The West African Ebola Outbreak As A Science Communication Challenge & Opportunity

I had the honor of speaking to a science communications seminar class at the North Carolina School of Science & Mathematics, recently described by Dave Dewitt at our NPR affiliate as, “[C]reated 35 years ago for serious NC students with grand aspirations. It was the first residential school of its kind in the country, and it’s public. The course catalog rivals many major universities, with classes in robotics, biomedical engineering, and astrophysics.”

Dean of Science, Dr. Amy Shenk, invited me to talk about the Ebola Virus Disease outbreak ongoing in west Africa in terms of its challenges to public science communication. I’ve put together my collection of stories written in my role as a contributor to the Pharma & Healthcare section of Forbes.com. With my training as a pharmacologist, I naturally focus on what drugs are in development to treat the potentially fatal disease. But what I’ve learned is that drugs have little use if a health system lacks infrastructure to even monitor blood or administer intravenous electrolytes.

General thought questions

What do you know about Ebola hemorrhagic fever (now called Ebola Virus Disease, or EVD)?

What were you thinking when news of the outbreak first broke?

What did you think about bringing infected U.S. missionaries to Atlanta for care?

What message might this send to the people of west Africa?

Where did science communication go wrong? Where did it go right?

 

For the following articles:

Which of these do you think have particularly high value (or low value!) in communicating the complexity of the Ebola situation to the general public.

Does the simple listing of facts lead to understanding, addressing legitimate concerns?

What ethical issues does the use of experimental Ebola drugs raise that present a general science communication opportunity?

Kroll Ebola articles at Forbes

Do We Have Any Drugs To Treat Ebola? – 29 July 2014

Should We Be Concerned About American Ebola Patients Coming To Emory Hospital? – 1 August 2014

Ebola ‘Secret Serum': Small Biopharma, The Army, And Big Tobacco – 5 August 2014

FDA Moves On Tekmira’s Ebola Drug While Sarepta’s Sits Unused – 7 August 2014

Beware Of Fake Ebola Supplements – 14 August 2014

American Missionaries Cured of Ebola Infections; Brantly: ‘Today Is A Miraculous Day’ - 21 August 2014

How Will We Know If The Ebola Drugs Worked? – 26 August 2014

NIAID/GSK Ebola Vaccines To Enter US, UK Human Safety Trials – 28 August 2014

BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks’ – 29 August 2014

WHO Ebola Drug Panel: Use Survivor Serum To Treat Ebola Victims – 5 September 2014

Gates Foundation Commits $50 Million To Ebola Containment Efforts – 10 September 2014

Cuba Responds To Ebola Crisis As Black Market For Convalescent Serum Emerges – 12 September 2014

CDC Ramps Up Ebola Worker Training In Advance Of Obama Announcement – 16 September 2014

 

Explaining the drugs, informed consent

Ebola, Experimental Drugs and Informed Consent: Should Those At Risk Simply Take The Doctors Orders? – by Elaine Schattner – 31 August 2014

 

Vaccines and public health – Another science communications challenge 

Final, somewhat unrelated issue on science communications relative to tomorrow’s NOVA documentary on vaccines: The need for humility in public health communications, by Dr. Brian Zikland-Fisher of the University of Michigan. The polarization of vaccine attitudes, regardless of scientific facts, requires a middle ground where people can have legitimate concerns addressed.

  • We must acknowledge that each parent has the right and the authority to make his or her own choices, and that it is our failing (either in the quality of our vaccines or the persuasiveness of our message), not theirs, if we have failed to convince them that vaccination is the better choice.

  • We must acknowledge that we have the best chance of convincing a skeptical public when we put the weaknesses of our arguments and the risks of our interventions front and center and acknowledge the fears that they evoke.

It may seem counterintuitive, but embracing humility may be the best thing we can do. Humility will build trust in those who believe (sometimes accurately) that we are not telling the whole story. Humility might resonate with those parents who genuinely want to do right by their children but have not been convinced by “the facts.”

Kroll LIVE at Durham’s Intrepid Life Coffee & Spirits – Friday, May 9 – 9:00 PM

Click on the image to  download the full-size version of this flyer for posting and dissemination.

