Conference Report:
American Public Health Association Conference
Boston, November 2006
Jul 19, 2007
Citation: Lux. "American Public Health Association Conference" Erowid.org. Jun 2007. Erowid.org/conferences/conference_apha2.shtml
The Conference
I staffed the Erowid conference booth at the American Public Health Association's annual convention from Monday, November 6 through Wednesday, November 8, 2006. There were a couple hundred other booths representing higher education, government agencies, advocacy groups, medical suppliers, and so forth. The Erowid booth was in a good spot near the main entrance and slightly off to the side, and we experienced a steady flow of traffic. During peak hours there were probably 3-5 people walking by the booth at any given time. Early and late in the day, that dropped to 1-2.
My anecdotal impression is that most attendees were unfamiliar with our site. Many people walked by and peered with a slightly puzzled expression at the slide show of site pictures we had running on an LCD display monitor. I took this to be an attempt to figure out who we were. Spoon and I, along with other booth volunteers from the Erowid crew, offered blurbs of varying length to passers-by. My spiel usually began with something like this:
"Erowid is an online library and resource center that hosts information pertaining to psychoactive plants and chemicals. We get about 50,000 users a day, ranging from clinical toxicologists to doctors to academicians to curious college students."As the conference progressed, I started volunteering that we are not an advocacy group, and that our mission is to make available as much reliable and high-quality information as possible without fee. I added this in response to the fact that I was often asked if we were pro-legalization, or an advocacy group. My sense is that this was so frequently asked for two reasons: 1) people were trying to figure out what we were doing there, i.e. "what are you selling?" 2) two medical marijuana advocacy groups, MPP and Americans for Safe Access, also had booths at the conference.
Roughly 50-70% of conversations ended with the blurb. Some people stayed on for lengthier conversations. Most were information-gathering and relatively friendly. I would only characterize a single interaction as in any way antagonistic. That was a conversation both Spoon and I had with a nurse who seemed very concerned that her teenage children might gain access to harmful information through sites such as ours. She seemed a little agitated, but was courteous and seemed to leave on a moderately-positive note, agreeing that the questions regarding access to information are complex.
Some Conversations of Note
Many of the people I had longer conversations had previous knowledge of Erowid from their personal lives, and some had even contacted us regarding this or that. I had a lengthy talk with an ethnobotanist who had studied the use of medicinal plants by indigenous peoples in Venezuela. We talked quite a bit about Wasson's work, and he told me with obvious pleasure that he had heard recordings of Maria Sabina chanting.
I had a long conversation with a teacher from Iowa University who teaches a class in drug use to undergraduates. She was very interested in our site and in potentially using it for the class. She reports that her students are zealous and unguarded advocates of their drugs of choice, which are largely alcohol and pot, with some abuse of prescription medication, and a tiny minority of self-identified artists opting for hallucinogens. I asked what she would like people to be more aware of in general, and she said these kids have no sense of the relative risks of different substances. They assume they can start and stop any substance, any time.
I spoke with a representative of a Cancer Institute who asked many, many questions and seemed very interested in and supportive of our work. She suggested that if we go to further trade shows, we might seek funding from the AACC, if we can tie what we're doing specifically to public heatlh.
We had a long conversation with Dr. Bill Sanders of the Children's Hospital, Los Angeles. Spoon ended up catching part of his presentation. He had administered questionnaires to a number of transient homeless teens in LA querying them about their drug use patterns. For each substance that teens reported taking, they had a single, open-ended question asking "What was it like?" On the basis of the experience reports they collected, Dr. Sanders concluded that these kids were not only unable to differentiate drug effects among phenethylamines and tryptamines in their reports, but were unable to differentiate the drug effects altogether. When questioned, he agreed that yes, this means that these kids can't tell the difference between 2C-B and DMT.
I was shocked, and tried to persuade him that he would benefit from both a clearer understanding of the language of drug users, and from a more structured instrument. I gave him a copy of the Erowid Extracts issue with the article on good self-reporting, and I offered to refer him to a hallucinogens survey that had been designed specifically to disambiguate different substances on the basis of reported experience.
NIDA
Our booth was located directly across the aisle from the National Institute on Drug Abuse (NIDA) booth, which several people noted with good humor. The aisle was wide and the corner crowded with other booths, so it did not seem a big deal. The NIDA booth was staffed by two women in their 50s or 60s. They had quite a bit of literature that they were handing out. They looked across the aisle with what I took to be a mild air of concern and curiosity a few times, but did not say anything.
I listened to them give their spiel a couple of times. Some of their oft-repeated bullet points were:
- NIDA's mission is neutral research, and the organization has no advocacy position or political agenda at all
- Research has recently found that the brains of young people (under 25) are not fully mature in the areas that pertain to caution and careful thinking. Many young people therefore get involved with drug use because "their brakes don't work"
- Drugs are comparable to a "dream machine" that people use, not knowing about the clearly-established harms
- Kids mistakenly believe that MDMA is a "safe" drug (see The Myth that Ecstasy Users Think Ecstasy is Safe for Erowid's rebuttal to this claim).
I asked her if she was aware of any noteworhty trends in drug use, such as an increases in use of DXM, for example. She referred me to their DXM literature without comment. I also mentioned that I had noticed a lot of newspaper articles on Salvia divinorum and had been wondering about the attention it seems to be getting; again, she had no particular comment.
I asked her about NIDA and she explained their charter, and their relationship to some of the other Federal agencies like the DEA and SAMHSA. She explained that NIDA is essentially the "research wing", and is often involved with other agencies in joint projects.
I asked her about her own background with NIDA, and she told me that in essence she works as a trade show employee.
I offered her a copy of Fire's writeup of Erowid's participation in the NIDA conference in 2002, which she took and read through. I also gave her a copy of a paper that Earth and Fire had delivered recently at a Toxicologist's Conference called "Straddling a Very Tall Fence".
Later that day I spoke at some length with her colleague, who said the her colleague had alerted her to who we were. We began talking and quickly entered an area of disagreement regarding the neurotoxicity of MDMA. I led with the assertion that the clinical research is inconclusive, which she clearly interpreted as me saying MDMA is completely safe, effectively advocating its use. She showed me slides of a Ricaurte MDMA animal study and said that the research is clear – MDMA is harmful.
When I mentioned that there might be problems of reliability with Ricarte's work (see Major Error in Ecstasy Research), she argued that NIDA had carefully reviewed his work, and "although Ricaurte withdrew his work on DOPAMINE for reasons that are unclear, his work on SEROTONIN still stands."
It was obvious I wasn't going to get anywhere with that debate, so I switched gears and asked questions, trying to understand where she was coming from. She pressed their MDMA document in my hand. When I read it a few hours later, I noted with some amusement and incredulity that the second paragraph of their document states "In humans, the research [regarding MDMA neurotoxicity] is not conclusive at this time".
For another perspective on the conference, see Erowid at the APHA Association Meeting & Exhibition.