34 The Encyclopedia of Addictive Drugs
size, or the manner in which a dose is given, or diet, or living conditions, or
any number of other causes. Perhaps the conflict is due to researcher errors—a
classic error being failure to run adequate controls (for example, failing to give
the drug and a placebo in the same manner to a large number of the same
kind of experimental subjects). The size of a drug experiment can also be a
problem. Many involve a handful of volunteers. Conclusions from small stud-
ies (that is, studies involving a small number of test subjects) are not as sig-
nificant as conclusions from studies measuring thousands of persons.
Sometimes drug effect information is based on medical case reports, in which
something has happened to one person but has not been experimentally tested
to determine how typical the effect is. Malnourishment and physical afflictions
can affect drug actions. Another tricky angle occurs when reports say a drug
is “associated” with an effect, meaning the drug is administered and an effect
follows. “Before and after” time sequence is not the same as “cause and effect”
(chanting may be associated with the subsequent end of a solar eclipse, but it
does not cause the termination). In scientific drug reports what scientists say
about drugs can be less certain than what public policymakers say.
This section of the book strives to present the consensus of mainstream
scientific thought. However, sometimes the only available information comes
from observations lacking experimental confirmation, at the present time; the
reader should keep in mind that by definition such observations are not yet
part of a consensus even if they are reported in scientific journals.