Click on the image to download the full-size version of this flyer for posting and dissemination.

I’m excited to announce that my 2014 spring tour of the three-county, Research Triangle region will kick off this Friday night at Intrepid Life Coffee & Spirits on Historic West Parrish Street in downtown Durham. I’ll start around 9:00 pm and play two, 75-minute sets.

I’ll be playing many of your old Dogs in the Yard classics from my band in Denver as well as some new and not-so-new original compositions. I’ve also gotten really excited about playing other great local music I’ve heard around the Triangle and on my last trip to Denver for the Association of Health Care Journalists meeting in late March (where I also had a nice night of jamming with Dan and Jay from the Dogs).

I’m particularly excited to be playing at Intrepid Life, my go-to coffee shop for business meetings in Durham. You’ve probably heard the story about the owner, Matt Victoriano, a Marine combat veteran who served two tours in Iraq.

He was first interviewed by WBUR’s Here and Now in Charlotte at the 2012 Democratic National Convention, where he had visions of opening a brewpub. Plans changed – not the least of it due to the challenges of small business loans for returning veterans – and we were fortunate that he chose Durham to open Intrepid Life Coffee & Spirits Bar.

The updated version of Matt’s story came earlier this year when Here and Now’s Robin Young caught up with him to check in. When I heard this story, I was impressed that the owner of Joe Van Gogh coffee roasters in Hillsborough loaned Matt equipment to get the place off the ground, instead of just thanking him for his service to the country.

So I emailed Matt when he opened the place and offered to play for free pretty much anytime to do my part to support his mission to advocate for veterans and progressive non-profits in his community space. Editor Lisa Sorg describes the vibe perfectly in her INDY Week piece last month.

So even if you don’t come to hear my sets, I encourage you to drop by Intrepid Life this Friday night, or anytime. If you can’t find street parking, you can try the city lot by Rue Cler and the Post Office, then just walk through Orange Street past Phoebe Lawless’s Scratch bakery.

I have a soft spot for people with the guts to volunteer their lives to serve in the military for this country. My Dad was a Marine and Heather’s been working at the VA hospital in Durham for almost two years. And my longtime Texas songwriting idol, Darden Smith, has been using his musical prowess to help veterans process their emotions through songwriting retreats – a project appropriately called SongwritingWith:Soldiers.

Matt has made an investment in our community so I hope that we can all make an investment in him – and in downtown Durham.

 

Elion-Hitchings Building Tour

  1. As discussed in my post last week, I had the opportunity on Saturday to tour the old Burroughs-Wellcome US headquarters building in Research Triangle Park, NC. Designed in 1969 by architect Paul Rudolph, the building was completed in 1972. The building became known as the Elion-Hitchings Building after BW scientists Trudy Elion and George Hitchings shared the 1988 Nobel Prize in Physiology or Medicine with Sir James Black.

    The building was acquired by Glaxo when they merged with Wellcome in 1995 (Glaxo had built its US headquarters in RTP in 1983, just north of the BW property.).

    Now GlaxoSmithKline (GSK), the company began liquidating buildings and consumer products over the last two years. When they announced their intent to sell the Elion-Hitchings Building in April, 2011, I suggested that someone purchase it to fashion into hipster condominiums. My hopes were dashed when United Therapeutics purchased it and two other buildings for $17.5 million in late June of this year. United Therapeutics has a 55-acre lot adjacent to the GSK property where they’ve constructed a new headquarters building of their own.

    What follows is a Storify compilation of my tweets from Saturday with photos that I sent out. I’ll post other photos later.

