29 June 2007

Hello, Goodbye Gun

ABC News
Non-Lethal Weapon Makes Targets Feel Like They're on Fire
Active Denial System Called 'Holy Grail' of Crowd Control but Raises Ethical Questions

Dec. 8, 2006 —

"If you're a soldier dealing with an unruly mob, you don't have a lot of options," says Noah Shachtman, editor-in-chief of Defensetech.org. "You have the M-16 option, the bullhorn option, and there's not that much in between."

That is, until now. A new non-lethal weapon developed by the Department of Defense intends to give soldiers a third option in these situations.

The ADS, or Active Denial System, fires an invisible beam that penetrates the top 1/64th of an inch on a target's skin, hitting sensitive pain receptors and causing a burning sensation some have likened to being dipped in molten lava.

When the target steps out of the beam's path, the pain goes away instantly, causing no permanent damage and leaving no marks, bruises or burns.

Some military experts are calling it the Holy Grail of crowd control. But critics fear that after incidents like the Abu Ghraib prison torture scandal, the potential for the technology to be used for more sinister means is simply too great.

"The big concern is exactly what it's going to be used for and do we want a weapon that simply causes pain because there are all sorts of ways that this could be misused," said David Hambling, who has monitored the ADS and other non-lethal technologies and written the book "Weapons Grade: How Modern Warfare Gave Birth to Our High-Tech World."

Can we please be honest here? Whatever one thinks about the justifiability of this weapon or its purposes, we can all agree that it will, without a doubt, be used for torture. That's not necessarily a conclusive argument against it --one can also avoid marks with a car battery and jumper cables. But that's the reality.

The ADS looks like a flat radar dish mounted on a military Hummer. Engineers are also developing an airborne, shipboard and hand-held version as well. Operators use a focused camera that shows exactly where the beam will hit and fire on targets from afar, keeping the device and the soldiers around it out of range of small arms fire.

"If you've ever used a blow dryer on your hair, and if you leave the blow dryer in one place for too long, you have to move it away -- it's very similar to that effect," said Susan LeVine, principle deputy for policy and strategy at Defense Department's Joint Non-Lethal Weapons Program.

An apt analogy, I'm sure.

The device uses millimeter waves that are much easier to control than microwaves but have a similar effect -- they heat things up.

LeVine insisted that millimeter waves are not nearly as harmful as microwaves -- though both can cause cancer. She said extensive testing has proven that the device isn't dangerous beyond the pain it generates.

"It does not penetrate or reach deep into the body, so it's not going to affect your internal organs or pacemaker -- it's only going to touch the outermost surface of the skin," she said. "This is by far the most researched non-lethal weapon in the history of the Department of Defense."

According to LeVine, there are no know long-term side effects and the weapon doesn't cause cancer. She also said that due to the instinctive reaction to close one's eyes and turn away from the heat the beam generates, it has shown no negative effect on a target's eyesight.


LeVine said that testing the ADS on more than 600 volunteers over the last 12 years showed that it makes people run away, leading to David Hambling nicknaming it the "Goodbye Gun."

"When you feel that millimeter wave energy, you get a heating sensation, a clear distinct sensation that you know somebody's telling you to stop your actions and get out of the area," said LeVine.

But what if you're stuck in a crowd? Trapped on the ground or simply unable to get out of the weapon's path?

LeVine said that's not possible due to the operator's training and the camera used to target the device. She said the operator will see what is happening.

And obviously we can trust the operator to not blast the innocent. Obviously she won't be tempted to hold the beam on someone for just a bit longer than necessary. Of course she'll let them up to run away. I'm sure none of us would misuse the weapon when the unruly mob we're trying to control is threatening our injured comrades.

Sarcasm aside, I'm certain that I myself would be very tempted to misuse the weapon in some of the situations its proponents envision. Now, maybe its an option that soldiers should have. If I were in the crowd, I'd rather be tortured for a few moments than shot full of 5.56mm holes. But let's be honest about the fact that it will be misused and misused a lot.

