Two weeks ago Zel McCarthy published a story in Thump about a mysterious infographic that’s been making the rounds lately. The infographic purports to show which drugs are popular at various music festivals by scraping Instagram for references to different drugs and certified cbd. The consumers of the Maeng Da variant have reviewed it repeatedly that the consumption of this medicine has improved their ability to concentrate on their work and their tasks hence increasing their efficiency, redirected here if you want to read this post. Scientific research elaborates that it has a direct effect on the cerebral system of the body making it a brain drug or a mental enhancement medicine that can be used as a supplement in small amounts to improve the ability to work and to concentrate more on the work. Anyone that knows a thing or two about research design would already raise an eyebrow but it gets worse.If you need Telescoping flagpole for festival  you can visit here. According to McCarthy:
This intentionally-opaque study was conducted and assembled by a Florida-based content marketing agency Fractl, which works regularly with DrugAbuse.com. While at first glance the site appears to be a credible resource for those struggling with addiction and abuse issues, it’s actually a redirect for for-profit rehab and addiction centers, mainly ones that bankrolls the site. Here are 11 things to look in an addiction treatment program. To help dig deep into the issues of research design, online performativity, and substance use I sat down over Skype with Ingmar Gorman, a clinical psychologist at the New School for Social Research who was quoted in the Thump article saying that this “study” was not only poorly constructed, it was also indicative of an archaic, “moralistic approach” to substance abuse research. What follows is edited to make us both sound more articulate. You can listen to the whole interview (warts and all), using the SoundCloud embed at the end of the interview. The recording, along with the sound of a computer fan and me saying “uhh” a lot, also includes something I’ll call “bonus content” about a study that used the Watson supercomputer to tell if someone was on psychedelics. Enjoy.

David A Banks: You are interviewed in Thump regarding research that was done by a treatment center that used Instagram tags to study drug use at festivals, or at least that’s what it billed itself as. Could you start by describing the basics of this study and why wasn’t it the best science it could have been?

Ingmar Gorman: From a methodological standpoint what this study consisted of was going through a large number of Instagram posts and looking to identify when words associated with substances appear along with the names of a festival or a photo from a festival. And essentially what they did was say, “in X percentage of these posts from this festival, this percentage mentioned this drug.” But now we have to get into the nitty-gritty of it a little bit. They used words like cocaine or marijuana which clearly mean a drug however they also use words that could be potentially more ambitious. For example, crack could mean someone spoke about cracks in the playa at Burning Man. When you design this study looking at the use of language and these words, yeah they’ll probably get a “hit” —what you’re looking for— but there will also be a substantial number of false positives. The issue with the study, really if I can go into it, is transparency.

It’s interesting because it is sort of an example of the democratization of science. Maybe you could think of it this way: do scientists and researchers have to be the only people that produce “scientific knowledge”? I don’t know very much about the background of the people who developed this study because well, it isn’t really available! I think in the Thump interview the reporter was able to contact the person behind the research and ask them questions, but in a peer reviewed publication we would see who the authors are but in this case we don’t even know who the person is. The first thing to do would be to speak to this person and ask what their methodology was.

Depending on how you design your study, the methodology you use, the data you collect, the quality of the data, how you ensure the quality of that data, and most importantly the question that you ask —what is your hypothesis— it will set you up for a result that you can deduce some sort of understanding from.

The main issue with the study was that well, all parts of it were poor. The design was poor, the data quality was poor, we have no idea of the quality checks that were in there, so its not that we can’t draw conclusions its that we don’t really know what it means! The best conclusion that we could make is that these words coincided with these festivals.

DAB: Some of the other words that struck me as, at the very best, ambiguous were, “coke”, “spice”, “pills”, “yellow jackets”, “white girl” and references to prescription drugs that could be totally legal! These could be prescribed to these people and no one has to defend why they are taking an Instagram photo of them having to take their medication.

IG: I could see someone responding to this, to play devil’s advocate here, saying “oh c’mon guys, we know when people use these words they are talking about drugs there’s no need to make excuses about it.” And we could concede to that sort of argument and say yeah let’s take [this study] at face value and everything is completely accurate, [but] the next issue is that —and this is where things get very tricky and very clever— this does not translate into behavior. The data showed something like 3% of Instagram messages had mentioned Burning Man and crack cocaine. So what does that mean? Do 3% of festival goers use crack at Burning Man? That’s highly unlikely. But we can’t know [from the data in this study].