  2. davidkroll
    Triangle folks: You can still come to tour the Elion-Hitchings Bldg in RTP today 9:00 – 12:40 for $15 at door http://bit.ly/T5YrxE
  3. davidkroll
    Just arrived at former GSK-held Elion-Hitchings Bldg, now owned by United Therapeutics. http://pic.twitter.com/qOiH8kf7
  4. sciencegeist
    @davidkroll It looks like the building is held up by giant lab jacks
  5. davidkroll
    You can’t erase the GSK. Logo outline on frosted glass. #elionhitchings http://pic.twitter.com/RiJPqN3a
  6. davidkroll
    I wonder if GSK was still paying these 1996-97 wages? #elionhitchings http://pic.twitter.com/okKeIVAU
  7. davidkroll
    This was the view for the executive secretarial pool. RTP requires that 40% of lots remain wooded #elionhitchings http://pic.twitter.com/YGGT75i4
  8. sbeckwral
    @davidkroll Very cool! Didn’t know that stat!
  9. Since Stephanie is a news producer for WRAL-TV in Raleigh, I thought I should do some fact-checking and find the source for this factoid once I got home. Turns out that I was wrong — I underestimated the wooded requirement.

    According to RTP’s Land Management plan, the built-up area of each lot is limited to 30%, leaving much more of the pine forest than I had originally cited.

  10. davidkroll
    The #elionhitchings patio where Christopher Walken and Natalie Wood appeared in “Brainstorm”; Burroughs-Wellcome then http://pic.twitter.com/AO67RfIK
  11. ProteinWrangler
    @davidkroll really cool building. just read it was in the movie “Brainstorm.” thought it looked familiar. thanks for sharing!
  12. I then realized that bombarding my Twitter followers with my tour photos required an explanation:
  13. davidkroll
    If my timeline is wondering what I’m writing about: I’m touring the 1966 Paul Rudolph creation that was US HQ for Burroughs-Wellcome…
  14. davidkroll
    The bldg was acquired by Glaxo and its subsequent iterations. Sold to United Therapeutics recently. First time open to public in decades.
  15. davidkroll
    One drawback to working in such an angular building: #elionhitchings http://pic.twitter.com/IvpaFt9X
  16. davidkroll
    2nd floor offices have nicer views than 5th (exec) floor. Hex design bring you closer to trees #elionhitchings http://pic.twitter.com/2YzFSHVQ
  17. davidkroll
    Can any GSKers tell us why all #elionhitchings bldg rooms have the MAI prefix? http://pic.twitter.com/zOnsbEbF
  18. collabchem
    Thank you @davidkroll great building, like a trippy Escher drawing but whiteboards were insightful big pharma relics http://pic.twitter.com/1S3T9nZ1
  19. MaverickNY
    @davidkroll like being stuck in a time warp, for posterity
  20. collabchem
    Thank you @davidkroll great building, like a trippy Escher drawing but whiteboards were insightful big pharma relics http://pic.twitter.com/1S3T9nZ1
  21. The story here is that I had originally purchased three tickets for later in the day before I realized that the time conflicted with my daughter’s soccer match. So on Friday night, I ran a little Twitter contest to give away these tickets.

    ADME-Tox guru and Collaborative Chemistry writer Sean Ekins was fortunately able to use one of my tickets — and I’m glad he did because his post on the visit is truly elegant and reflective on the metaphors this building holds for the past and present state of drug discovery. He also has much cleaner photos than I do here.

  22. collabchem
    Pharma architecture and informatics, whiteboards as the silo of ideas, symbol of demise: http://www.collabchem.com/2012/10/21/pharma-architecture-and-informatics-whiteboards-as-the-silo-of-ideas-symbol-of-demise/ ThankU @davidkroll for Ticket
  23. And from the organizer:
  24. georgesmartTMH
    Thanks to the over 300 people who came and visited the Burroughs Wellcome building this morning…..and thanks to… http://fb.me/1FpDobZb5
  25. Many thanks to George Smart and Triangle Modernist Houses for making this tour possible. Volunteers told me that George had been negotiating this tour for several years. The vacancy made by the GSK sale to United Therapeutics provided an excellent time for the tour to take place.

    Thank you to all involved in making this possible.

Terra Sigillata finds the right chemistry at CENtral Science

Update your bookmarks and RSS feeds

Come to our new home at CENtral Science:

cenblog.org/terra-sigillata

CENtral Science is the blog presence of the weekly ACS magazine, Chemical & Engineering News

Well, as I’ve been alluding to, I’ve decided to leave this state of indie blog purgatory and join CENtral Science, the blog platform of the American Chemical Society’s Chemical and Engineering News.

