Whether it’s a festival, concert or celebratory party, music unites people and pervades every aspect of our lives irrespective of geography or culture [1,2]. May 20th is the date we celebrate Clinical Trials Day, which raises the question, what theme music would you choose to mark the day? How has the music industry celebrated our success?
Historically, the intersection between clinical pharmacology and music has been the subject of debate and controversy. Drug themes appear in nearly every music genre, with songwriters exploring both their ups and downs [3,4]. Many great songs delve into the emotional trauma, stigma and discrimination associated with drug abuse.
Psychostimulants are a broad class of drugs that include amphetamine, methylphenidate and cocaine. They all produce similar mood-altering effects, which have been widely explored and depicted in the music industry. Clinical trials (and life experience) have shown these drugs to have a high potential for abuse and dependence. Any route of administration can lead to absorption of toxic amounts of cocaine, leading to acute cardiovascular or cerebrovascular emergencies that could result in sudden death.
The informal/social use of psychostimulants have left an indelible stamp on music itself. Songs that immediately come to mind (to me) are “Cocaine” by Eric Clapton (originally by J.J Cale), “Snowblind” by Styx and “Life in the fast lane” by The Eagles. However, (perhaps) the two biggest ‘bangers’ that repeatedly feature in Top 100 charts are “Hotel California” by The Eagles and “Gold Dust Woman” by Fleetwood Mac. With “Hotel California,” the Eagles sought to capture the excesses and self-destructive behaviour that have become a rock and roll cliché. Music critics view the song as a first-person allegory about hedonism and self-destruction played out in the setting of a 1960s mental institution. In contrast, Fleetwood Mac’s “Gold Dust Woman” sees the group’s singer/songwriter celebrating the suit of armour that she felt the drug provided her. That belief would end up almost costing her life.
Psychedelics, a term coined by Humphrey Osmond in 1957, are a subclass of hallucinogenic drugs whose primary effect is to trigger non-ordinary mental states ("trips") and/or an apparent expansion of consciousness. They are generally considered physiologically safe and not associated with dependence or addiction. Their origin predates written history, having been employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today, there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors.
As a class of drugs, psychedelics have generally been frowned upon by the scientific community as offering useful medical properties. Indeed, the United States (US) federal funding agencies (e.g., two of the National Institutes of Health – National Institute on Drug Abuse and the National Institute of Mental Health) make no consideration for research into the potentially useful properties of psychedelics. However, the idea pre-historic shamans had that psychedelics may have useful properties is not at all farfetched. Recent clinical studies have reinforced the belief. In recent years, one of the most striking developments in this field has been initiating and successfully completing a variety of clinical studies of psychedelics over the past 10–15 years into specific medical indications – where the results have generally been positive.
The relative dearth of research on psychedelics in the past half-century did not result from a lack of scientific interest but rather occurred as a consequence of political forces that manifested principally in the US in the 1960s and 1970s [5]. The use of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD) and marijuana by so-called hippies who demonstrated against the Vietnam War during the 1960s created great consternation among US authorities and legislative bodies, both at the federal and state levels. Psychedelics (N,N‑dimethyltryptamine [DMT], 5-MeO-DMT, DMT, LSD, mescaline, psilocybin mushrooms, etc.) are beginning to be rehabilitated into experimental psychology, looking at their potential for treatment. Psychedelics are slowly reappearing in clinical development programmes targeted at indications like anxiety, depression, post-traumatic stress disorder and more. Here at Niche Science & Technology Ltd., we are involved with a number of novel compounds being investigated.
Psychedelic music covers a wide range of popular music styles and genres influenced by 1960s psychedelia, a subculture of psychedelic drug users looking to experience synesthesia and altered states of consciousness. The aim of psychedelic music is to enhance the experience.
Some of the best psychedelia-inspired songs of all time include: “Eight Miles High” by The Byrds, “Venus in Furs” by The Velvet Underground, “I Can See for Miles” by The Who, “A Whiter Shade of Pale” by Procol Harum, and “Light My Fire” by The Doors. Few bands in the history of music have ever been as popular as The Beatles, and as many people know, they became intimately acquainted with drugs in the late 1960s. “Lucy in the Sky with Diamonds,” a thinly veiled reference to an LSD trip and appeared on Sgt. Pepper’s Lonely Hearts Club Band in 1967 when the band was at the peak of their psychedelic rock phase. John Lennon famously claimed it was innocently inspired by a picture drawn by his young son, but most people don’t believe that story. The Beatles also produced hit songs like “Day Tripper” and “Strawberry Fields Forever.”.
