, it is all essentially true.  Therein lies the problem with stimulant medications: students seem to love them, and research to date is relatively ambivalent about their risks and benefits.
We have a problem in drug prevention when speaking truthfully about an issue becomes self-defeating.  With alleged “enhancement” drugs, we are already there.  Acknowledging the conflict between prevention and our elementally human temptation to enhance is a necessary first step before real dialogue and meaningful prevention can occur.

Ross Aikins recently received his Ph.D. in Education from UCLA studying collegiate enhancement drug use.  He is the Chair-Elect of The American College Health Association’s Alcohol Tobacco and Other Drug Coalition.

Wednesday, August 31, 2011

The Pop Culture Drug Blog (or the greatest chapter I will never get to use)

I discuss a lot how the mere concept of cognitive enhancement has obvious appeal among college students.  This makes prevention difficult when this concept is ubiquitous in the culture at large.  This dissertation aims to understand the broader conversations surrounding academically oriented drug use, including behaviors, beliefs, and the cultural influences that shape student beliefs.
            It deserves to be noted first that mental health, ADHD, prescription stimulants, marijuana ballot initiatives, FDA bans on Four Loko, and all of the other many drug-related issues mentioned throughout this dissertation are news.  Medical advancements are of public interest, and pharmacological advancements are covered in medical journals and academic peer-reviewed publications before subsequent controversies (e.g., overmedicalization in America, an ADHD crisis, too much legal pot, etc.) raise the level of the discourse to where it becomes cover fodder for mainstream magazines and lead material for broadcast news[1].
            In other words, cognitive enhancement is a known issue.  Joe got the idea to try Adderall after reading the article “Brain Gain” in The New Yorker (Talbot, 2009); Patrick from the pilot study cited the seminal editorial in Nature as his inspiration to seek nootropes (Greeley et al., 2008).  This proves that even responsibly written editorials or academic literature can inspire irresponsible—or at least illicit—drug use.  Our culture is replete with other cautionary and tempting stories about human enhancement in film, literature, and television that are both high- and lowbrow.
We’ll start with the highbrow.
            Aldous Huxley’s Brave New World is arguably the preeminent postmodern cautionary tale about the limits of human enhancement, but what’s most striking about the novel today is Huxley’s prescience, despite being first published in 1932, before genetics and Ritalin existed.  The fictional panacea drug “soma”[2] represented chemical escapism, but this was a cautionary tale.  Just as Huxley’s utopian society takes markedly dystopian trajectory, the rampant therapeutic use of soma is revealed to be more of a great chemical pacifier and stultifier of the human condition rather than an agent for its progress (Huxley, 2006)[3].  This is the opposite of what nootropics are designed to do.
            An earlier and perhaps more apt cautionary tale of human enhancement is Mary Shelly’s Frankenstein.  There could arguably be no more fitting enhancement allegory than a classic about creation, where a man (Dr. Frankenstein, of course) creates a superior being (Shelly, 2000).  Dr. Jekyll and Mr. Hyde also deals thematically with the consequences of a medically altered self (Stevenson, 1991).  Science fiction as a literary and film genre has produced countless works that incorporate similar themes, and there is no possible way for this discussion to meaningfully catalog them all.  The point is that human enhancement is not an uncommon plot premise.
Classic fictional takes on this enhancement narrative are usually not specific to illicit use of ADHD medications in educational settings.  Thus the participants in this study, or students in general, are not likely to get the specific idea to use Adderall non-medically through classic literature and films.  Contemporary popular culture however is different.  Here’s where it gets lowbrow.
Over the course of this approximately four-year research period, people have graciously reported all kinds of pop-cultural references to Ritalin, collegiate drug use, and other related topics, whenever they occur.  Though I cannot possibly comprehensively and exhaustively archive every “study drug” scene in television or film, or mention every episode of drug celebrity drug misbehavior occurring over nearly a half-decade, there are several worth noting.