C&EN is a weekly publication of the American Chemical Society, the world’s largest scientific society that counts 161,000 members across chemistry-related disciplines. Their blog, C&ENtral Science was retooled last March to establish seven blogs written by several C&EN editors and staff writers.

The CENtral Science blogs and their descriptions are as follows:

Cleantech Chemistry by Melody Voith with Alex Tullo

The Cleantech Chemistry blog will take a close look at the business and technology strategies of a number of companies – many of them new – that hope to serve the world’s need for renewable energy, sustainable agriculture, clean water, and non-polluting manufacturing and transportation, among other cleantech sectors.

Just Another Electron Pusher by Leigh Krietsch Boerner

Just Another Electron Pusher will keep you informed about non-traditional careers in chemistry. Here we talk to people who’ve pursued professions away from the bench about what they do and how they got there. We’ll also follow our blogging heroine in her quest for a satisfying job that uses her degree, but doesn’t involve running any %$@& columns.

Newscripts by Lauren Wolf, Bethany Halford, and Rachel Pepling

“Newscripts” is the companion blog to the like-named weekly C&EN column. Here you’ll find even more quirky news nuggets plus videos, polls, and photo galleries.

The Chemical Notebook by Alex Tullo with Melody Voith

The name directly encapsulates what the blog is meant to be. The topic is the chemical industry: those companies such as Dow, ExxonMobil, BASF, and DuPont that are engaged in the chemical transformation of one molecule to another as of part of a manufacturing stream that ultimately results in products suitable for daily use. By “notebook” what is meant is a reporter’s notebook. The blog aims to make use of those interesting tidbits of the sort found in a reporter’s notebook but might not fit neatly in the print edition of C&EN for one reason or another.

The Editors’ Blog by Rudy M. Baum and A. Maureen Vorhi

There’s nothing cute about the name of this blog or its contents. The only thing to note about the title is that “Editors” is plural, as both Rudy M. Baum, C&EN editor-in-chief, and A. Maureen Rouhi, C&EN deputy editor-in-chief, will host it.

The content you can always expect to find here is the current week’s editorial. We hope readers will use the Editors’ Blog to add their own point of view on the topic being discussed in the editorial. We’ll do our best to respond to comments as they come in. Occasionally, we’ll post an additional entry during the week when something of interest comes to our attention.

The Haystack by Lisa Jarvis and Carmen Drahl

C&EN editors Lisa Jarvis and Carmen Drahl weed through pharma’s molecular mountain to pluck out the drug developments worth noting. Coverage spans science and business context for drug industry news; spotlights on academic and industry conferences; interview outtakes and updates from drug discovery features in C&EN’s pages; and the employment prospects for chemists working in life sciences.

The Safety Zone by Jyllian Kemsley and Jeff Johnson

The Safety Zone covers chemical safety issues in academic and industrial research labs and in manufacturing. The blog is a place for exchange and discussion of lab and plant safety and accident information without the fanfare of a news article. The lead writers are C&EN associate editor Jyllian Kemsley and senior correspondent Jeff Johnson. The blog also includes contributions from other C&EN staff writers as well as health and safety experts in academia, corporations, and government.

I’m delighted to join this fantastic group of writers and will focus on the chemistry aspects of natural products – from prescription and OTC drugs to herbal and non-botanical supplements.

My initial welcome post at the CENtral Science home of Terra Sigillata provides the backstory on my move to my chemistry roots.

I apologize for moving again about a month after leaving ScienceBlogs but I’m grateful that you chose to follow me here. I hope that you’ll join me over at CENtral Science.

These are interesting times. The diaspora from ScienceBlogs and mergers with indie bloggers has brought together new partnerships, such as Scientopia, and strengthened existing ones, such as Lab Spaces.

To help you keep track of these networks, Dave Munger, Anton Zuiker, and Bora Zivokvic launched this week an aggregator of science blogging networks called – no surprise – scienceblogging.org. Many thanks to these fine North Carolina gents for including CENtral Science among their featured networks.

The discerning science connoisseur have more and more choices out there and we appreciate your readership. The next time your leisure reading calls for a science blog, I hope that you’ll consider joining us at CENtral Science, the new home of Terra Sigillata.

