Tag Archives: social justice

Evidence-based Treatment

19 Nov

I read this article the other day on the success of treatment for juveniles in justice populations.  It’s pretty solid, and has to do with a lot of what I worked on at TASC this summer.

Because here’s the deal: we can’t fix everything with science. Yet. (I would argue for that “Yet.” Some people would argue “Ever.” Some people also smoke cigarettes and don’t wear seatbelts and watch American Idol and pronounce it “nuculer.” Only a person standing at the precise intersection of arrogance and ignorance could possibly believe that science will ever stop changing and improving and discovering new things.)

So: We can’t fix everything with science yet, but we can help. A reduction, as per the article, from 15.5% of juvenile offenders (a problematic word, but let’s press on) committing violent felonies to only 4.3% of those who underwent the treatment committing violent felonies isn’t perfect, but it’s not nothing. The fact that the treatment has proven to be effective for as long as I’ve been alive is also pretty promising.

I was, though, a little bemused by the repeated use of the term “evidence-based treatment.” I mean, as opposed to what? I understand that it’s generally just shorthand for “treatments that have been thoroughly studied and are based on scientific premises,” but really, that raises the question: What other kinds of treatments are people trying?  Treatments that have not been thoroughly objectively studied and that are not based on scientific premises? Non-evidence-based treatment?

It’s as simple as this: We have science; use science. The day someone can explain to me why that is complicated will be the day I can truly claim to understand the human brain.

So Wrong It’s Not Even Wrong

10 Sep

So here I am, on a Saturday afternoon, innocently looking to download this week’s Wait Wait… Don’t Tell Me!, when I stumble upon the headline “Addiction Is Not A Disease of the Brain.” At that point, I know I should just walk away — or, even simpler, click away. I should just let it be. But of course, that’s not what happened.

On the one hand, this article seems to be deliberately baiting scientists — enough so that I probably shouldn’t dignify it with a response. On the other hand, there’s just too much to respond to here to avoid it.

The first point that the author makes, after a fairly standard and obvious introduction with which I have no major issues, is this:
“Let us first ask: what makes something — a substance or an activity — addictive? Is there a property shared by all the things to which we can get addicted?
Unlikely. Addictive substances such as alcohol, heroin and nicotine are chemically distinct. Moreover, activities such as gambling, eating, sex — activities that are widely believed to be addictive — have no ingredients.”

As a scientist, my objective reaction was something along the lines of ” Bu…. Wha….? No.” (I’m paraphrasing here.)

The author is fond of analogies, so let me attempt one of my own. “What makes something — a substance or activity — cause weight gain?  Is there a property shared by all things which can cause weight gain?
Unlikely. Substances such as sugar, salt, and fat are chemically distinct. Moreover, activities such as watching too much tv, buying junkfood, and underestimating portion sizes — activities that are widely believed to cause weight gain — have no ingredients.”

A thing doesn’t need “ingredients” to be addictive. The commonality between all addictive substances and activities is their effect on neural pathways — and the differences between brains, let alone the differences between one brain in different states and at different periods within the lifespan, make it impossible to single out neural circuits and say “Aha, this and no other thing causes addiction!” Just as the substances and activities in my analogy above all may cause weight gain despite their differences, certain substances and activities are addictive because they are addictive, tautology or no. The fact that addiction is a complicated process in the brain does not mean that the solution to the problem can’t be found in neuroscience — in fact, I would say it indicates the opposite.

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Bertrand Russell

9 Sep

You could say that staying up reading Bertrand Russell until 2 in the morning for a few weeks during the summer between my senior year of high school and my freshman year of college made me who I am today. Of course, you could say a lot of things — but few of them would be so obviously causally true as the above.

The following quote by Russell (source) manages to say approximately everything I have ever intended to say about life, better than I could have done.

“Three passions, simple but overwhelmingly strong, have governed my life: the longing for love, the search for knowledge, and unbearable pity for the suffering of mankind. These passions, like great winds, have blown me hither and thither, in a wayward course, over a great ocean of anguish, reaching to the very verge of despair.