Also, how long do you think it'll be before civilian police forces have these mounted on the roof of every squad car? I'm sure cops won't ever teach the smart-mouthed some respect or disburse nefarious-looking groups with a blast or two.

After all, its not like loud-mouths in libraries are getting Tasered


Uh oh. Apparently I'm a purveyor of filth:
Online Dating
This rating was determined based on the presence of the following words:
* pain (348x)
* torture (43x)
* sex (16x)
* cocaine (9x)
* drugs (8x)
* bomb (6x)
* abortion (4x)
* kill (2x)
* death (1x)

I've only used 'pain' 348 times?!?!?!?!

26 June 2007

Pharmacology bleg

I have a request for any of you who know about the pharmacology of antidepressants. I have a friend who is taking Wellbutrin (bupropion) for smoking and codeine for chronic pain. I'm curious whether the combination may be attenuating the effect of the codeine and thus whether he should talk to his doctor about changing the codeine dose or switching medications.

Here's why: Codeine itself isn't really an analgesic. It is a substrate of a polymorphic P450 enzyme CYP2D6, and is metabolized to the more potent drug morphine. Some SSRI's like fluoxetine inhibit CYP2D6 activity. Thus combining prozac with codeine can attenuate its effects (see below).

What I'd like to know is whether bupropion might have the same effect on codeine metabolism. But I can't find anything directly on the topic.

From this chart of the various enzymes involved, it looks like that might be the case. But then I found this in the Wikipedia entry on buproprion

As bupropion is metabolized to hydroxybupropion by CYP2B6, drug interactions with CYP2B6 inhibitors (paroxetine, sertraline, fluoxetine metabolite norfluoxetine, diazepam, clopidogrel, orphenadrine and others) are possible. The expected result is the increase of bupropion and decrease of hydroxybupropion blood concentration. The reverse effect (decrease of bupropion and increase of hydroxybupropion) can be expected with CYP2B6 inducers (carbamazepine, clotrimazole, rifampicin, ritonavir, St John's Wort and others).

Hydroxybupropion (but not bupropion) inhibits CYP2D6 and is a substrate of that enzyme. Significant increase of the concentration of some drugs metabolized by CYP2D6 (venlafaxine, desipramine and dextromethorphan, but not fluoxetine or paroxetine) when taken with bupropion has been observed.

So I need your help. Can anyone point me in the direction of studies on bupropion and codeine? Or maybe just explain this in a way I can understand?

For your enjoyment, here are a few studies of fluoxetine and codeine that I came across in looking for an answer.

Inhibition by fluoxetine of cytochrome P450 2D6 activity.
Otton SV, Wu D, Joffe RT, Cheung SW, Sellers EM
Clin Pharmacol Ther. 1993 Apr ; 53(4): 401-9

Potent inhibition of cytochrome P450 2D6 (CYP2D6) in human liver microsomes by fluoxetine and its major metabolite norfluoxetine was confirmed (apparent inhibition constant values, 0.2 mumol/L). Several other serotonergic agents were also found to be competitive inhibitors of this genetically polymorphic enzyme. The O-demethylation ratio of dextromethorphan that expressed CYP2D6 activity in 19 patients receiving fluoxetine fell in the region of the antimode separating the O-demethylation ratio values observed in 208 extensive metabolizers from 15 poor metabolizers of a control group of healthy subjects. Inhibition of CYP2D6 activity in patients undergoing treatment with fluoxetine or other serotonin uptake inhibitors could contribute to toxicity or attenuated response from concurrent medications that are substrates of this enzyme. Other in vitro studies indicated that CYP2D6 catalyzes the O-demethylation of oxycodone to form oxymorphone. This reaction was inhibited by fluoxetine and its normetabolite in liver microsomes from both extensive and poor metabolizer individuals, indicating that these compounds are not selective inhibitors of CYP2D6 activity.