Update your bookmarks and RSS feeds

Come to our new home at CENtral Science:

cenblog.org/terra-sigillata

How to promote a science blogging network at a national scientific meeting

Bora Zivkovic, DrugMonkey, and I have been really impressed by this idea by the online folks over at the American Chemical Society’s Chemical & Engineering News. This week, their blog network, CENtral Science, has been promoting their presence at the upcoming national ACS meeting in Boston.

Folks may not know this but ACS is the largest professional scientific society in the world with 161,000 members.

DrugMonkey, the king of science blogging schwag, has previously mentioned the benefits of such a promotion several times to another science blogging network but it never got traction with the powers-that-be.  But here’s the idea from CENtral Science – from this post:

<start>

Here’s how to win:

  • Six key words will be hidden among the blogs between August 15–22
  • Collect all six key words and bring them to the C&EN booth #527
  • Pick up your FREE CENtral Science t-shirt*
  • Wear your t-shirt in the exposition hall Monday and Tuesday and you might be selected by C&EN staff to receive one of the VISA gift cards (worth up to $50) given out every half hour

*While supplies last

CONTEST RULES: This promotion is ONLY valid from 8/15 to 8/24. A total of 350 t-shirts will be given out (one per person) from 9:00 a.m. through 5:00 p.m. on 8/23 and 8/24 at booth #527 in the expo hall only. To receive a t-shirt each individual must present all 6 (correct) key words. Winners must be ACS members to participate. ACS staff and their families are not eligible. All gift card recipients must be wearing a CENtral Science t-shirt. There is no guarantee of winning any prize. Gift card winners will be chosen at random every half hour during published expo times.

<end>

Now THAT’s how you do it.

You have to read the blogs to pick up each of the six keywords.

Three hundred and fifty T-shirts. 350!

And you wear them at the meeting.

And they give away a $50 $10, $25, or $50 gift cards every half hour for two days.

The T-shirt is very nice, by the way, and I’m grateful to C&EN Online editor, Rachel Pepling (Twitter) for sending me one. I will be wearing it for our panel discussion on Tuesday! Rachel’s also a Gator so she gets even more favor points from me.

Once again, hunt me down in Boston if you’d like to say hello.  I’ll be the one in the yellow CENtral Science T-shirt.

Metamorphosis

Warning: rare self-indulgent post.

Blogging has been and will be light over the next few days while we are packing up things around here to move to our next, more permanent home.

In the meantime, you may have noticed here and on Twitter that part of my big news is that I will begin writing under my PharmMom-given name.

My dilemma has been that I have two Twitter accounts. @AbelPharmboy has been the one I use for all blog-related stuff as well as any other gems of my mind that can fit into 140 characters.  Thanks to you, I have 1,600 followers at that account. However, I also have a real name Twitter account that I used for my now-fledgling-and-almost-nonexistent music career and local banter with folks in the Durham-Chapel Hill area. That one only had 200 followers until I began announcing my metamorphosis.

With the pending blog move and melding of my IRL and online identities, one of my mentors, Twitter follower, writer, editor, and Johns Hopkins journalism professor, Mary Knudson, asked what I was going to do regarding the two avatars I use for each Twitter account.

One of my dear friends was enthusiastic about me coming up with a new avatar for the real name account but I’ve been worried about losing old followers who might not recognize the real name avatar.

But coming to the rescue from across the pond is my devoted reader and neuropharmacology enthusiast, Synchronium – world-famous for showing not one but both nipples in the British press.

Here is my metamorphosis:

Follow me now @davidkroll on Twitter.

More news on our move as it becomes available.

Lunch-and-Learn with us next week in Boston at the American Chemical Society meeting

I'll get to meet one of my heroes. Image courtesy of Pharmagossip.

I’m really excited to be going up to Boston for a few days next week to attend the fall meeting of the American Chemical Society.

Besides presenting some of our collaborative work, the highlight of my time there will be with Carmen Drahl of C&EN and The Haystack blog hosting a panel on chemistry and pharmaceutical blogging. The session will be held 12 noon – 2 pm on Tuesday, August 24 with Derek Lowe (In the Pipeline), Ed Silverman (Pharmalot), Michael Tarselli at Scripps Florida, and your humble correspondent.