The clever piece about this is that the clinic never made that claim. So, if you had a peer-reviewed journal and you made a statement that said this is the data we collected and this is the conclusion we’re drawing, 3% of Burning Man attendees take crack we could argue against that. But what this group did, which is interesting, is they said “we’re just going to look at this data,” which we might call a convenience sample, “and we just make an infographic.” Which wasn’t really all that obfuscating, but then they ask you to draw your own conclusions. So what happened was the EDM festival community of web sites picked up on this and started spreading these infographics around. And then all sorts of claims are drawn from these. “These sorts of drugs at these festivals.” Which is a logical leap, there’s no indication of that.

DAB: Do you know any that could use social media to study these sorts of claims or do you think that this might be a fool’s errand: to attach what we say online to actual action?

IG: You might know more about this than I do but the first thing that pops into my mind is “how we present ourselves online, is that necessarily accurate of who we are and how we actually behave?” I think you and probably most people would argue that we present a persona, so that is an issue in interpreting data like this. The other question about whether this is a fool’s errand: you know, no. On some level I would even applaud this group who did this study… I even hesitate to call this a study because I don’t even know if that’s what they would call it, but the people that collected this data and presented it— I applaud them for using a novel method. But I think there’s a little aspect of it that’s disingenuous when— we have science and we present our methodologies and look for controls and confounds so that… we’ll never get a 100% accurate, objective picture of reality but we’re trying to sort of do the best we can.

DAB: I think that while everything we’ve already discussed definitely indicates problems with this study in particular, the beginnings of the privatization of social data in general in science is also at play here. Would you say that this study starts to reify or make stronger our long-standing beliefs of what you described in that Thump article as the moralistic approach to treating issues related to substance use?

IG: So is there a connection between my statement about the moralistic approach and the privatization of data?

DAB: The structure of the data that is already available to us, and the people that hold the keys to this data, are probably not as versed as you in what it means to do a good study on drug research. So then, is all of this data in the wrong hands? Is it fixable? Can this data ever be used for good research in your field?

IG: There are several things that come to my mind. First of all the data that they accessed in this study, this project that they did, was available from people’s feed.

DAB: They used the Instagram API which almost anyone can get, where in their very tiny methodology section, they said over March 2015 using the Instagram API they collected all of that data. [Editorial Note: while I said “anyone can get” it is also totally within the discretion of parent company Facebook to withdraw a person or organization’s access to the API for any reason.]

IG: Right, so I want to be fair to that group and not misrepresent what they did, however clearly there is data privatization that exists which is an issue! So the question is an interesting one. Yeah, how you execute a proper study is important. But also the deeper question is “how do the questions that we pose reflect our biases?” When I spoke [in the Thump article] about the moralistic approach to substance abuse treatment, that was a response to a statement made by the group that generated the data for this project.  The article reads, “One of the report’s authors, Michael Genevieve, tells THUMP the study was conducted with the intention of ‘[raising] enough awareness to scare readers into a sober festival experience, in fear of being arrested.’” My response was that that quote itself represents a moralistic approach to substance abuse treatment.

Now the reason why I said that –and this really goes into the area of substance use that’s outside of the social media question– is because historically the early perspectives of why people misuse and become dependent on substances was thought to be because they lacked moral character. “You are a bad person. There is something wrong with you. You are sinful. Therefore you are weak and you engage in these behavior because you lack self control.” The next movement was the disease model which is still prevalent and is difficult to unpack. Some people have a very strict, narrow scope of the disease model which is, “Substance addiction is a disease, an illness, you have it for your entire life, there’s nothing you can do, you’re allergic to alcohol [for example] and you can never touch it again.”Incredibly popular throughout Southeast Asia (particularly Thailand and Indonesia where the overwhelming majority of Red Maeng Da Kratom strains are grown), in just the last few years Red Maeng Da Kratom has also gained popularity around the world and is now one of the best selling kratom options anywhere on the planet.  click site for more details of Kratom.

What is beginning to come into our conversation is a kind of model of self medication, a model of harm reduction. Which is an idea that encompasses the bio-psycho-social perspective. Yes, there are biological components, so it takes that piece of the disease model but it also has to do with a person’s psychology. Meaning, the way they see the world, the way they view themselves, histories of trauma, things like that. And then the sociological, which is the broader culture that perpetuates use or the context for the person’s use. The best kratom vendors among the hundreds can be daunting, somewhat like looking for a needle in a haystack this helpful site here.