Treatment of codeine dependence with inhibitors of cytochrome P450 2D6.
Fernandes LC, Kilicarslan T, Kaplan HL, Tyndale RF, Sellers EM, Romach MK
J Clin Psychopharmacol. 2002 Jun ; 22(3): 326-9

Codeine is O-demethylated by cytochrome P450 2D6 (CYP2D6) to form the more potent drug morphine, accounting for much of codeine's analgesic and dependence-producing properties. Because morphine production can be decreased by inhibition of CYP2D6, the authors hypothesized that CYP2D6 inhibition could be used to treat codeine dependence. A randomized, double-blind, placebo-controlled trial was conducted. All patients received brief behavioral therapy. Two weeks of baseline monitoring were followed by 8 weeks of daily treatment with fluoxetine or quinidine (two potent CYP2D6 inhibitors) or placebo. Thirty patients were assessed (all white, age 40 + 12 years using 127 + 79 mg/day of codeine [mean + SD]), and 17 entered treatment. Eight patients remained in the study by treatment week 8. Quinidine > fluoxetine > placebo inhibited CYP2D6 as reflected in the change of the O-demethylation of dextromethorphan, a specific CYP2D6 probe. At treatment week 8, placebo, quinidine, and fluoxetine reduced mean daily codeine intake by 57%, 56%, and 51% of baseline intake respectively; there was no difference among treatment groups. In this small sample, CYP2D6 inhibitors did not appear to have a useful role in the treatment of codeine dependence.

25 June 2007

The Daily Headache: Newsweek on Chronic Pain Research & Treatment

A potentially helpful blog for chronic headache sufferers :
The Daily Headache

15 June 2007

Torture in Iraq

Do not read this excerpt from Monstering: Inside America's Policy of Secret Interrogations and Torture in the Terror War (Carroll & Graf) if you've just eaten.

12 June 2007

Some links

A nice set of posts on pain from the blog the Transparent Eye.

And, in case I haven't linked to them before, check out the blog Psychology of Pain

07 June 2007

Sensory deprivation torture

From Salon:
The CIA's favorite form of torture
By Mark Benjamin

Jun. 07, 2007 | According to news reports, the White House is preparing to issue an executive order that will set new ground rules for the CIA's secret program for interrogating captured al-Qaida types. Constrained by the 2006 Military Commissions Act, which contains a strict ban on abuse, it is anticipated that the order will jettison waterboarding and other brutal interrogation techniques.


The answer is most likely a measure long favored by the CIA -- sensory deprivation. The benign-sounding form of psychological coercion has been considered effective for most of the life of the agency, and its slippery definition might allow it to squeeze through loopholes in a law that seeks to ban prisoner abuse. Interviews with former CIA officials and experts on interrogation suggest that it is an obvious choice for interrogators newly constrained by law. The technique has already been employed during the "war on terror," and, Salon has learned, was apparently used on 14 high-value detainees now held at Guantánamo Bay.

A former top CIA official predicted to Salon that sensory deprivation would remain available to the agency as an interrogation tool in the future. "I'd be surprised if [sensory deprivation] came out of the toolbox," said A.B. Krongard, who was the No. 3 official at the CIA until late 2004. Alfred McCoy, a history professor at the University of Wisconsin-Madison who has written extensively about the history of CIA interrogation, agrees with Krongard that the CIA will continue to employ sensory deprivation. "Of course they will," predicted McCoy. "It is embedded in the doctrine." For the CIA to stop using sensory deprivation, McCoy says, "The leopard would have to change his spots." And he warned that a practice that may sound innocuous to some was sharpened by the agency over the years into a horrifying torture technique.

Sensory deprivation, as CIA research and other agency interrogation materials demonstrate, is a remarkably simple concept. It can be inflicted by immobilizing individuals in small, soundproof rooms and fitting them with blacked-out goggles and earmuffs. "The first thing that happens is extraordinary hallucinations akin to mescaline," explained McCoy. "I mean extreme hallucinations" of sight and sound. It is followed, in some cases within just two days, by what McCoy called a "breakdown akin to psychosis."


Just like waterboarding, Massimino said, extreme sensory deprivation techniques "push people beyond the brink of what they can bear, physically and mentally. Once you understand that, the veneer of acceptability -- the myth that 'it's not torture, it's just harsh' -- completely falls apart." But compared to the outcry over physical torture, she described a "deafening silence" about techniques like sensory deprivation.