When talking about prescription drug stigmas, participants often mentioned recently deceased celebrities.  Posthumous Oscar-winning actor Heath Ledger was the most commonly cited example during the pilot phase of research, but students interviewed months later for this dissertation brought up Michael Jackson more often[4].  In each of these cases, students discussed tragic celebrity overdoses to illustrate the realized harms of prescription drugs—but not specifically prescription stimulants.  In most cases, these deaths were caused by prescription opiates, sedatives, or combinations thereof, but not stimulants.  Frank, Kendall, and a few other participants felt that stimulants were less harmful and less negatively-stigmatized, but this study can’t conclude that all or most students will accurately discern the variable risks associated with different classes of prescription drugs.
            In terms of penetrating youth demographics, MTV has been a cultural presence since I was born.  The Emmy award-winning MTV series “True Life” has featured several mini-documentaries about alcohol, drug use, and college, including a 2003 episode “I’m on Adderall,” which chronicled the lives of three college students coping with varyingly severe non-medical prescription drug addictions (Sirulnick, 2003).  And after 25 seasons of fairly regular alcohol and drug consumption on MTV’s groundbreaking reality show “The Real World,” recent casts have included individuals with prescription drug problems[5].  Controversially, MTV adapted the BBC teenage drama “Skins,” in 2010, which featured liberal amounts of underage sex, lawlessness, and prescription drug abuse[6] (Elsley & Brittain, 2011).
            In the first season (2004) of the ABC network’s hit show “Desperate Housewives,” a key plot point featured one of its title housewives diverting Ritalin from her ADD-diagnosed children in order to clean the house, pick up her kids from soccer practice, and just to more expediently do general housewifery (Cherry, 2004).  The raunchy and seminal Comedy Central animated satire “South Park” also took aim at ADD and Ritalin in an episode from its fourth season (Parker & Stone, 2000).  As of this writing, the center of the popular culture universe seems to be orbiting around the speculation that actor Charlie Sheen might be on drugs.
In 2009 Middlebury College President Emeritus and Amethyst Initiative founder John McCardell appeared on the “Colbert Report” to discuss his campaign for higher education to reconsider the 21 year-old drinking age.  The host, comedian/political satirist Stephen Colbert quipped “this is one of the things I worry about: if we have freshman in college drinking, that alcohol will mess up the Ritalin and Adderall they’re taking to study for their finals. And the Provigil.” (Hoskinson & Colbert, 2009).
Stimulant medications and prescription drugs have made inroads within contemporary popular music as well.  The popular Grammy Award-winning Philadelphia-based jazz/hip-hop band “The Roots” seemed to make a daft commentary about the state of American education, juxtaposing the Columbine school shooting and overmedicalization in their 2006 song “False Media” where they sing: “America’s lost somewhere inside of Littleton / Eleven million children are on Ritalin.” (Trotter, 2006).  And Ryan, a participant, cited mainstream rap/hip-hop mogul Lil’ Wayne’s song “I Feel Like Dying” where the rapper discusses “jumping off a mountain into a sea of Codeine” and “[feeling like] a prisoner locked up behind Xanax bars” (Carter, 2004).
Mental health also seems to be prevalent in popular culture.  There are currently at least three reality shows about hoarding, a mental disorder listed in the DSM related to obsessive compulsive disorder.  There are reality series’ about drug interventions and celebrities undergoing drug rehabilitation.  Anecdotally, ADHD has become commonplace in our cultural lexicon; it is used often as an everyday adjective applicable to anybody rather than as a specified learning disorder affecting some, as in, “I’m totally ADHD right now.”
Then there are films.  Gabe credited “Charlie Bartlett” for giving him the idea to try study drugs, which is a 2007 rated-R comedy satire about an affluent high school student who feigned various psychological disorders in order to receive a litany of medications that he could in turn trade to peers in-need for money and popularity (Poll, 2007).  The film was a limited-release and not hugely successful commercially, but it was well received critically[7], and with regards to relevant issues surrounding doctor shopping and medication diversion, it is a great satire.
Charlie Bartlett” is a cutting and surprisingly accurate lampoon of our therapy and prescription-happy culture, but its scenes involving drug diversion was more of a vehicle for other character-based plot points.  Still, from the standpoint of somebody researching this exact topic, I could not have envisioned a more relevant or topical studio film.  Then “Limitless” came out.
