Medication use to improve performance in poker

From the one-of-these-things-is-not-like-the-other research file, this gem of a study was heavily influenced by the psych titans who I was fortunate enough to collaborate with. I learned quite a bit, including the term cosmetic psychopharmacology. I rationalize this occasional stream-adrift type of research with the findings of a 2015 MIT Sloan Management Review piece which concluded that professionals with diverse (Twitter) networks who get out of their comfort zones and gain exposure to different processes were more likely to surface innovative ideas. That’s my story. I am sticking to it.

Cognitive and performance enhancing medication use to improve performance in poker.
Journal of Gambling Studies. 2015 Oct 8.
Caballero J, Ownby RL, Rey JA, Clauson KA.

Use of neuroenhancers has been studied in groups ranging from students to surgeons; however, use of cognitive and performance enhancing medications (CPEMs) to improve performance in poker has remained largely overlooked. To assess the use of CPEMs to improve poker performance, a survey of poker players was conducted. Participants were recruited via Internet poker forums; 198 completed the online survey. Approximately 28 % of respondents used prescription CPEMs, with the most commonly used including: amphetamine/dextroamphetamine (62 %), benzodiazepines (20 %), and methylphenidate (20 %). CPEMs were used in poker to focus (73 %), calm nerves (11 %), and stay awake (11 %). Caffeine (71 %), as well as conventionally counter-intuitive substances like marijuana (35 %) and alcohol (30 %) were also reported to enhance poker performance. Non-users of CPEMs were dissuaded from use due to not knowing where to get them (29 %), apprehension about trying them (26 %), and legal or ethical concerns (16 %). Respondents most frequently acquired CPEMs via friends/fellow poker players (52 %), or prescription from physician (38 %). Additionally, greater use of CPEMs was associated with living outside the United States (p = 0.042), prior use of prescription medications for improving non-poker related performance (p < 0.001), and amateur and semi-professional player status (p = 0.035). Unmonitored use of pharmacologically active agents and their methods of acquisition highlight safety concerns in this cohort of poker players, especially among non-professional players. The current state of guidance from national organizations on CPEM use in healthy individuals could impact prescribing patterns.


Identifying and evaluating apps for clinical practice

IJCPCoverArticleRecently I was invited to participate on an article by some of the fine folks at iMedicalApps. While I had done some things with them in the past dating back to a guest post in 2011, including providing early coverage of Medicine 2.0 @ Stanford, I had never collaborated with them on a conventional journal article. In this case, the effort was led by fellow pharmacist Timothy Aungst, PharmD as part of his efforts to bring a stronger eye of assessment to the unsettled world of medical apps. This particular effort yielded the article, “How to identify, assess and utilise mobile medical applications in clinical practice”, which was published in the International Journal of Clinical Practice. The aim of the article is basically outlined in the title. This was to be a practical paper for a clinician audience highlighting key aspects of the steps for: 1) identifying, 2) assessing, and 3) using medical apps. I believe a good paper came out of this collaboration and it certainly sparked the most creatively titled editorial comment (Battle for the Planet of the Apps).

Source: Aungst TD, Clauson KA, Misra S, Lewis TL, Husain I. How to identify, assess and utilise mobile medical applications in clinical practice. Int J Clin Pract. 2014;68(2):155-62. doi: 10.1111/ijcp.12375.


World Health Organization eHealth Report

The World Health Organization (WHO) Global Observatory for eHealth (GOe) released the fourth volume of its eHealth series, “Safety and security on the Internet: Challenges and advances in Member States“. It was a true learning experience to serve as a lead author for this volume, which explored survey results from over 100 participating countries. Data in the publication were originally collected as part of the second global survey on eHealth by WHO. This fourth volume of the GOe eHealth series is focused on the public health implications of issues regarding:

*Online health information seeking and quality
*Digital literacy
*Internet pharmacies
*Internet safety and security

Among the findings of the report was that the most common approach by Member States to assure online health information quality remained “voluntary compliance”.










Also notable was that less than half (47%) of responding countries have government sponsored sites or initiatives to educate citizens about internet safety and literacy. Demonstrating that the process of legally purchasing medications online lacks a global consensus, most (66%) countries still do not have any legislation in place that specifies if Internet pharmacy operations are either allowed or prohibited.

The 86-page report fully characterizes the findings from these outlined domains. It also includes case studies that illustrate the advances and challenges in these arenas such as the Health On the Net Foundation (Switzerland) for online health information quality and the Verified Internet Pharmacy Practice Sites (USA & Canada) for Internet pharmacies. A free, full-text PDF of the WHO report can be accessed here.