The timeless rock band Jefferson Airplane was one of the pioneering acts in the psychedelic rock genre. Lead singer Grace Slick personally wrote their biggest hit “White Rabbit,” which was realeased in 1967 during the height of the hippie culture. The song both narrates and sets the stage for an LSD hallucination styled after Lewis Carroll’s Alice in Wonderland. The song has become legendary for its crescendo where Slick repeatedly declares “Feed your head!”
Anyone who has worked in clinical development is well aware of the high rate of attrition seen with candidate molecules. Therefore, no playlist would be complete without “The Drugs Don’t Work” by The Verve. Richard Ashcroft, the lead singer of The Verve, wrote the song in early 1995 and, in an interview at the time, related it to his experience with drug use. On a similar theme, when considering reasons why new medicines fail during clinical trials one is reminded of the tracks “Toxic” by Brittany Spears, “Bad Medicine” by Bon Jovi and “Everybody Hurts’” by R.E.M. Any clinical pharmacologist would tell you that all drugs are poisons and that success often lies in finding the right ‘dose’. Excipients can play a key role in drug disposition once in the body, an observation famously celebrated by Julie Andrews in the song “A Spoonful of Sugar.”
If the recent COVID-19 pandemic has taught us anything, it is that disease is still out there and remains a miserable part of the human condition. No one (to my knowledge) has successfully rendered COVID-19 into a chart-topper, but there are still some notable references to disease in our playlist. "Streets of Philadelphia" is a powerful song performed by American rock musician Bruce Springsteen. The song was written for the 1993 film Philadelphia, starring Tom Hanks – an early mainstream film dealing with HIV/AIDS. Released as a single in 1994, the song was a hit in many countries across the globe and is regarded as one of Springsteen’s best songs (despite tough competition). On a lighter note, there’s "Industrial Disease," another great disease-related song. Written by British rock band Dire Straits and composed by Mark Knopfler, the song appeared on the band's 1982 album Love Over Gold. The lyrics ostensibly addressed the decline of the British manufacturing industry in the early 1980s, describing strikes, clinical and economic depression, and societal dysfunction (not greatly different to what the current UK government has ‘achieved’ in the 2020s). However, the song is an extended metaphor, highlighting the dehumanising routine and repetition of the nine-to-five as the real culprit of society's malaise. About halfway through the song, the narrator goes to the doctor, only to be told his own illness is diagnosed as industrial disease – a reference to ‘brewer's droop’.
For your enjoyment and in celebration of all the efforts of those working on the discovery of new therapies and recognition of the selfless contributions of those taking part in clinical studies, we have compiled the songs mentioned here into a playlist on Spotify that runs about 95 minutes(it’s also downloadable). We’d love to hear your thoughts on our choices and on any tunes we may have missed.
HAPPY CLINICAL TRIALS DAY!
References
- Mehr, A., Singh, M., Knox, D., Ketter, D. M., Pickens-Jones, D., Atwood, S., et al. (2019). Universality and diversity in human song. Science 366:eaax0868. doi: 10.1126/science.aax0868
- Blacking, J. (1976). How Musical Is Man? London: Faber & Faber.
- Grinspoon, L., and Bakalar, J.B. (1979) Psychedelic Drugs Reconsidered, Basic Books, New York.
- Hanba C, Hanba D. Opioid and Drug Prevalence in Top 40’s Music: A 30 Year Review. J Am Board Fam Med. 2018 Sep-Oct;31(5):761-767. Doi: 10.3122/jabfm.2018.05.180001. PMID: 30201672.
- Christenson P, Roberts DF, Bjork N. Booze, drugs, and pop music: trends in substance portrayals in the billboard top 100-1968-2008. Subst Use Misuse. 2012 Jan;47(2):121-9. doi: 10.3109/10826084.2012.637433. PMID: 22217066.