Limitless” is an action-drama that was wide-released in early 2011[8], and it represents the ultimate manifestation of the modern “enhancement” dilemma (Burger, 2011).  Limitless” follows a struggling writer protagonist whose life changes completely when he discovers an experimental drug called “NZT.”  The movie is of course fiction, bordering on science fiction, but it touches upon many of the same psychological issues experienced by students in this dissertation research (mainly dependence, withdrawal, extreme swings in perceived self-efficacy, etc.).  Limitless” is such a fitting modern allegory for the “Frankensteinian” cautions or Faustian pacts of human enhancement because its feature substance, NZT, represents the ultimate nootrope.
In “Limitless” NZT is introduced as a prototype designer drug concocted through a vague confluence between the pharmaceutical industry and underground street chemists[9].  One dose lasts about a day, is worth $800, and it is awesome: on it, users can recall any information they’ve ever seen, instantly grasp complex concepts, harness complete creative control, and basically perform any mental function flawlessly and quickly.  (Side effects of NZT include: awesomeness, violence, balling out of control, occasional prostitute murder, severe psychological dependence, withdrawal, crash like symptoms, sickness, and death.  It may or may not also make you sort-of a ninja).
The relevant question asked in all of this is: are we the same people when we’re on drugs?  We tell troubled addicts that they are not the same when they’re on drugs.  This can be dear friends, family, or just people we know.  Alcohol and drugs are a problem for them.  And they know it’s a problem for them—neither they nor others want them to be on drugs because it’s a problem.
But therein lies the dilemma with enhancement.  Outwardly, nobody knows if there’s a drug “problem” because the problem manifests in success with work, school, or relationships.  Nobody cares if you’re the same person on drugs or not, because that person kicks ass.  Only you know—or wonder—if you’re the same person on drugs.  Maybe you even think you’re a better person on drugs[10].
            This is probably a greater occupational concern for students, soldiers, and athletes who occupationally confront these competitive and career-determining pressures to medicate (or in soldiers’ case, life-determining).
Professional athletics remains one of the more prominent concurrent examples of enhancement being played out in the court of public opinion, especially major league baseball.  As of this writing, Barry Bonds was charged with obstruction of justice in the federal case against his use of illegal performance enhancement drugs (undetectable steroids and HGH), and Roger Clemens has yet to resolve his considerable legal troubles against federal prosecutors[11].  These are arguably two of the greatest players—Bonds as a hitter; Clemens a pitcher—in baseball history, and the specter of their probable drug use looms as a testament to the reach of enhancement’s appeal[12].
Baseball, like cycling and other sports, also has a rich tradition of amphetamine use.  But with high profile steroid and HGH cases like Bonds and Clemens dominating the discourse, over a hundred professional baseball players quietly filed for “therapeutic exemption clauses” to the MLB’s less-heralded 2005 ban on amphetamines.  In the season prior to this ban there were only 35 exemptions, of which 28 were for ADHD medications (Blum, 2008).  In 2008, 103 of 111 exempt players were using ADHD medications.  This can’t be coincidental, and yet relative to steroids, nobody really cares.  Though different contexts, therapeutic exemption clauses and 504 plans undeniably present a similar type of opportunity for advantageous gamesmanship[13].
During a San Francisco Giants broadcast on August 13, 2010, a local network field reporter talked about Giants outfielder Andres Torres: “Andres Torres was a track star in Puerto Rico, and says it took him a while to develop as a hitter, but there's another reason why he got it going late: he was diagnosed with ADD in 2002, but didn't start taking medication until 2007 during his second stint with the Tigers organization,” (CSN, 2010).  Looking at Torres’ career stats, his highest batting average prior to 2007 was .220 (168 at-bats in 59 games in 2003, which is not a lot), he then struggled in 2004, was subsequently demoted to play in the minor leagues for a couple years before returning to the major league (Detroit Tigers) in 2007, and then the Giants in 2009 where he batted .270.  Last season he batted .284[14].  Thus for guys like Torres, it’s possible Ritalin can make or save your career[15] (Torres’ 2010 salary was $428,000; in 2011 it is $2.2 million; ESPN, 2011).
College students clearly feel similar competitive pressures to medicate, with many reporting successful outcomes.  This begs the question of what exactly is “responsible” use when it comes to enhancement drugs?