The issue, said Massimino, is that sensory deprivation is relative -- she compared it to a "rheostat." Former CIA executive director Krongard made the same point about sensory deprivation's variability, saying that the techniques exist on a spectrum. The term could refer to anything from being left alone in a room to being subjected to complex get-ups combining goggles, earmuffs, mittens and darkened cells that quickly drive subjects into psychotic states.

On the low end, said Krongard, sensory deprivation techniques would pass muster with most observers. But he admitted that taken to extremes, some methods "would not pass anybody's muster." Sensory deprivation techniques taken to extremes would clearly violate the Geneva Conventions, according to international law experts, and would appear to be illegal under the Military Commissions Act, which bans "severe or serious mental pain and suffering." McCoy stated that based on his experience tracking down and interviewing subjects from the CIA's early research, some subjects never fully recover.

Sensory deprivation has apparently already been employed during the so-called war on terror. The prevalence of its use has been hinted at in images of alleged terror-plotter Jose Padilla and of detainees at Guantánamo shown wearing blacked-out goggles and earmuffs -- basic deprivation tools intended to soften prisoners up mentally by plunging them into a sensory void. A source familiar with the 14 high-value detainees interrogated at the CIA's so-called black sites and transferred to military custody at Guantánamo late last year, said the CIA appeared to have used some form of sensory deprivation techniques on most, if not all, of those 14 high-value detainees.

But the CIA's reliance on sensory deprivation goes all the way back to the early days of the Cold War. It is a big part of the CIA's 1963 "KUBARK" interrogation manual, obtained in 1997 by the Baltimore Sun. That agency manual describes sensory deprivation as a central tenet of coercive interrogations. For particularly rapid results, the manual endorses the use of a "cell which has no light (or weak artificial light which never varies), which is sound-proofed, in which odors are eliminated, etc." Following that plan, the manual says, "induces stress; the stress becomes unbearable for most subjects." The manual adds, "The subject has a growing need for physical and social stimuli; and some subjects progressively lose touch with reality, focus inwardly, and produce delusions, hallucinations, and other pathological effects."

As proof, the KUBARK manual refers to a raft of CIA-sponsored Cold War research on sensory deprivation, including studies at McGill University in Montreal and the National Institute of Mental Health. Subjects in that research were placed in isolated water tanks or confined to silent rooms on soft mattresses, wearing blacked-out goggles and earmuffs. In one study, subjects experienced "visual imagery somewhat resembling hallucinations" within three hours. In another study, only 6 of 17 subjects could last 36 hours on a mattress in a quiet tank that prohibited movement. The stress is described in the KUBARK manual as "unbearable."

The dark world of CIA-sponsored sensory deprivation research is plumbed in depth in the book "A Question of Torture: CIA Interrogation From the Cold War to the War on Terror," written by McCoy. "They've been doing this for 50 years," McCoy explained. His book discusses more CIA-sponsored research at McGill by Dr. Donald O. Hebb, who during the same era placed 22 college students in small, sound-proof cubicles, wearing translucent goggles, thick gloves and a U-shaped pillow around the head. Most subjects quit within two days and all experienced hallucinations and "deterioration in the capacity to think systematically."

The theory behind the CIA's fascination with sensory deprivation, McCoy said, is that subjects are so starved for stimulation that they will even crave interaction with their interrogator. "The idea is that they break down and then they cling to the interrogator, because you are hungry for stimulus," McCoy explained.


Bauer, who was the most forward-deployed Army interrogator during Operation Desert Storm, said sensory deprivation can drive people to come up with lies "based on ending the harsh treatment. That is not an effective way to conduct intelligence collection operations."


If the White House chooses to go the sensory deprivation route, it is unclear what, if anything, Congress could do to put a stop to it. There are limited tools available to the Senate Intelligence Committee, the committee with direct oversight of the agency, to step in. As one committee aide explained, "We don't have a veto over it."

-- By Mark Benjamin
Copyright ©2007 Salon Media Group, Inc.