So when I talk about this “moralistic approach” to say “oh well we’re just scaring people” essentially what this person is communicating is “we looked at Instagram, we can associate festivals with drug use, therefore if you’re posting about the drugs that you’re using or you’re using drugs at these festivals, we know about it and you better not do it otherwise you’ll get thrown into jail.” It’s a fear tactic. It is unfortunately a dominant perspective in this country about why people use drugs and how people who use drugs should be treated, but in my opinion it is an archaic perspective that will be replaced by the newer perspectives on substance use. That’s why I made that statement.

DAB: I would like you to actually go a little deeper into why this new bio-psych-social perspective might be said to be better on lots of different axes. It could be more efficacious in helping people lead lives that allow them to flourish, or it could be a better explanatory model for why people engage in drug use at all. Could you do a little more unpacking on why it’s a better model. Then —given what we discussed earlier about how a lot of social media is performative— if there is any compatibility in doing better work in the bio-psycho-social perspective using big data analytics.

IG: Our approach to data analysis, and our approach to asking questions, whether it is big data or [conventional] scientific research, reflects our biases and that is something we have to own. And if individuals who are responsible for data analysis and big data have a moralistic attitude towards substance use, then they will very likely find what they are looking for because of how they structured their questions or analysis. What’s almost more important than developing a better study is having a different understanding of substance use and why various people use. An issue in this country is that people outside of the mental health field is that the dominant cultural perspective of why people use drugs —whether they have a problem or not— is set in this moralistic “you have a weak character” kind of approach. So that’s where I see those two things coming together.

Moving to your first question, the bio-pyscho-social model has been around for quite a while, a few decades at least, so that’s not necessarily new. What I believe is newer, and to be transparent I am a big fan of this, this is one of the models I use when I do psychotherapy as a clinician, is called the harm reduction psychotherapy model.

You’ll be familiar with harm reduction in terms of needle exchanges and safe sex education, there’s a whole host of things you can do. Harm reduction psychotherapy applies that perspective to the psychotherapeutic process in terms of dealing with substance use. And this is what I think is more novel and which is gaining steam is this idea that people who use and have a problematic relationship with a drug are doing it because it works for them and it helps them, or it did at one point and now it is a sort of residual behavior that is difficult for them to let go of. That idea kind of blows people’s mind.

By looking at the bio-psycho-social model through the harm reduction lens you can say, “there are reasons and motivations for substance use drugs.” Its fantastic because it includes everything. Biology is essential. I’m a materialist. I think some experiences which are hard to pinpoint in biology are important, ‘meaning’ is really important, but I’m a materialist and everything as far as I know is in the brain or somewhere in the body. That is essential especially when you’re altering your brain chemistry with a substance, that’s very biological.

The psychological piece, to speak more to that: the co-morbidity among substance use issues, what we call personality disorders, and trauma is enormous. Studies vary but I’ve heard something between 30 and 60 percent overlap [among these categories]. And this bears out. I was recently at a psychiatric emergency room and, this is anecdotal, but I’d say 95% of cases that were there at that moment all had a history of substance use and mental illness. There’s a lot of crossover, so understanding psychology is really important.

And then, the most important thing to talk about from a socio-cultural perspective, is the incarceration rates of black individuals and marijuana and other drug-related crimes. That’s the critical perspective. However, from a perspective of clinicians, [we ask ourselves] why do we not think twice about alcohol and caffeine ––or at least think minimally about it–– and there are minimal consequences for using these drugs. That’s a cultural context.

So this model is important for research because we are looking at causes and roots, but it’s also important in terms of treatment. What we look at in a clinical, psychological context is how a person derives meaning and understands their behavior. You need that insight, but there’s more than that. If someone comes from a disease model and I ask them “what’s behind this problematic, repeated use” they’ll say “well I’m an addict.” That closes off all exploration. No, you’re not just an addict! You’re a father, you have had a difficult childhood, you have issues becoming employed because of your criminal history, there’s so much there that makes someone depressed or upset that will drive them to their use. So really, what’s really important in this model is understanding the complexity that exists in the person.

DAB: I think we can leave it at that. Thanks so much for doing this.

IG: This has been really great, and thanks for having me.