Web Sites with
Misinformation about Illicit Drugs
A response to a letter in the New England Journal of Medicine
Citation: Erowid, Fire. "Web Sites with Misinformation about Illicit Drugs: A response to a letter in the New England Journal of Medicine". Erowid Extracts. December 2001;2:12.
In August, the New England Journal of Medicine published a letter to the editor by Boyer, Shannon and Hibberd entitled "Web Sites with Misinformation about Illicit Drugs".1 In this article, Boyer et al. criticize government websites for not competing successfully with "partisan" drug information web sites, name sites they consider partisan, and offer specific criticism of information found on those sites.
Internet Drug InformationBoyer et al. cite a study (Wax 2000) which looked at the effects of internet drug information on the use of drugs by students. Their letter states that this study found:
"24 percent of college students used the Internet to obtain information on illicit substances, and 27 percent of Internet-using college students reported that Internet use increased the likelihood that they would use drugs."
While this certainly implies that drug use increased after exposure to information on the internet, a closer examination of the study cited reveals that an even higher percentage of students reported that internet drug information reduced the likelihood that they would use illicit drugs.
From the study itself, 168 students were surveyed (94 college and 74 first year medical students). Nineteen percent reported having used the internet to find information on recreational drugs (24% college and 14% medical). Of those who surfed for drug information, 9% said this increased their likelihood of using recreational drugs (27% college and 0% medical) while 19% said it decreased their likelihood of using recreational drugs (27% college and 10% medical).2
MDMA & SSRIsBoyer's primary criticism of Erowid was in reference to a comment made about the potential use of SSRIs to reduce negative side effects of MDMA. They commented that "The combined use of SSRIs (selective serotonin reuptake inhibitors) or MAOIs (monoamine oxidase inhibitors) with drugs possessing serotonergic activity such as MDMA has led to serotonin syndrome in selected patients."
While it is true that combining MAOIs with MDMA increases risks of serotonin syndrome, there is little evidence to suggest the same is true about SSRIs. We submitted a formal response to the New England Journal of Medicine (below) which they declined to publish, citing space limitations.
It should be noted that Boyer's original submission was a 30 page article cut to two pages by the editors of the NEJM. It is unclear whether the problems with the final content were part of the original or a result of these cuts, but we were disappointed that the NEJM would publish such a letter and not allow space for a response.