Here’s a PDF with more details. Fellow Haystack blogger and C&EN Senior Editor, Lisa Jarvis, will be livetweeting the session. So be sure to follow Lisa @lisamjarvis.

Here’s the description from Carmen:

These folks will each give a short talk, but the real highlight here is the panel. I’d love for people to show up with great questions. Want to talk about how blogs are playing a role in discussing layoffs and employment? How about the trickiness to promoting new drugs on the web? Or what role new media should have in critiquing papers? The panel’s as good a time as any to bring those issues up.

I’ll be moderating the event, which is slated for Tuesday, August 24, from 12 noon till 2PM in the Boston Convention Center, Ballroom West.

It costs $16 to sign up for the session, which includes lunch. You can register for the event at the main ACS meeting registration site here. It is listed as the MEDI Lunch and Learn/Ticket No. SE 19.

Get more information about the event from this promo flyer.

I’ll be honest with you folks – I’m peeing my pants with anticipation.

Derek Lowe is the grand master of pharma blogging. Derek is a medicinal chemist who has somehow managed to write from the standpoint of a pharmaceutical industrial chemist and give us insights that you’ll rarely find elsewhere in the blogosphere. In fact, it was an interview with Derek in The Scientist in August 2005 that led me to start this blog. Derek does us a great service in academia by helping our trainees learn what it’s like to work inside a drug company, a place that about half of my trainees and fellow Ph.D. students now work. The 52 posts in his “Academia vs. Industry” category is a great place to start reading.

Ed Silverman is the go-to writer for coverage of the pharmaceutical industry, at least on this side of the pond (hello, Pharmagossip!). I respect a lot of other pro writers and bloggers on that beat such as Matthew Herper at Forbes and Scott Hensley when he was at the Wall Street Journal Health Blog, but now editor of NPR’s Shots health blog.

But Ed wrote for many years at the newspaper of my childhood, the Newark Star-Ledger, at a time when I dreamed of working for a northern New Jersey pharmaceutical company. With 75% of US pharmaceutical companies having a presence within 150 miles of Newark, Ed was at the heart of the business and told it like it is.  In the new home of Pharmalot with Canon Communications, he continues to provide cutting edge news on the drug industry and current legal actions in the community. Ed’s off on summer break right now but will return in time for our talks and panel discussions.

I haven’t met Michael Tarselli yet but I’m excited to do so and learn about the Scripps presence in Jupiter, Florida, where I have a few old colleagues. I’ve already been fortunate to meet Carmen, a Princeton-trained PhD chemist-turned journalist – Bora Zivkovic has a nice interview with her from ScienceOnline2010.

For those of you who won’t be there, Carmen is asking folks to send in questions for the panel via this survey form.

I want to ask Derek how in the heck he got the okay to blog from the highly risk-averse environment of a pharmaceutical company and how he approached this when a plant closure required that he find another position. Did his blogging help him drum up prospects and did his ultimate employer view his visibility as a blogger as a plus?

And in the wake of the Pepsigate exodus from ScienceBlogs, what is the place for writing about being a scientist in industry without being a pawn of one’s employer? I think that it’s essential for there to be just as much blogging by industry scientists as by academics and professional science writers. In chemistry, it seems to be much more accepted that one will work in a corporation (my data-free impression only). But our fellow scientists trained in pharmacology, genetics, or molecular biology have just as much opportunity to work in industry, large and small. Why aren’t we doing more in the blogosphere to prepare our trainees for these opportunities?

What would you like to see discussed at this panel? Drop a line in the comments or go over to Carmen’s response page.

And if you’re in Boston, please come say hello!

Louisiana K2 ban hurts convenience stores, but is there a homeopathy loophole?

I’m trying not to make this the synthetic marijuana blog but the news on K2, Spice, and other “herbal incense” products keeps coming fast and furious.

This weekend, I saw a Lake Charles, Louisiana story from KPLC-TV coincident with the statewide ban on synthetic marijuana products that took effect on August 15th following legislation signed by Gov. Bobby Jindal in June. One convenience store owner remarked on how the ban will affect her business:

Patricia Maynard, co-owner of Westlake’s Quick Stop, said selling the herbal substances has allowed her to stay in business and keep her electricity on.

