My initial mindset on reviewing a manuscript is driven by two things.

First, do I want to see it in print?. Mostly, this means is there even one Figure that is so cool and interesting that it needs to be published.

If there is a no on this issue, that manuscript will have an uphill battle. If it is a yes, I’m going to grapple with the paper more deeply. And if their ARE big problems, I’m going to try to point these out as clearly as I can in a way that preserves the importance of the good data.

Second, does this paper actively harm knowledge?. I’m not as amped up as some people about trivial advance, findings that are boring to me, purely descriptive studies, etc. So long as the experiments seem reasonable, properly conducted, analyzed appropriately and interpreted compactly, well I am not going to get too futzed. Especially if I think there are at least one or two key points that need to be published (see First criterion). If, OTOH, I think the studies have been done in such a way that the interpretation is wrong or clearly not supported…well, that paper is going to get a recommendation for rejection from me. I have to work up to Major Revision from there.

This means that my toughest review jobs are where these two criteria are in conflict. It takes more work when I have a good reason to want to see some subset of the data in print but I think the authors have really screwed up the design, analysis or interpretation of some major aspect of the study. I have to identify the major problems and also comment specifically in a way that reflects my thinking about all of the data.

There is a problem caused by walking the thin line required for a Major-Revision recommendation. That is, I suppose I may pull my punches in expressing just how bad the bad part of the study really is. Then, should the manuscript be rejected from that journal, the authors potentially have a poor understanding of just how big the problem with their data really is. Especially if the rejection has been based on differing comments between the three sets of reviewers. Sometimes the other reviewers will have latched on hard to a single structural flaw…which I am willing to accept if I think it is in the realm of ‘oh, you want another whole Specific Aim’s worth of experiments for this one paper, eh?’.

The trouble is that the authors may similarly decide that Reviewer 3 and Reviewer 1 are just being jerks and that the only strategy is to send it off, barely revised, to another journal and hope for three well-disposed reviewers next time.

The trouble is when the next journal sends the manuscript to at least one reviewer that has seen it before….such as YHN. And now I have another, even harder, job of sorting priorities. Are the minimal fixes an improvement? Enough of one? Should I be pissed that they just didn’t seem to grasp the fundamental problem? Am I just irritated that IMO if they were going to do this they should have jumped right down to a dump journal instead of trying to battle at a lateral-move journal?

Look people, this is really very exceptionally easy to understand. It is not rocket science.

New drug “Molly” produces lasting side effects

Recent social media posts have focused on the side effects of Molly, an MDMA (3,4-methylenedioxy-methamphetamine) drug similar to ecstasy that has become increasingly popular among college students over the past year.

No, it is not “an” MDMA drug and it is not “similar” to ecstasy.

Recreational drugs have all kinds of nicknames. Names that vary across time, place and subpopulation. A given user, however, means something specific.

“Ecstasy” was and is the drug 3,4-methylenedioxymethamphetamine, known as MDMA for short. You can read my musings in the archives.

It is also the case that illicit drug sellers, at times, provide the customers with a drug product which is something other than what the person intends to purchase. In the case of cocaine and heroin, most casual readers will be intimately familiar with teevee and movie plot lines which involve “cutting” pure cocaine or heroin with other substances. The goal, in fiction and in reality, is to make more money from a limited commodity.

“Ecstasy” supplies are notoriously variable in both active drug quantity per dose (i.e. traditional concepts of “cutting”) and in the psychoactive ingredients contained therein. In the case of the latter, there is reason to believe that the non-MDMA, psychoactive drugs might serve as a partial substitute. These alternatives include meth/amphetamine, MDA, MDE, mCPP and caffeine here, here, here, here and here. (Lots of caffeine, actually.) Head over to and you can search for pill constituents yourself.

Now, given this diversity and given that these are psychoactive drugs that have their own fan bases, it would not be surprising in the least to find people actually seeking out or preferring “Ecstasy” that was in fact not MDMA. There is a set of focus group comments here that I find illuminating. You can imagine for yourself why an Ecstasy consumer would prefer to think of methamphetamine as “speedy”-MDMA rather than good old methamphetamine. Also, people are very bad at blind identification of, say, methamphetamine vs MDMA. So there’s that. It is not impossible that some individual might have consistently been sold “Ecstasy” that is actually something else, like mCPP and caffeine, and prefer it and think that this is “Ecstasy”. But I doubt it. Hard to get clear estimates and it varies across time but something on the order of at least half of “Ecstasy” contains only MDMA.

Now, against this history of things marketed as “Ecstasy” that might or might not be pure MDMA, there arose a marketing trend (and user bragging right boast) for pure, genuine Ecstasy/MDMA. Reflecting, of course, that this particular compound/molecule is what substantial parts of the “Ecstasy” market were intending to purchase.

This marketed-as-pure MDMA became termed “Molly” in recent parlance.

Get it journalists? Molly = MDMA = Ecstasy.

And juuuuuusssst as with the prior episode, illicit drug suppliers are motivated to cut and substitute the product they move to people who are seeking to purchase MDMA. Once again, there is undoubtedly drug being sold as “Molly” that in fact contains other psychoactive substances and/or is cut with inert substances.

None of this makes “Molly” some new drug of uncertain identity, however.

Additional Reading:
Music Festival in Washington Leads to Dozens of Drug Overdoses, One Death
Molly: Pure, but Not So Simple
There’s something (potentially dangerous) about molly
Club drug ‘Molly’ on major upswing as Ultra Music Fest Miami approaches
These Rappers Hate Ecstasy

“The proposal is extremely well-written and clear.”