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William White's Response to Cliff Anderson's Rebuttal: "The Bad News Isn't In"

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William White's Response to Cliff Anderson's Rebuttal: "The Bad News Isn't In"

(Quoting Earth of Erowid) I will spare you the full history of White's 1998 "Bad News" article (marked with version number 0.1), but it has always been considered somewhat shaky. Cliff Anderson's rebuttal article stated what a lot of people had discovered: the evidence for NAN (olney's lesions) type damage from DXM was very weak and largely speculative.

William White has now formally retracted his findings from his 1998 article
and responds to Cliff Anderson:

"Response to 'The Bad News Isn't In': Please Pass the Crow"

http://www.erowid.org/chemicals/dxm/dxm_health3.shtml

Response to "The Bad News Isn't In":
Please Pass the Crow
by William E. White
v1.1 - Dec 28, 2004

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Citation: William WE. "Response to 'The Bad News Isn't In': Please Pass the Crow" Erowid.org, Dec 2004: http://www.erowid.org/chemicals/dxm/dxm_health3.shtml.

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This is a response to Cliff Anderson's rebuttal1 to the NMDA antagonist neurotoxicity paper I published online years ago2, and a retraction of my original claims. As this is intended as informal commentary, the style is somewhat free form.


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General comments
I feel I should explain where I went wrong. Although I do not believe this explanation excuses the mistakes I made, you do speculate about my motivations, so I think it fair to respond to that. When I published the NAN argument -- which you rightly critique -- I did not, as you suggest, believe I suffered cognitive impairment or lasting psychosis from DXM use. I do appreciate that you dismissed the possibility of fraud; it has always been important to me to provide accurate and balanced information. I failed to do so, in this case, and am quite ashamed of that.

Four unrelated events occurred in the six months prior to publishing the NAN warning. First, I received an influx of reports of lasting cognitive impairment from DXM users (in retrospect, of course, I realize they were not sufficient for the conclusions I drew). Second, I was contacted by several very vocal critics of the DXM FAQ, two of whom were angry enough to make threats. Third, I discovered that adolescents were making extensive use of DXM and misunderstanding, if not dismissing outright, some of the more measured warnings in the FAQ. In response I made the classic drug war blunder: if they aren't listening, try scaring them. Fourth, and perhaps most influential, I was experiencing a hypomanic episode and did not recognize either it or the mistakes I was making (I do not know whether DXM triggered the episode itself, though when I was diagnosed as bipolar, I had long ceased DXM use and history prior to DXM use was considered relevant).

"Certainly, the more I've learned on the subject, the more painfully aware I've become of how limited our knowledge is."
-- William E. White
Even at the time I expected a critique or rebuttal from the community; the only one I recall receiving was to the claim that nitrous oxide was an NMDA antagonist. I found this quite surprising. I should have submitted the paper to others for review prior to publication online, just as I did with the FAQ itself.


Specific comments
In reference to the sudden increase from the three reports of impairment from DXM to "dozens": Some were from people (largely ketamine and PCP users) answering questions about dissociative use and cognitive impairment. The rest were solicited responses to the FAQ feedback form. As such they are useless as evidence, being both insufficient in number and obviously biased.


In reference to anticholinergics: that was pure sloppiness in note-taking. I reread the original papers I kept on the subject and made a mistake.


In reference to education: I wish I could plead ignorance in this case, but I have had sufficient formal education in logic, statistics, and research to know better.


In reference to the tone of the paper: The original publication was on Usenet, and I attempted simultaneously to act as an authority on a subject, and an average Usenet poster in a common, if indefensible, style of that time (i.e., make ridiculously aggressive claims and wait for rebuttal). Yet another mistake I do not intend to repeat.


My current position
"I would not use dissociatives at high doses for extended periods of time, and I think people would do best to avoid frequent or heavy use of dissociatives entirely."
-- William E. White
I do not have sufficient evidence to state any conclusion on the subject beyond what's obviously available in published literature (i.e., NAN occurs in lab rats). Clearly some dissociative users show lasting impairment, and that's worth noting, but concluding NAN is involved is premature. If long-term impairments following dissociative use seems consistent with the speculated functions of the brain regions affected by NAN, there's no sound reason to believe it's anything beyond coincidence.

