No abstract

No abstract

Nonprofit efforts to develop ±3,4‐methylenedioxymethamphetamine (MDMA)—better known as the street drug Ecstasy—as a prescription pharmaceutical provide the opportunity to examine recent theorizations of pharmaceuticals as fluid objects transformed in new informational and material environments. Drawing from ethnographic research, this article interrogates MDMA researchers’ own distinction between MDMA and the street drug Ecstasy. While researchers maintain that pure MDMA is distinct from Ecstasy, this article argues that the difference between the two hangs not on a distinction in substance, but on a distinction in safety that must be produced through the trial. This article tracks the production of safety through the inter‐connected work of clinical documents, which manage both which bodies are allowed to absorb the drug and which bodily events count as effects. MDMA's safety emerges from the careful management of relations through these documentary practices.

Social equity provisions in cannabis legislation are premised on the hope that the profit generated around adult-use cannabis can be leveraged to ameliorate the damage done by racially biased enforcement of prohibition in black and brown communities. As such, they encapsulate an attempt to reconcile the history of racism in the enforcement of cannabis law through its new future as a profit generating commodity. These programs are gaining traction, but with minimal empirical examination. The development and implementation of these programs raises a number of questions in need of study that we outline in this paper. We argue that Creary’s concept of bounded justice—which critiques the inherent limitations of social justice projects that ignore structural forms of social exclusion—can provide a framework for critical understanding of the limitations of such programs, ethnographically grounded empirical research, and a framework for evaluating the justice impacts of legislation. Specifically, we argue that in order to interrogate the possibilities for social justice projects around cannabis, we must address equity at a deeper level by working with communities to investigate hyper-localized and historical factors that have influenced systems and structures.

OBJECTIVES/GOALS: Pharmacogenomic testing for major depressive disorder is an expanding area of precision medicine with multiple direct-to-provider tests available. While clinical evidence supporting testing is expanding, there has been little research on the views and experiences of patients and clinicians utilizing this novel intervention. METHODS/STUDY POPULATION: This ongoing study is conducting semi-structured interviews with clinicians and patients exploring their views of the benefits and limitations of pharmacogenomic testing. Qualitative interviews have been conducted with 10 patients and 10 clinicians who have experience with ordering or receiving results within the past 12 months. Interviews are being thematically coded following a modified grounded theory approach using the Dedoose software. Following the principles of exploratory sequential mixed methods design, findings will be used to develop a survey to be administered to prescribing clinicians in both primary care and psychiatry. The survey will examine clinician's knowledge, interest, and concerns about utilizing testing. RESULTS/ANTICIPATED RESULTS: Preliminary analysis of qualitative interviews indicates that both patients and clinicians find that the broader testing process has benefits beyond the test results themselves. Benefits identified by patients include an increased trust in the process of selecting medications, validation of their negative experiences with medications, and improved communication with their provider. Limitations identified by patients include difficulty in accessing test results, and gatekeeping for testing by providers. Benefits identified by clinicians include increased empathy with patients, medication adherence, and improved communication with patients about medication. Limitations identified by clinicians include difficulty with ordering and interpreting test results. DISCUSSION/SIGNIFICANCE: Medication selection is a difficult process for both patients and clinicians. Improvements to clinician-patient communication and medication adherence are important benefits to consider in the adoption of testing. Future research should include these dimensions in assessment of the benefits and limitations of testing.