[1] I’ve used several Time and Newsweek magazine covers featuring Ritalin, ADHD, and prescription drugs, and several TV news magazines have covered the issue as well, most recently 60 Minutes, with Katie Couric interviewing Alan DeSantis and several other researchers cited in this dissertation (Fager, 2010).
[2] Not to be confused with the opiate medication soma that is currently available on the market, though I suspect its etymology may come from Brave New World.
[3] Ironically, Huxley in real life became quite an advocate for the therapeutic and spiritual use of mescaline, chronicling his experiences with the drug in 1954’s The Doors of Perception (Elliott, 2003).
[4] Actress Brittany Murphy, musician “DJ AM”, and Comedian Greg Giraldo were also mentioned.
[5] Mainly presciption opiates, but alcohol and other illegal drugs are pretty constant.  Please don’t ask me how I know this.
[6] The ensuing controversy had many advertisers abandoning MTV and the show.
[7] It received a 56% positive rating on Rotten Tomatoes as of April 27, 2011 (, 2011).
[8] Serendipitously, I first caught wind of this development about a year ago, when my roommates got teamed up with Andrew Howard for 9 holes of golf at Griffith Park. (Howard played an Eastern European goon, arguably the movie's main bad guy).  He told them about his current project at the time—a movie about a miracle brain drug that grants super cognitive powers and turns lives around. They came home and said “Dude, I think they’re making a movie about your dissertation …”
[9] The small pills are about the size of a 20mg tablet of methylphenidate, only translucent, resembling those clear plastic rubber tabs that you stick on the inside of IKEA desk drawers to keep them from slamming.
[10] This is the central thesis in Carl Elliott’s “Better Than Well,” cited in the Literature Review and throughout this dissertation (Elliott, 2003).
[11] But it’s not looking good for “The Rocket.”
[12] On April 8, 2011, Tampa Bay Rays outfielder Manny Ramirez announced his sudden retirement from baseball after his third positive test for banned substances. Ramirez was issued a 50-game suspension after his second positive test as a member of the Dodgers in 2009-10, and rather than receive the 100-game suspension for the failed third test, he retired.  Sports critics widely speculated that Ramirez—widely regarded as one of the greatest right-handed hitters ever—has no chance to be voted into baseball’s Hall of Fame despite career statistics that would otherwise merit near-automatic induction (Stark, Rojas, & Padilla, 2011).
[13] Maybe not quite though.  If the medical exemption clause was truly like 504-plans, then Andres Torres, Texas Rangers All-Star Ian Kinsler, and the over 100 other exempt players would be given four and a half strikes instead of three.
[14] Which is relatively good, or at least vastly improved from his early career numbers.  Batting averages represent percentages of at-bats that are hits, thus a .284 means that Torres safely reached base 28.4 percent of his at-bats.  Batting around or above .300 is statistically considered very good, potentially all-star worthy.
[15] And all you have to do is tell a doctor you can’t concentrate?  Who wouldn't do that?  (Footnote-footnote: I first wrote this piece of discussion as a blog entry in August focusing on Torres and Kinsler; serendipitously, both teams later reached the 2010 World Series, which the Giants won).