Certainly, the more I've learned on the subject, the more painfully aware I've become of how limited our knowledge is. Until I have sufficient means to resume my formal education -- and assuming I have not burned too many bridges to do so -- my own knowledge will be second-hand at best, coming from published material and communication with those doing the actual research.

Having reviewed the risks of dissociative use, what is known of those risks, and the reports -- worthless for drawing conclusions, yet still interesting -- from people claiming to suffer long-term impairment from dissociatives, I would not use dissociatives at high doses for extended periods of time, and I think people would do best to avoid frequent or heavy use of dissociatives entirely. Whether due to NAN or not, I find it plausible that impairment due to dissociative use may reappear, or only become apparent, many years after use, i.e., after gradual age-related neuron loss.


References
White WE. "This is Your Brain on Dissociatives: The Bad News is Finally In." Originally published on Frognet, now hosted on Erowid.org. Version 0.1 - 11/28/1998: http://www.erowid.org/chemicals/dxm/dxm_health1.shtml.
Anderson C. "The Bad News Isn't In: A Look at Evidence for Specific Mechanisms of Dissociative-Induced Brain Damage and Cognitive Impairment." Erowid.org, Jun 2003: http://www.erowid.org/chemicals/dxm/dxm_health2.shtml.
 
Clearly some dissociative users show lasting impairment, and that's worth noting, but concluding NAN is involved is premature.

Whether due to NAN or not, I find it plausible that impairment due to dissociative use may reappear, or only become apparent, many years after use, i.e., after gradual age-related neuron loss.

It seems from those two statements he's not retracting that dissociatives can cause lasting impairment he's just retracting that NAN is the cause.
 
I think it is a pretty safe bet that dissociatives can cause
lasting impairment. It is definitely possible to build
irreversible tolerence to them.

I, for example, have to take more than 1.2 grams to achieve
any effect at all from DXM! I suppose you can call that an
impairment of sorts. lol, my ability to get fried has been
impaired!!! :)


-Maitland
 
I don't think he made a mistake before. He pretty much said:

NMDA Antagonists, including DXM, are known to cause mild to severe impairment in long-term high-dose users. NMDA Antagonists, including DXM, are known to cause Olney's Lesions in lab rats. Therefore, it is possible that the impairment is caused by NAN. And if we believe that DXM causes impairment, the question is if unnoticable impairment occurs at lower doses and lower frequencies, and if this will cause problems later in life. And he said that this question has been unanswered, and thus it is possible that even single use of DXM is bad for your brain.

I think he was correct, and I don't think he needs to apologise. It is prudent to think that if something bad happens when you give a drug to a rat, it may happen to humans as well. And it is prudent to realise that there are dissociative users who are highly impaired, and to question if lesser impairment occurs at lesser doses.
 
I have always considered DXM a risky pursuit when chasing doses in the hundreds of milligrams. However my opinion on this is no different to most pharmaceuticals. That being where measurements are used on animals 10x what the therapeutically accepted amount, ofcourse there are going to be complications! This is especially true where the regimen is repeated daily for several weeks without allowing the bodys repair mechanisms a window pane of opportunity to cope with the damage inflicted.
 
After reading the post on this same topic in psydrugs, I take some of my words back. Walkaway provides a good reason to believe that DXM is not as bad for you as I thought it was and White implied it was (NAN has never been shown in primates even with very toxic research chemical NMDA antagonists, and Walkaway also gives some anecdotal evidence).

However, I will still put drugs like ketamine, DXM, and PCP in the same place as MDMA. It may cause damage in some people, it may not cause damage in some people. I personally have seen cases of people who did too much too often, and now have HPPD or other impairments. I also have heard of people who do a shitload and have no problems. We just don't know enough. And if you are willing to explore, kudos to you. Just recognise that it is not like psylocibin of LSD or marijuana where study after study has consistantly failed to show any neurotoxicity.

But, I was a little mislead by White's last paper, and it is good that this has been cleared up. I'm just kinda worried that some kids will think this is a green light to mess with NMDA antagonists and think its definately safe.
 
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