pinwheel, to clarify, by dopamine/sigma agents i meant, as the original article stated, anti-psychotics ("major tranquilizers") such as haloperidol. not coke.
it's true we shouldn't be criticizing White's motives, since that constitutes an argument ad hominem; we can only criticize his data. so let's do that.
i'm turning the caps on now.
In my opinion, White's article contains two major types of statements which can reasonably be held suspect: interpretation and prediction of possible consequences based on existing research, and the use of a random sample of DXM users to examine the ill effects.
Interpretation and Questionable Synthesis
Very frequently, White synthesizes a conclusion from several sources of data independently, and therefore arrives at a conclusion supported only by logic, with no material evidence of its own. A particularly dangerous example of this is his recommendation that DXM should be taken at most at intervals of one week per plateau, ketamine once per two weeks, and so on. I e-mailed him about that once, and he replied that no user who had done DXM or K that often or less often had reported long-term negative effects. The conclusion makes sense--he's being reasonable, and knows that people won't do the drugs once every 6 months, but there is no research that supports his claim (or any research that suggests a definition for "frequent" dissociative use, afaik).
There's several other examples, such as where he warns you not to drive on DXM, and the entire section on frontal lobe lability. While it is true that these paragraphs do inform the user of a *possible* risk, no supporting evidence is given. Not driving on DXM, of course, should be obvious, though White does assume the responsibility of informing a population that might not find it so obvious. The part on frontal lobe seizures, however, is a bit less scientific. He admits that his belief that DXM may cause frontal lobe lability is based entirely on the fact that DXM can induce similar symptoms. He does not say that DXM *causes* frontal lobe lability, just that it can produce symptoms similar to it--but a casual reader could easily read the paragraph as "DXM causes seizures" and go around informing ravers of the fact while advocating that E is harmless if you close your eyes when you swallow the pill.
Another example is the assumption than yohimbine, an alpha-2 antagonist, is highly dangerous because alpha-2 agonists are neuroprotective. There may be evidence on that subject, but it seems like that one, as well as several of the other risky combinations, are based on speculation. Which is fine - I'd strongly discourage mixing two drugs based on mere speculation as well, but it shouldn't be held as concrete evidence that the combination is dangerous.
Extrapolating risk from a sample
White frequently draws on the experiences of users who have informed him of negative effects they experienced from dissociatives. While I certainly believe there is a place for anecdotal information in an area where no statistically sound sampling has taken place, I do not agree that the information should be taken as fact.
To put it simply, anecdotal evidence is emotional, not scientific. As an example, a local paper ran a story about an E overdose on the front page with the headline "NO MORE DEAD TEENS!". This was, in effect, an anecdotal report arguing that MDMA is a highly dangerous drug that frequently causes death. Such reports--taking the case of one individual, and extrapolating their experience as if it were universal, or common--are frequently used by the media and tend to make phenomena seem far more common than they actually are.
A more scientific report of that death would compare the rate of MDMA use with the rate of deaths caused by MDMA. If something unusual had happened, they would report it as unusual; if the person had died bleeding from every orifice, a scientific journal would stress that this particular MDMA death was different than the usual kind of MDMA death, rather than saying "take E and you'll die bleeding from your eyes" as one UK paper basically did. Moreover, the mainstream media will never, never report that thousands, perhaps tens of thousands, of people in the city did E the same night and felt no ill effects.
White's article, in a way, is victim to this kind of argument. Sometimes he makes percent statements, e.g. "5% of regular DXM users in my sample". But this is the problem - how many people are emailing him to say they've never felt psychotic? How many of those who have felt psychotic have neglected to mention they're also occasional cocaine users (as an example)?
Essentially, White's sample could be biased towards negative effects, because people who have experience a negative effect are far more likely to inform him of that than those who have not. There is a place for his kind of sample - it's effective at suggesting what POSSIBLE side effects DXM might have - but it cannot evaluate their frequency. It's not a flaw of White's reasoning, it's an inadequacy of his resources, and a full statistically supported study should certainly be performed.
To understand the real prevalence of the risks of dissociatives as experience by users (it must be noted that there may be long-term effects which have not yet manifested, or which the user has not noticed), a random sample of users must be taken. Each user must be classified according to frequency of use. It must be determined what other drugs they use, to ensure that they are not mistaking the effects of the dissociative for the effect of another drug. Questions must be carefully worded to avoid leading questions, since many people will hear a symptom mentioned and think "hey, that's me", even though they hadn't previously noticed it to be a problem. This might be done by including effects which are known NOT to be caused by DXM - I once read a study on the effects of marijuana that had some rather funny (and some more subtle) questions intended to exclude users who claimed to have effects they didn't actually experience.
One final thing - dissociatives in TBD seem to have far more negative effects than they do in scientific articles.
I'll stop here now.. In conclusion, meanin' no disrespect. TBD can probably do far more good than any dissection or rebuttal I could come up with; don't read my statements as "dissociatives don't do X" because I said that White can't conclusively state that dissociatives do X. Correlation is not causation. Lack of conclusive evidence does not mean a phenomenon does not exist.