Friday, August 12, 2011

Drug blog back from break!

I think I've started the past few entries by apologizing for being such an irregular blogger ... that streak ends here!  Dissertating is not easy, but it is (almost) over.  Here's the deal: it's been an intense past few month stretch, I defended (!), graduated (!!), but have yet to formally file.  For those as unfamiliar with the idiosyncrasies of academia as I apparently was, in order to officially get my degree (as in the actual, physical piece of parchment), a finished dissertation has to be officially "filed" where it is meticulously checked page by page with a microscope by a librarian.  This process, according to a friend and recent graduate is "a total pain in the ass."

So I'm looking forward to that soon.  I have a bunch of blogs saved up on my hard drive (cloud? Never!) and many of them are about sensitive academic politics.  For my friends and most nerds, such juicy gossip and commiseration would likely be welcome.  But I'd like to wait until I actually get my degree before griping on a public blog about university policies and people who still hold my future in their hands.  Plus, c'mon, as much as I attempt to anonymize myself and human subjects, I'm barely anonymous.  In fact, I think my Android phone may have automatically outed me via Google+.

So drug blog posts ripping on the dissertation process will have to wait until later.  And though the dissie is almost done, this blog is not.  I had 645 pages of pharmacological poetry that I whittled down to 250, that extra type will end up here for sure.  A look at entries/deleted chapters to come:

- Conference feedback: "I can't believe he didn't know about bath salts!"
- What we can all learn from 4 1/2 episodes of "Intervention"
- Weed law changes: watch out, Chico!
- I got a new job! (hopeful entry)

Monday, June 20, 2011

"Can I have my drugs now?"

After so many years of writing for the Daily Bruin, I wrote my final column a few weeks ago about the culmination of my research to date.  Below is my version, which I think the editors tweaked a little (and made up their own (inferior) headline) for the version found online here:


Four years ago I started researching students who used drugs like Adderall and Ritalin for academic purposes.  Maybe you’ve seen my flyers around campus or have a friend who was actually brave enough to sit down with me and let me interview them.
This project became my dissertation, which is almost finished, as is my time at UCLA.  But if I could summarize the culmination of my graduate education into a single bold statement/prediction, it would be that college students really like their drugs, and see no compelling reason to stop doing anything that they see as potentially enabling their success.
Before I go any further, I want to apologize in advance to anybody who reads this and was previously unaware of the dilemma of cognitive enhancement.  It’s the kind of topic that makes any prevention-oriented research self-defeating, since the idea alone of a drug with academic utility is bound to be virally appealing in fiercely competitive climates like UCLA.
In other words, how can I, or any researcher, talk truthfully about cognitive enhancement in the name of prevention or “responsibility” without making it sound appealing to anybody?
It’s not for everybody.  Stimulant medications are controlled substances with physiological, psychological, and legal risks.  But the truth is that many college students feel that the associated risks are far outweighed by the academic benefits of use.  What’s even more problematic is that research doesn’t completely disagree.
Concern over collegiate “cognitive enhancement” is nothing new, but higher education has done little since ADHD-diagnosed students first began bringing their renewable Ritalin prescriptions to college in the mid 1990s.  Word quickly got out that there was something “better” than coffee.
National databases on collegiate substance abuse put non-medical use of stimulant medications at around 8%, which doesn’t include the approximately 7.5% of American students diagnosed with ADHD.  Independent studies conducted on college campuses report illicit use prevalence at 25% and as high as 34%, with over half of upperclassmen and students in Greek life having used prescription stimulants.
From The Beatles and Elvis to JFK and Hitler, speed scares are not without historical precedent.  Desoxyn and Pervitin were used heavily by both allied and axis military soldiers in World War II, (Provigil and Adderall are still used today by British forces and Air Force pilots).  The then over-the-counter stimulant Benzedrine allowed Jack Kerouac to pen “On the Road” in 20 days, while domestic use of amphetamine pills were immortalized in the Rolling Stones’ song “Mother’s Little Helper."
Two things separate this generation of stimulant use from the past: medical sophistication and the advent of ADHD.  Today’s drugs are better, and we’re vastly more knowledgeable about what they do.  Leading clinical researchers and bioethicists have recently started conceding that these drugs may actually work, leading to real gains in concentration, memory, and sustained cognitive performance.
ADHD is a different kind of game changer in that it medically legitimizes the everyday use of amphetamines for a relatively broad swath of the population.  This separates our current dilemma with prescription amphetamines over controversies in past decades.
Despite skepticism from conservative pundits, the Church of Scientology, and my dad, ADHD is a real condition with real genetic determinants.  It is about 70% heritable, which is as much as height, or blood pressure.  But this doesn’t mean that our diagnostic system isn’t flawed.  Many savvy, opportunistic students and parents have been known to feign ADHD symptoms just to seek medications.  This is called “doctor shopping.”
I certainly saw some of this in my own research, but it was surprising to see how the situation with unstoppable drug-seeking behavior mirrored the burgeoning medical cannabis scene that erupted throughout Los Angeles over the past several years.
I recruited students who used “any drug” for academic purposes, and to my surprise, many inquired about using marijuana and salvia (which is currently legal) for creative purposes.
Whether you find the premise of creativity-enhancing drug use plausible or not, there is an historical precedent for that too.  Literary greats generally preferred booze, but prolific drug using artists and intellectuals included the beat poets and bebop jazz generation, Francis Crick, Aldous Huxley, and again, The Beatles.
As seen with medical cannabis, some drug policies seem to be in flux, or at least newly reopen to public debate.  Distinguishing what’s legal or illegal, however, isn’t as important as what’s “responsible” or “moderate,” and it may be moot if anybody can get what they want, whenever they want.  We may be there already.