I have sought love, first, because it brings ecstasy – ecstasy so great that I would often have sacrificed all the rest of life for a few hours of this joy. I have sought it, next, because it relieves loneliness–that terrible loneliness in which one shivering consciousness looks over the rim of the world into the cold unfathomable lifeless abyss. I have sought it finally, because in the union of love I have seen, in a mystic miniature, the prefiguring vision of the heaven that saints and poets have imagined. This is what I sought, and though it might seem too good for human life, this is what–at last–I have found.

With equal passion I have sought knowledge. I have wished to understand the hearts of men. I have wished to know why the stars shine. And I have tried to apprehend the Pythagorean power by which number holds sway above the flux. A little of this, but not much, I have achieved.

Love and knowledge, so far as they were possible, led upward toward the heavens. But always pity brought me back to earth. Echoes of cries of pain reverberate in my heart. Children in famine, victims tortured by oppressors, helpless old people a burden to their sons, and the whole world of loneliness, poverty, and pain make a mockery of what human life should be. I long to alleviate this evil, but I cannot, and I too suffer.

This has been my life. I have found it worth living, and would gladly live it again if the chance were offered me.”

What else is there to say?  “With equal passion I have sought knowledge.” “A little of this, but not much, I have achieved.” There are no better words.

I found especially relevant the lines on pity:  “Love and knowledge, so far as they were possible, led upward toward the heavens. But always pity brought me back to earth.” This is the common and fallible argument against investing in space exploration and other scientific research — that the money would better be spent here on Earth, on everyday problems. I love that Russell acknowledges that it’s all right to sort of exist in both planes, to acquire knowledge in your ivory tower, as it were, but still to be fully engaged in the social injustices of your time (as Russell himself certainly was). For me, at least, there is this sense that I’m privileged not only economically and materially, but really privileged over anyone who has ever lived in my ability to study modern neuroscience, considering the advances that have taken place even in the past 10 years.

On the flip side, of course, an optimist would have to conclude that I am to be hopelessly pitied by future generations who feel the same about the neuroscience of my generation. It is certainly the best that can be hoped for. But still, discounting possible futures, Russell hits the nail on the head when explaining the balance between the elevation of love and knowledge and the way in which suffering diminishes even those who do not themselves suffer.  (Although I have spent years learning, as another great philosopher once wrote, that it ain’t no sin to be glad you’re alive.)

Anyway, there is nothing more to add, except to suggest that you scroll back up and read the passage again.

“The dark ages of ignorance and fear”

12 Aug

This Wednesday was the last day of my internship. As I may have mentioned before, I spent this summer writing overviews of research and statistics on various social and medical issues as they relate to substance use and related disorders. I spent my last morning there researching parental substance use and childhood welfare. Which is quite the way to bring down your mood at lunch, to say the least. Here’s one graph I threw together:

The percent of all children in America living with a substance-using parent, as of 2005, via: The National Center on Addiction and Substance Abuse at Columbia University. (2005). Family Matters: Substance Abuse and the American Family. New York: Author.

On the one hand, it’s great that we are gathering this information and have access to this data, because that is the first step toward presenting it to people in such a way that policy can be made to improve the situation. On the other hand, the current situation is pretty painful even to read about.

On Thursday, the wonderful GirlHack (a fellow NASATweetup STS135 alumna) posted a link to this 2006 article by none other than Patrick Stewart.

There is something particularly gratifying about finding out that people you are admire are actually good people and/or support noble causes. (There’s also something gratifying, though perhaps somewhat petty, about finding out that people you admire agree with you politically.) The article is worth a read.

Sir Patrick ends his article thus: “Violence against women diminishes us all. If you fail to raise your hand in protest, then you make yourself part of the problem.” I think that about sums up any number of social issues: “If you fail to raise your hand in protest, then you make yourself part of the problem.”

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