Now, that the state has banned synthetic cannabinoid, Maynard is worried her business will suffer. [APB: should be "cannabimimetic" not "cannabinoid" because the active compounds differ structurally from cannabinoids]

“Look how much revenue the state’s going to lose,” said Maynard. “I really don’t understand it. I really don’t understand their reasoning behind it and yeah, it’s definitely going to hurt my business.”

But the final sentence is what caught my eye:

Synthetic cannabinoid is still legal if prescribed by a doctor as a homeopathic drug.

Today’s our first day of classes so it’ll take me some time to dig into the laws governing homeopathics in Louisiana. Technically, a K2 or Spice product cannot possibly a homeopathic remedy because it actually contains measurable amounts of active components. I wonder how long it will take K2 manufacturers to take advantage of this loophole and how much  homeopathic “physicians” might charge “patients” for such a referral.

K2 Spice associated with death of young Indiana mother of two

Welcome to readers arriving via Adam Brown’s referral from Cracked.com. I’ve since moved my blog where I have written extensively on the fake weed phenomenon over the last year-and-a-half.

Click here to read my compilation of synthetic marijuana posts at the new home of this blog.
 


 

From the overnight e-mail referrals of PharmGirl, MD, whose insomnia fuels much of my blogging, comes a story from Middletown, Indiana, on the death of a 28-year-old woman from smoking a synthetic marijuana product.

From WXIN-TV in Indianapolis:

A mother of two is dead after using a synthetic-marijuana laced incense known as “Spice.”

Now her friends and family want the drug outlawed since more and more people appear to be dying from it.

“Yesterday I lost one of the most important people in my life,” says Heather Hogan, blinking back tears, still trying to make sense of a life taken so suddenly.

A common brand of "herbal incense" or "synthetic marijuana."

Several “herbal incense” products sold as K2 or Spice (usually Spice Gold) have permeated the media over the last year, in the US at least, as legal alternatives to marijuana. These products contain one or more synthetic chemicals designed to bind the same cannabinoid receptors in the brain as those affected by the active compounds in marijuana.  These synthetic compounds, called cannabimimetics, do not have the same chemical structure as marijuana’s THC but still have equal or greater potency and effectiveness. Most recognized among these chemicals is JWH-018, so named by the research team of Clemson University professor emeritus, John W. Huffman, who worked on these molecules as biological probes in the mid-1990s together with some of the best behavioral pharmacologists in the US.

For more reading, go to these posts by us, DrugMonkey, and Dr. Leigh.

However, if these compounds do indeed behave like those in marijuana, deaths associated with their use might not be expected.  However, there is at least one other Indiana death from May that is associated with Spice use. Unlike the current article, the May case has a statement from the coroner:

“Given that it was reported that the decedent may have used an unknown substance call “K 12 spice”, a synthetic drug being used by some smokers as a legal substitute to marijuana, we will review the toxicology results to determine what chemicals are involved. We know that there are current studies being done to determine the effects of this substance. We will follow this case closely and watch for other related types of unexpected deaths.”

The coroner probably meant K2, not K12. But regardless, could this stuff cause death?

DrugMonkey, Leigh, and I have been monitoring the literature and our comment threads but most of what we see are from users who report, at worst, some very unpleasant experiences with K2 or Spice use.  However, a couple of our commenters have noted that the products can cause seizures. And if severe enough, a seizure can cause death. (P.S. Leigh has started writing a new blog at Scientopia.org called Neurodynamics.)

This particular commenter of ours who purchased pure JWH-018 to make his own herbal blend reports that while one cannot usually overdose on marijuana, high doses of this compound are very different. Other habitual marijuana users report that some high-dose effects of K2 Spice reported sound similar to those of very strong strains of cannabis.

More and more of these kinds of products are popping up under other names such as Colorado Chronic, Dragon Spice, HUSH, and others.

So, what’s the story here? Let’s assume for a moment that these deaths can be causally linked to synthetic marijuana use.

Could lethal effects of K2 Spice be due to a synthetic contaminant?