Wednesday, April 20, 2011

4-20 Special: Why ADHD meds are better than weed ... to deal

The following is an excerpt from my "Discussion/Conclusion" chapter.  It being April 20th today, a doobieous day for so many college students, I thought it appropriate to post some of my findings related to cannabis use.  This piece discusses the financial incentives for a prospective dealer of ADHD medications (controversial!), and concludes that if you're a weed dealer on a college campus, you're in the wrong game (even more controversial!).  Enjoy.

There are several advantages to quasi-licit use achieved through doctor shopping. First of all, it’s legal. Second, it’s safe; you know what you’re getting. The “safety” of dealing stimulant medications is not a concern to begin with, but several illicit users had concerns about what they were taking. This is not to say that illicit drug diversion can’t be dangerous or “sketchy.” As seen with “operation sudden dawn” and “operation Ivy league” with the experiences of several participants, dealers of illicit medications may be the same dealers who peddle more dangerous street drugs. Sometimes interactions can be unsafe, or the products can be of questionable. Getting it from a doctor is cheaper, more convenient, and certainly safer.

Another advantage is simply having a consistent, reliable, and price-controlled source. Especially with health insurance, nootropic medications obtained directly through pharmacies are much cheaper than typical WCU illicit market prices. Looking closely at the specific price differences, it’s easy to see why savvy or entrepreneurial students would consider feigning ADHD symptoms for profit, rather than (or in addition to) primarily for their own personal use.

For example, student patients with the WCU student health insurance plan can fill a prescription for 30 20mg pills of generic methylphenidate or dextroamphetamine for $15; $30 if they choose the drugs by their respective name brands, Ritalin and Adderall (citation omitted). Considering that illicit users seldom discern what they take, let’s assume that the profit-motivated hypothetical dealer opts for generics: $15 for 30 pills. Students quoted many prices for a single Adderall or Ritalin pill, depending in part on potency (mg) and release formulation. Just to control for this hypothetical example though, an oft-quoted average price was $5 (even though Mike reported selling Adderall at peak times for as much as $30 for a single pill). A student could therefore resell his/her $15 prescription for $150—a ten-fold markup. A patient could refill this prescription monthly, bi-weekly, or even more frequently, depending on the patient and prescribing physician. If you factor in higher prices for higher dosages or extended-release formulations, or varying market dynamics (read: finals), diverting ADHD medications in college can be extremely lucrative.

This study echoes earlier research callings to urge student health centers to exercise extreme caution, both when diagnosing ADHD, and when prescribing treatment medications (Harrison & Rosenblum, 2010). With on-campus pharmacies at many large universities offering even better price discounts, dealing could hardly be more convenient or profitable.

Being college students, cost is a huge barrier for many. A lot of participants found the prices of Adderall prohibitive; for many it was the same with weed. Unlike stimulant medications however, most insurers do not cover medical cannabis, and the illicit market value of marijuana is nearly identical to its store price (at least it’s nothing close to the approximately 1000% markup hypothetically outlined). This offers relatively little financial incentive for prospective dealers to consider diverting medical marijuana over ADHD medications, and considering that medications are small, concealable, logistically easier to divert, with very little perceived concern among dealers getting caught. All of this amounts to arguable advantage for licit users, who include doctor-shoppers-turned-dealers of ADHD medications.