Curb Your Enthusiasm—Unless You Want to Be Charged With a Felony

On Saturday The New York Times ran a surprisingly sympathetic front-page story about Maryland psychiatrist Peter Gleason, who was arrested in March for talking too much about Xyrem, the prescription version of the depressant gamma hydroxybutyrate (GHB), which used to be sold over the counter as a nutritional supplement but was banned for most uses in 2000 after being demonized as a "date rape drug." Although the FDA has approved Xyrem only for treating narcolepsy, Gleason says he has found it is also useful as a pain reliever and antidepressant. Under federal law, doctors may prescribe drugs for purposes other than those specifically approved by the FDA, and they are free to discuss the evidence supporting such off-label uses with their colleagues. Drug companies, by contrast, are forbidden to promote off-label uses for their products. Gleason's crime, according to federal prosecutors, was conspiring with the Xyrem's manufacturer to evade that prohibition by giving lectures about the drug for which the company paid him. But doctors routinely give such lectures, which have not heretofore been deemed a felony. Although the Times implies that Gleason's enthusiasm for GHB leads him to underplay its hazards (which were shamelessly hyped by the drug warriors who pushed its prohibition), it correctly notes that prosecutions like this one raise serious First Amendment problems and are apt to have a chilling effect on scientific debate.