My hypothesis is driven by pharmacology/toxicology history. In the early 1980s, young people started showing up in San Francisco hospitals with symptoms of shaking and muscle rigidity that looked just like Parkinson’s disease that usually afflicts folks in the 60s or, in the early-onset version, their 40s. The cases were traced back to an East Coast chemistry graduate student who had been trying to synthesize MPPP an analog of the synthetic opioid drug, meperidine, to prepare a “synthetic heroin.”

In this 1983 Science paper, J William Langston and other colleagues at Stanford identified the presence and activity of a neurotoxic by-product of illicit MPPP syntheses called MPTP. Langston’s group reviewed that case of the Maryland chemistry graduate student who had presented with similar symptoms in 1976 while using this 1947 synthetic scheme, part of a series of four piperidine synthesis papers in that issue of the Journal of Organic Chemistry. Davis et al. reported on this case in 1979 in Psychiatry Research that the student noted the onset of parkinsonian side effects when injecting the compound made after taking some synthetic shortcuts following several successful batches. The student, now known as Barry Kidston, died after a cocaine overdose and his brain slices are those shown in the Davis paper.

Langston’s group later reported in Neuroscience Letters that MPTP is metabolized in the brain of non-human primates to the highly-reactive neurotoxin, MPP+ (interestingly, an equally high ratio of MPP+ to MPTP was observed in the heart but I’ve not read anything about cardiac effects of MPTP). I should also note that the use of non-human primates for this work was critical to understanding how this toxin caused parkinsonism – the effects were not seen in rats given MPTP.

Production of this highly-reactive pyridinium ion was later shown to result form neuronal metabolism by monoamine oxidase B, the same enzyme we normally use to inactivate dopamine. The MPP+ caused selective death of dopamine neurons in the substantia nigra, “comparable in severity to that usually seen in idiopathic parkinsonism.” (Quote from Langston et al, Science 1983; 219:979-80 about Kidston’s pathology)

For more reading on this topic, Langston co-authored a 1995 book entitled, The Case of the Frozen Addicts, that also fueled a NOVA special. A New England Journal of Medicine review of the book appears here.

MPPP, the intended illicit compound, and MPTP, the proneurotoxin that is oxidized in the brain to MPP+.

This remains an active area of research today because environmental causes of parkinsonism may be mediated similar by compounds we encounter daily – in the 1980s, Sol Snyder’s group at Hopkins showed that MPP+ is made in and exported from astrocytes to kill surrounding neurons and just last year another group at Rochester and Columbia showed that identified an organic cation transport protein, oct3, that’s responsible for this export.

In the case of JWH-018 and related compounds, they are not piperidine (a six-membered saturated ring containing nitrogen) but rather indoles, a five-membered nitrogen-containing ring connected to a benzyl ring. Both are heterocycles, meaning they are carbon rings with nitrogen and, like the methyl on the pyridine nitrogen in MPTP, the nitrogen in JWH-018 is modified with an aliphatic group (a five-carbon pentyl group, in this case).

The cannabimimetic, JWH-018, sold pure and in K2, Spice, and other "synthetic marijuana" or "herbal incense" products.

My question to my chemistry colleagues is whether something could happen in the JWH-018 synthesis to create a situation on the indole that could allow this to be activated to a reactive cation. I’m not sure how the carbonyl electrons one carbon off from the indole might influence things. But then again, we have indoles everywhere endogenously – in tryptophan and serotonin.

Just thinking out loud here – although I’m happy to partner with one of my chemistry colleagues to suss this out – but the cases of deaths reported with K2 Spice, if causally associated, seem too sporadic to be a general theme. The fact that these two cases (and perhaps three) in Indiana smells to me like a locally-restricted distribution of a “bad batch.” I anticipate that poison control centers and forensic analytical chemists in Indiana are on the case.

But here’s a case where I really wish I knew chemistry better. But, in true blog tradition, I’d rather open up this discussion to chemists of the blogosphere rather than try and be all secretive and see if this hypothesis can be quietly tested with my colleagues.

I see that some of my chemist friends have followed me over here from the old digs at ScienceBlogs – what say you, o learned ones?